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Trouble With Social Cues: Social Cognitive Deficits With MS

Recently, I was talking to another person with multiple sclerosis, and she mentioned that she believed she was having trouble understanding when people were joking. She then asked me if I thought it could be related to MS. It’s a pretty interesting question. Can MS affect our ability to pick up on social cues? Can it impact the way we recognize and interpret various signals like tone of voice or facial expressions?

Avoiding the risk of blaming MS for unrelated issues

Given the wide range of cognitive issues that people with MS can experience, it certainly seemed possible. I do, however, think we should always be aware of the risk of blaming everything on MS. With that in mind, I decided to dig a little deeper to see if MS has been known to affect one’s ability to pick up on social cues.

Cognitive dysfunction

When it comes to cognitive issues, such as difficulty with brain fog, memory loss, attention, concentration, planning, understanding, and thinking, I most certainly have some experience. It’s an area of MS symptoms that has had a huge impact on my life. Some of these symptoms, along with others, factored into me leaving my career and pushed me onto disability. I continue to suffer from these issues (though I have moments of clarity, too).

How my cognitive issues have impacted me

Living with compromised thinking has affected numerous parts of my life, from simple tasks, like my ability to read to more complicated ones, like being able to drive. When it comes to social moments, it has definitely affected me there as well. I often have issues with following along during conversations. It can occasionally be difficult for me to comprehend what people are saying too. I also jumble words in my head and forget, more than the average person, what I wanted to say.

Social cognitive deficits

What about picking up on social cues? I’m not sure I’ve ever had an issue with that, but I suppose there’s a chance I wouldn’t recognize it even if I did. After doing some research, it looks like this is indeed an issue for people with MS (chalk this up to yet another thing the doctors never told me about my lovely disease). Those with MS can suffer from social cognitive deficits, problems in their cognition that affect their social abilities. In fact, one study determined that these social cognitive deficits can occur even in the early stages of MS and that “deficits in recognizing negative emotions seem to be more pronounced than those of positive ones among MS patients”.1 Several studies have also concluded that MS patients can experience difficulty in facial emotion recognition, meaning we can have problems when it comes to detecting emotions from facial expressions.2,3 This is way bigger than just missing out on a joke, it means we can miss out on the seriousness of a conversation as well.


I was already well aware of the effects that MS has had on my ability to socialize. I even understood that some of my cognitive issues directly impacted it as well. I admit though, I had no idea about these other specific issues that could arise with regard to picking up on the emotions and expressions of others. I’m not sure if I’ve ever suffered from it (though my long list of failed relationships might be a clue). It’s an interesting topic for sure and one that I don’t often hear mentioned much when it comes to cognition problems. It’s a reminder of how important the brain and nervous system are, and with MS directly affecting those areas, a large number of symptoms are possible.

Have you noticed any problems picking up on social cues or the emotions of others?  Tell us in the comments!

Thanks so much for reading and always feel free to share!


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