# Exploring Social Cognition Sub‐Domains and Predictors in Multiple Sclerosis: A Cross‐Sectional Study

## TL;DR

This study explores how multiple sclerosis affects social cognition, finding that lower cognition and depression are key predictors of social cognition impairments.

## Contribution

The study identifies distinct social cognition sub-domains and their predictors in MS patients, highlighting the independence of these impairments from disease duration and gender.

## Key findings

- Progressive MS patients showed significantly lower social cognition performance across all sub-domains compared to healthy controls.
- Lower global cognition (MoCA scores), higher depression (BDI scores), and lower educational attainment were significant predictors of impaired social cognition.
- SC deficits were observed even in cognitively preserved individuals, indicating SC impairments are relatively independent of general cognitive decline.

## Abstract

Social cognition (SC) is increasingly recognized as a key cognitive domain affected in multiple sclerosis (MS), yet its sub‐domains and clinical correlates remain underexplored. This study aimed to assess different SC sub‐domains and identify their cognitive, emotional, and demographic predictors in people with MS (pwMS).

This cross‐sectional study included 93 pwMS and 34 HCs. Assessments included the Reading the Mind in the Eyes Test (RMET) for emotion recognition, the Trail Making Test (TMT) for executive function, the Tromso Social Intelligence Scale (TSIS) for nonverbal understanding, the Implied Meaning Test (IMT) for implicit understanding, the Social‐Emotional Competence Scale for adaptability, the Barratt Impulsiveness Scale for impulsivity, the Stroop Test for inhibition, the Beck Depression Inventory (BDI) for depression, the Montreal Cognitive Assessment (MoCA) for cognition, and the Short Form‐12 (SF‐12) for quality of life (QoL). Multiple regression analyses were conducted to identify independent predictors of SC performance.

PwMS, particularly those with progressive MS, exhibited significantly lower SC performance across all sub‐domains compared to HCs. Regression analyses revealed that lower MoCA scores, higher BDI scores, and lower educational attainment were significant predictors of impaired SC, while disease duration and gender were not. Notably, SC deficits were also observed in cognitively preserved individuals, suggesting the relative independence of SC impairments.

SC impairment is a distinct and clinically relevant feature of MS, associated with both cognitive and emotional factors. Routine SC screening may enhance patient care by informing personalized interventions. Future research should include larger cohorts, longitudinal designs, and practical SC assessment tools for clinical use.

This graphical abstract illustrates the associations between social cognition sub‐domains (emotion recognition, social intelligence, adaptability, and implicit understanding) and their cognitive, emotional, and demorgraphic predictors in people with multiple sclerosis. Progressive MS patients showed the most pronounced impairments. Lower global cognition, higher depression scores, and lower educational attainment were significant predictors of poor social cognition.