scholarly journals Improved cognitive outcomes in patients with relapsing–remitting multiple sclerosis treated with daclizumab beta: Results from the DECIDE study

2017 ◽  
Vol 24 (6) ◽  
pp. 795-804 ◽  
Author(s):  
Ralph HB Benedict ◽  
Stanley Cohan ◽  
Sharon G Lynch ◽  
Katherine Riester ◽  
Ping Wang ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Processing ◽  
Processing Speed ◽  
Cognitive Outcomes ◽  
High Yield ◽  
Meaningful Improvement ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis ◽  
Cognitive Processing Speed

Background: Cognitive impairment is common in multiple sclerosis (MS), with cognitive processing speed being the most frequently affected domain. Objective: Examine the effects of daclizumab beta versus intramuscular (IM) interferon (IFN) beta-1a on cognitive processing speed as assessed by Symbol Digit Modalities Test (SDMT). Methods: In DECIDE, patients with relapsing–remitting multiple sclerosis (RRMS) (age: 18–55 years; Expanded Disability Status Scale (EDSS) score 0–5.0) were randomized to daclizumab beta ( n = 919) or IM IFN beta-1a ( n = 922) for 96–144 weeks. SDMT was administered at baseline and at 24-week intervals. Results: At week 96, significantly greater mean improvement from baseline in SDMT was observed with daclizumab beta versus IM IFN beta-1a ( p = 0.0274). Significantly more patients treated with daclizumab beta showed clinically meaningful improvement in SDMT (increase from baseline of ⩾3 points ( p = 0.0153) or ⩾4 points ( p = 0.0366)), and significantly fewer patients showed clinically meaningful worsening (decrease from baseline of ⩾3 points ( p = 0.0103)). Odds representing risk of worsening versus stability or improvement on SDMT were significantly smaller for daclizumab beta ( p = 0.0088 (3-point threshold); p = 0.0267 (4-point threshold)). In patients completing 144 weeks of treatment, the effects of daclizumab beta were generally sustained. Conclusion: These results provide evidence for a benefit of daclizumab beta versus IM IFN beta-1a on cognitive processing speed in RRMS. Trial registration: ClinicalTrials.gov identifier NCT01064401 (Efficacy and Safety of BIIB019 (Daclizumab High Yield Process) Versus Interferon β 1a in Participants With Relapsing-Remitting Multiple Sclerosis (DECIDE)): https://clinicaltrials.gov/ct2/show/NCT01064401 .

Cognitive trajectories in relapsing–remitting multiple sclerosis: A longitudinal 6-year study

2019 ◽  
Vol 26 (13) ◽  
pp. 1740-1751 ◽  
Author(s):  
Alfredo Damasceno ◽  
Luciana Ramalho Pimentel-Silva ◽  
Benito Pereira Damasceno ◽  
Fernando Cendes
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Decline ◽  
Processing Speed ◽  
Brain Mri ◽  
Cognitive Deterioration ◽  
Clinical Progression ◽  
Cognitive Domains ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis

Background: Information concerning longitudinal cognitive trajectories in multiple sclerosis (MS) is relatively scarce. Moreover, it is unclear which factors are associated with cognitive decline and what is the clinical impact of cognitive impairment (CI) in the long run. Objective: To investigate cognitive trajectories in relapsing–remitting multiple sclerosis (RRMS) patients, analyzing clinical and magnetic resonance imaging (MRI) predictors of cognitive decline. Methods: We enrolled 42 patients and 30 controls. They underwent brain MRI and clinical/neuropsychological evaluation at baseline and after 1, 2, and 6 years. We evaluated cognitive domains with principal component analysis and performed multivariable regression analyzing predictors of clinical/cognitive deterioration. We also performed repeated measures analysis to assess whether clinical progression was different according to CI at baseline. Results: A total of 23 (62.2%) patients deteriorated in combined cognitive domains after 6 years, most in processing speed and memory. The number of baseline impaired cognitive domains was strongly associated with 6-year cognitive ( R2 = 0.452; p < 0.001) and Expanded Disability Status Scale (EDSS) deterioration ( R2 = 0.263; p < 0.001). Patients with baseline CI in combined domains had worse clinical progression. Conclusion: Isolated CI tends to become more widespread, affecting memory and processing speed alongside. The extent of baseline CI was the best predictor of both clinical and cognitive deterioration after 6 years.

scholarly journals Two Year Progression of Working Memory Impairments In Early Relapsing-Remitting Multiple Sclerosis: Appraisal of Working Memory Profiles And Measurement Sensitivity

2021 ◽  
Author(s):  
Meaghan Clough ◽  
Jade Bartholomew ◽  
Owen White ◽  
Joanne Fielding
Keyword(s):  
Multiple Sclerosis ◽  
Working Memory ◽  
Cognitive Processing ◽  
Processing Speed ◽  
Digit Span ◽  
Central Executive ◽  
Phonological Loop ◽  
Visual Spatial ◽  
Relapsing Remitting ◽  
Cognitive Processing Speed

Abstract Working memory (WMem) impairments are a devastating symptom of Multiple Sclerosis (MS) that manifest as distinct profiles depending upon the type of impairment. It is unknown what WMem impairment profiles occur in early MS and how best to diagnose and measure their progression.88 participants (63 early relapsing-remitting MS, 25 healthy controls) were reviewed annually for two years (baseline, +1 year, +2 years) and completed five WMem tasks: oculomotor (OM) n-back-visual spatial sketchpad; digit-span forwards-phonological loop; California Verbal Learning Test (CVLT)-episodic buffer; digit-span backwards- central executive; symbol digit modalities test (SDMT)-cognitive processing speed. 65% of RRMS patients exhibited visual-spatial WMem impairments followed by 32% for episodic, 30% phonological loop, 24% central executive, 11% cognitive processing speed. These manifested alone (51%) or in combination (48%), with combined impairments the best marker of general WMem impairment. Significant progression in visual-spatial impairments was found for 24% of RRMS patients, with the OM n­-back maintaining sensitivity to general WMem impairment and progression. No other WMem subcomponent progressed or task maintained sensitivity. The results of this study provides crucial knowledge for the creation of interventions to treat WMem impairment in early RRMS, providing key targets for treatment and endpoints for determining efficacy.

Pattern of neuropsychological impairment in the early phase of relapsing-remitting multiple sclerosis

2005 ◽  
Vol 11 (2) ◽  
pp. 191-197 ◽  
Author(s):  
T Olivares ◽  
A Nieto ◽  
M P Sánchez ◽  
T Wollmann ◽  
M A Hernández ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Processing ◽  
Cognitive Deficits ◽  
Motor Execution ◽  
Information Processing Speed ◽  
Neuropsychological Profile ◽  
Relapsing Remitting ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis ◽  
Post Onset

To investigate the neuropsychological profile in the first few years post-onset of relapsing-remitting multiple sclerosis (MS) we carried out a comprehensive neuropsychological evaluation of 33 patients characterized by very short evolution of this disease, minimal levels of neurological disability and preserved general cognition. Thirty-three individually pair-matched controls were also evaluated. Patients performed as well as controls on many of the cognitive exploration measures. Nevertheless, the group of patients evinced a general slowness that affected motor execution and cognitive processing. Memory functions were characterized by preservation of working memory, retrieval or storage of information and a deficit at the acquisition phase in (verbal and visual) supraspan tasks. In addition, significant correlations were observed between some measures of information processing speed and memory. These results highlight the importance of studying cognitive deficits not only in the different subtypes of MS but also in different phases of the disease.

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