Understanding Multiple Sclerosis and Brain Fog

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Multiple sclerosis (MS), an autoimmune disease (where the immune system attacks spine and brain nerve cells), is commonly linked to brain fog.

Brain fog (which is not a medical condition on its own; it's a symptom of other issues) refers to a feeling of mental sluggishness or haziness. Those experiencing it may lack the ability to concentrate or experience clarity of thought.

Brain Fog and Multiple Sclerosis

According to the National Multiple Sclerosis Society, over 50% of people living with MS struggle with cognition-related issues. Individuals may refer to this as brain fog or “cog fog,” and it can present challenges in day-to-day living. 

Brain fog in individuals living with MS can show up in many ways, most commonly as forgetfulness and confusion. 

Brittany Quiroz, an MS advocate, speaker, writer, and content creator who has lived with relapsing-remitting Multiple Sclerosis since 2019 and often experiences forgetfulness.

She says brain fog can be frustrating, especially because there’s no pattern or consistency to it. “I’ll be in the middle of a conversation and forget words,” she says. “Like a game of Mad Libs, I have to find a lesser-than term to fill the blank of what I’m trying to express.” 

Quiroz’s brain fog also causes her sometimes to forget how to do certain tasks or misplace household items. 

Why Brain Fog Occurs With Multiple Sclerosis

Dr. Mary Ann Picone, Medical Director of the MS Center at Holy Name Medical Center, states that brain fog occurs due to the disruption of normal nerve signaling that occurs in MS.

Brain Function Disrupts Nerve Signaling

“These cognitive problems are a result of demyelinating lesions and disturbances caused by loss of myelin in the connective pathways between the frontal lobes and deeper midbrain structures,” she says. 

Brain Fog Leads to Fatigue

Another reason why brain fog is common in MS is the fatigue individuals living with MS experience. Dr. Mahmud Kara, a former physician at the Cleveland Clinic, says this can make it difficult for individuals to summon the energy to focus on or finish particular tasks. It can also cause additional cognitive symptoms like forgetfulness or lack of interest.

Other Factors

Finally, brain fog can happen in individuals living with MS due to various co-occurring factors. According to Dr. Paige Sutton, a neurologist at OhioHealth, sleep challenges, mental health problems like depression or anxiety, and medication side effects may also lead to brain fog.

It’s important to speak to your physician about these issues if they arise. 

How to Cope With Brain Fog Related to Multiple Sclerosis

Living with MS-related brain fog can be challenging. But, according to Dr. Picone, recognizing the problem is the first step in overcoming brain fog.

“Having a neuropsychological evaluation to pinpoint areas of difficulty can be very helpful,” she says. “The next step is working on cognitive therapy.”

Below are several ways individuals living with MS can cope with brain fog.

Eat Brain-Healthy Foods

Choosing foods that are high in omega-3 have been shown to be particularly helpful in maintaining healthy brain function,” says Dr. Kara. These include fish, flax and chia seeds, and walnuts.

Antioxidants are just as crucial in fighting against disease and inflammation that may worsen brain fog. Foods like berries, citrus fruits, leafy greens, black beans, ginger, and green tea can be helpful in this regard.  


A little bit of movement can go a long way. Studies have even shown that those living with MS-related cognitive impairment who completed eight weeks of aerobic and strength-based exercise experienced improvements in long-term memory, cognitive fatigue, and mental quality of life. 

Engage in Mental Activities

MS-related fatigue and brain fog can make it harder to muster the energy to focus on cognitive tasks. However, Dr. Kara says that certain mental activities can help strengthen brain structures.  

Spending a few minutes a day playing card games, learning a new language, or completing crossword puzzles can improve cognitive function in the long term.

Cognitive Rehabilitation

Along with these steps, Dr. Picone also recommends cognitive rehabilitation to many of her MS patients with brain fog.

“Cognitive rehab is a great non-pharmacologic intervention for reversing or halting the progression of cognitive impairment,” she says. 

In cognitive rehab, people with MS learn specific activities that help compensate for impairments. These activities build connections between neurons to make it easier to carry out particular tasks. “The mind requires exercise to get stronger just like our muscles do,” Dr. Picone says.  

Practice Acceptance

Quiroz emphasizes the importance of embracing her brain fog for what it is.

Brittany Quiroz, MS advocate

Rather than seeing my brain fog as a source of shame, I’ve learned to give myself grace and see it as something I deal with.

— Brittany Quiroz, MS advocate

Quiroz has found it helpful to communicate with friends, family, and colleagues about her limitations. Being more open about her brain fog has allowed her to develop more resilience and practice self-compassion.

A Word From Verywell

Brain fog is common in individuals living with multiple sclerosis. Though this can be a debilitating symptom, there are ways to improve cognition and cope. If you find that your brain fog is negatively interfering with certain areas of your life, it’s important to speak to your physician. They can determine which course of action is appropriate, whether that’s lifestyle changes, medication tweaks, or help from a mental health professional.

2 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Multiple Sclerosis Society. Cognitive Changes.

  2. Ozkul C, Guclu-Gunduz A, Eldemir K, Apaydin Y, Yazici G, Irkec C. Combined exercise training improves cognitive functions in multiple sclerosis patients with cognitive impairment: A single-blinded randomized controlled trial. Mult Scler Relat Disord. 2020 Oct;45:102419. doi: 10.1016/j.msard.2020.102419.

By Brina Patel
Brina Patel is a freelance writer from Sacramento, California. Prior to writing full-time, she worked as an applied behavior analysis therapist for children on the autism spectrum. She leverages her own experiences researching emotions, as well as her personal challenges with chronic illness and anxiety, in her storytelling, with the hope of inspiring others to take better charge of their overall wellness and understand themselves on a deeper level.