Inclusion Criteria:  All types and representations of MS patients were included in this study. - The age of the patients ranged from 20-45 years. - All the patients subjected to a standard neurological examination before participating in the study( sensory, motor, coordination , balance, gait and fundus examination). All the patients were free from any other neurological problems. Multiple sclerosis patients were subdivided into two equal groups, (Conventional physical therapy program group)(G1) & Computer-based Cognitive training program (G2). All patients in both groups complained from fatigue for more than two months with total score of FSS ≥ 36. All patients in both groups complained from varying degrees of cognitive decline persisted for more than 3 months. All the patients were ambulatory with mild to moderate disability according to the expanded disability status scale (EDSS) ≤ 5(Ambulatory without aid or rest for 200 meters). Main complain for all patients is sense of fatigue with varying degrees of cognitive decline. All the patients were medically stable with absent or mild hemiparetic, ataxic, motor or sensory manifestations. All patients were educated .  Exclusion Criteria:  Severe visual, verbal or acoustic impairments that may interfere with cognition testing, Serious chronic illness that could interfere with or modify assessment. Low leukocyte count & elevated ESR as this interfere with cytokine levels. Secondary causes of fatigue including severe depression ( beck depression inventory (BDI ≥ 21) and sleep disturbance ( Epworth sleepiness scale (ESS ≥ 12) Inability to complete questionnaires study outcome measure as in severe cognitive impairment and illiteracy.