Cognitive functions over the course of 1 year in multiple sclerosis patients treated with disease modifying therapies
Utz KS, Lee DH, Laemmer A, Waschbisch A, Linker R, Schenk T (2016)
Publication Type: Journal article
Publication year: 2016
Journal
Book Volume: 9
Pages Range: 269-80
Journal Issue: 4
Abstract
Disease-modifying therapies (DMTs) are applied to delay or prevent disease progression in multiple sclerosis (MS). While this has mostly been proven for physical symptoms, available studies regarding long-term effects of DMTs on cognitive functions are rare and sometimes inconsistent due to methodological shortcomings. Particularly in the case of fingolimod, comprehensive data on cognitive functions are not yet available. Therefore, we set out to reliably assess cognitive functions in patients with relapsing-remitting MS (RRMS) treated with DMTs over 1 year.Cognitive functions were assessed with eight tests at three timepoints: baseline, 6-month follow up and 12-month follow up. First, we investigated whether the stability of cognitive functions (i.e. not falling below the 5% cut-off in more than one test) over 1 year in RRMS patients (n = 41) corresponds to the stability in healthy individuals (n = 40) of a previous study. Second, we compared the percentage of declined and improved patients in the different tests. Third, we compared patients treated with fingolimod (n = 22) with patients treated with natalizumab (n = 11) with regard to cognitive stability. Fourth, based on the patient data, the Reliable Change Index was applied to compute cut-offs for reliable cognitive change.Approximately 75% of RRMS patients treated with DMTs remained stable over the course of 1 year. The Paced Auditory Serial Addition Test (PASAT) and the Spatial Recall Test (SPART), produced improvements in 12.5% and 30.6%, respectively, probably due to practice effects. Patients treated with fingolimod did not differ from patients treated with natalizumab with regard to cognitive stability.Cognitive functions remain relatively stable under DMT treatment over 1 year, irrespective of the type of medication. Furthermore, the tests PASAT and SPART should be interpreted cautiously in studies examining performance changes over time. The provided RCI norms may help clinicians to determine whether a difference in two measurements observed in a RRMS patient is reliable.
Authors with CRIS profile
De-Hyung Lee
Medizinische Fakultät
Anne Waschbisch
Department of Neurology
Ralf Linker
Department of Neurology
Involved external institutions
Germany (DE)How to cite
APA:
Utz, K.S., Lee, D.-H., Laemmer, A., Waschbisch, A., Linker, R., & Schenk, T. (2016). Cognitive functions over the course of 1 year in multiple sclerosis patients treated with disease modifying therapies. Therapeutic Advances in Neurological Disorders, 9(4), 269-80. https://doi.org/10.1177/1756285616643892
MLA:
Utz, Kathrin S., et al. "Cognitive functions over the course of 1 year in multiple sclerosis patients treated with disease modifying therapies." Therapeutic Advances in Neurological Disorders 9.4 (2016): 269-80.
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