Abstract
Previous studies reported that Multiple Sclerosis (MS) patients treated with natalizumab for one or two years exhibit a significant reduction in relapse rate and in cognitive impairment, but the long term effects on cognitive performance are unknown. This study aimed to evaluate the effects of natalizumab on cognitive impairment in a cohort of 24 consecutive patients with relapsing remitting MS treated for 3 years. The neuropsychological tests, as well as relapse number and EDSS, were assessed at baseline and yearly for three years. The impact on cortical atrophy was also considered in a subgroup of them, and are thus to be considered as preliminary. Results showed a significant reduction in the number of impaired neuropsychological tests after three years, a significant decrease in annualized relapse rate at each time points compared to baseline and a stable EDSS. In the neuropsychological assessment, a significant improvement in memory, attention and executive function test scores was detected. Preliminary MRI data show that, while GM volume did not change at 3 years, a significantly greater parahippocampal and prefrontal gray matter density was noticed, the former correlating with neuropsychological improvement in a memory test. This study showed that therapy with Natalizumab is helpful in improving cognitive performance, and is likely to have a protective role on grey matter, over a three years follow-up.
Highlights
In recent years, several new drugs have been approved for the treatment of relapsing remitting multiple sclerosis (RRMS) [1]
Natalizumab treatment considerably targets grey matter and these findings may likely represent the anatomical background for its impact on cognitive functions, which are strongly associated with cortical pathology [11,12,13,14,15]
This study shows that natalizumab is effective in reducing cognitive impairment in Multiple Sclerosis (MS) patients treated for three years: both the number of pathological tests and the single test performances in attention (PASAT), executive functions (WCST) and memory functions
Summary
Several new drugs have been approved for the treatment of relapsing remitting multiple sclerosis (RRMS) [1]. The natalizumab (Tysabri, Biogen, Cambridge, MA) has been shown to have a large effect in reducing disease activity. Studies from our and other groups reported that patients under treatment with natalizumab for a period of time between 6 months and 2 years exhibit a significant reduction in the decay and, interestingly, even an improvement in cognitive functions, in information. Neuropsychological Improvement in MS after 3 Years of Natalizumab processing, executive functions and memory domains [2,3,4,5,6,7,8,9]. Recent studies showed that, after one year of administration, treatment with natalizumab was able to inhibit the accumulation of cortical lesions and the progression of cortical atrophy with a significantly higher effect compared to other immunomodulatory therapies [9,10]. Natalizumab treatment considerably targets grey matter and these findings may likely represent the anatomical background for its impact on cognitive functions, which are strongly associated with cortical pathology [11,12,13,14,15]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
