Clinical trials for multiple sclerosis: Outcome measures and impact on cognitive function

Abstract

Multiple sclerosis (MS) is a complex immune-mediated disease characterized by recurrent demyelinating episodes of the central nervous system, which is the most common disabling neurological disease of young people. Cognitive impairment is common and one of the disabling symptoms of MS, resulting in reduced quality of life. This often emerges early in the disease and is independent of physical disability; however, it is more prevalent in progressive disease. With the advent of a number of disease-modifying drugs, including agents with high efficacy at reducing inflammatory activity, patients with MS can receive more efficacious treatment. Although the currently available disease-modifying drugs have been shown to reduce the inflammatory disease activity, their effects on the neurodegenerative aspect or cognitive functions are still unclear. Cognitive rehabilitation and physical exercise are promising strategies to prevent cognitive decline or improve brain function. Beneficial effects of these interventions have been reported, but the evidence is still sparse. The present review article describes the clinical trial data on interventions for cognitive impairment in MS.