This goes in line with the findings of other studies investigating the relationship between CSF CHI3L1 levels and cognitive impairment in MS patients as in the study of Semra and colleagues in 2003, which concluded that the presence of high levels of CHI3L1 in the CSF and serum of MS patients correlated with more severe disease and a greater number of relapses [16]. This evidence concerns the gene CHI3L1 and Cognitive impairment.