Treatment of cognitive impairment in patients with multiple sclerosis

Abstract

Introduction: Identifying and treating cognitive impairment in patients with multiple sclerosis (MS) is increasingly recognized as a crucial step in selecting the most appropriate treatment for the individual. Currently, the neuropsychological tests used to assess patients are time-consuming and require specialist training to administer; consequently, cognitive impairment in MS is underdiagnosed. Many treatments are available for MS, including disease-modifying drugs (DMDs) and symptomatic therapies, but what are their effects on cognitive performance?

Areas covered: This article will review published studies describing the cognitive effects of DMDs and symptomatic treatments for MS.

Expert opinion: Some DMDs may improve cognitive performance in patients with MS. None of the symptomatic drug treatments reviewed showed positive effects on cognitive performance, with the possible exception of L-amphetamine, which may improve memory in patients with existing deficits, and methylphenidate, on which more data are needed. Cognitive rehabilitation can improve cognitive performance, but experience with these techniques is limited. Treatment for patients with MS and cognitive impairment should, therefore, include a DMD in combination with a pharmacological or perhaps non-pharmacological cognitive-enhancement strategy. However, the methods used to diagnose cognitive impairment, and to assess the effect of treatment on function over time and need to be refined.

Keywords::

• cognitive impairment
• cognitive rehabilitation
• disease-modifying drugs
• multiple sclerosis
• symptomatic therapies
• treatment

Acknowledgments

The author thanks V Porkess, PhD, and A Plant, PhD, of Caudex Medical, Oxford, UK, for editorial assistance in the preparation of this manuscript. The manuscript has been reviewed by M Serono for the limited purpose of providing complete and balanced medical/scientific information and to ensure that the publication is objective and scientifically/medically accurate. The views and opinions described herein do not necessarily reflect those of M Serono.

Notes

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