Cognitive function did not improve after initiation of natalizumab treatment in relapsing-remitting multiple sclerosis. A prospective one-year dual control group study
| Autor: | Fredrik Piehl, Mathias Sundgren, Tom Brismar, Åke Wahlin |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Neuropsychological Tests 050105 experimental psychology 03 medical and health sciences Disability Evaluation 0302 clinical medicine Natalizumab Cognition Multiple Sclerosis Relapsing-Remitting Internal medicine medicine Humans Immunologic Factors 0501 psychology and cognitive sciences Cognitive skill Effects of sleep deprivation on cognitive performance Prospective Studies Prospective cohort study Depression (differential diagnoses) business.industry Multiple sclerosis 05 social sciences General Medicine Interferon-beta medicine.disease Cognitive test Treatment Outcome Neurology Physical therapy Regression Analysis Female Neurology (clinical) Self Report business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Multiple sclerosis and related disorders. 10 |
| ISSN: | 2211-0356 |
| Popis: | Cognitive impairment in multiple sclerosis (MS) is common and has severe implications. Natalizumab (NZ) has documented effects on relapse rate and radiological disease activity in relapsing-remitting MS (RRMS) but studies regarding its specific effects on cognitive functioning are few. Previous studies have reported improvement, however, often lacking relevant control groups. The objective of the present study was to evaluate the cognitive effects of NZ treatment, compared to patients on stable first-line treatment and healthy control subjects.MS patients starting NZ (MS-NZ), MS controls with stable interferon beta therapy (MS-C) and healthy control subjects (HC) were evaluated twice with one year interval, using a cognitive test battery covering six cognitive domains. The effects of NZ on levels of self-reported depression, fatigue, daytime sleepiness and perceived health were also examined.MS patients (MS-NZ and MS-C) had significantly lower baseline cognitive performance compared to HC (global score, p=0.002), but there were no significant differences between MS-NZ and MS-C. At follow-up, both MS-NZ and MS-C had improved significantly in four and five cognitive domains, respectively, and in global score (p=0.013 and p0.001, respectively). HC improved significantly in three cognitive domains but not in global score. A regression analysis including baseline cognitive z-score and z-score change showed that participants with lower baseline scores had a significantly greater improvement, compared to those with better initial performance (p=0.021). There were no significant changes in depression, fatigue, daytime sleepiness or perceived health in MS-NZ or MS-C.Initiation of NZ therapy did not result in true cognitive improvement over one year. Presumably, the increased test performance in both MS groups was artificial and due to retest effects that were stronger in patients with lower baseline performance. Adequate control groups are essential when evaluating cognitive functioning in intervention trials among RRMS patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect