Influences on cognition by immunosuppression and immunomodulation in multiple sclerosis

Tumani, Hayrettin; Uttner, Ingo

doi:10.1007/s00415-007-2016-3

Cited by 8 publications

(3 citation statements)

References 38 publications

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“…Th is may be due to the partial ineff ectiveness of immunomodulatory treatment to correct recognition in MS patients compared to retrieval or it may be due to the type of immunomodulatory treatment which might have worsened cognitive function in MS patients. Few studies have shown that corticosteroids might worsen neuropsychological defi cit known to occur in early stages of disease (Tumani and Uttner 2007). Patients under steroid treatment were reported to have reversible impairment in long-term memory functions, whereas short-term memory and attentional functions remained unaff ected (Brunner et al 2005).…”

Section: Discussionmentioning

confidence: 97%

The relationship of cognitive impairment with neurological and psychiatric variables in multiple sclerosis patients

Karadayi¹,

Arısoy²,

Altunrende³

et al. 2014

International Journal of Psychiatry in Clinical Practice

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Section: Discussionmentioning

confidence: 97%

The relationship of cognitive impairment with neurological and psychiatric variables in multiple sclerosis patients

Karadayi¹,

Arısoy²,

Altunrende³

et al. 2014

International Journal of Psychiatry in Clinical Practice

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“…Each disorder causing these syndromes will be addressed by investigation within the relevant research community, and preventive, medical, surgical, psychiatric, and rehabilitative interventions may all be relevant. Among many questions is whether immunosuppressive and immunomodulatory treatment in MS will effect cognitive improvement, as has been suspected (Fischer et al, 2000; Tumani and Uttner, 2007). Other promising therapeutic avenues for white matter disorders include bone marrow transplantation (Krivit et al, 1999), gene therapy (Leone et al, 2000), and stem cell therapeutics (Goldman, 2007; Tran et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

White matter dementia

Filley¹

2012

Ther Adv Neurol Disord

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White matter dementia (WMD) is a syndrome introduced in 1988 to highlight the potential of cerebral white matter disorders to produce cognitive loss of sufficient severity to qualify as dementia. Neurologists have long understood that such a syndrome can occur, but the dominance of gray matter as the locus of higher function has strongly directed neurobehavioral inquiry to the cerebral cortex while white matter has received less attention. Contemporary neuroimaging has been crucial in enabling the recognition of white matter abnormalities in a host of disorders, and the correlation of these changes with cognitive performance. Comprising about half the brain, white matter is prominently or exclusively involved in well over 100 disorders, in each of which white matter dysfunction can potentially cause or contribute to dementia. Neuropsychological findings from ten categories of white matter disorder lead to a convergence of findings that document remarkable neurobehavioral commonality among the dementias produced. More recently, the syndrome of mild cognitive dysfunction (MCD) has been introduced to expand the concept of WMD by proposing a precursor syndrome related to early white matter neuropathology. WMD and MCD inform the understanding of how white matter contributes to normal and abnormal cognition, and the specific neuroanatomic focus of these syndromes may enhance the diagnosis and treatment of many disabling disorders that do not primarily implicate the cerebral cortex. Forming essential connections within widely distributed neural networks, white matter is critical for rapid and efficient information transfer that complements the information processing of gray matter. As neuroimaging continues to advance, further information on white matter structure can be expected, and behavioral neurology will play a central role in elucidating the functional significance of these emerging data. By emphasizing the contribution of myelinated systems to higher function, the study of white matter and cognition represents investigation of the basic neuroscience of human behavior.

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“…Wegen des nachteiligen Einflusses einer GKS-Behandlung auf die kognitive Leistungsfähigkeit ist von einer neuropsychologischen Funktionsdiagnostik während und mindestens 8 -14 Tage nach der GKS-Gabe abzusehen. In mehreren Studien wurde gezeigt, dass sich immunmodulatorische Therapien im Krankheitsverlauf günstig auf die kognitiven Beeinträchtigungen auswirken können[43,92,93].Sowohl die Prävalenz von demenziellen Erkrankungen bei MS-Patienten als auch die Frage, ob diese infolge des neurodegenerativen Krankheitsgeschehens oder inwiefern diese koinzident auftreten, sind bislang nicht systematisch untersucht worden. Somit kann die bisherige Annahme, Demenzen seien bei MS selten, nicht mit belastbaren Daten belegt werden.…”

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Kognitive Teilleistungsstörungen und Demenz bei Patienten mit Multipler Sklerose: Status quo und offene Fragen

Wegener

Marx

Zettl

2013

Fortschr Neurol Psychiatr

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Multiple sclerosis (MS) is the most common chronic immune-mediated disease which goes along with serious somatic and psychic symptoms. Whereas recent research rather focussed on the neurological symptoms of MS, there is nowadays an increasing interest among researchers in psychological symptoms of the disease. It is known that about half of the MS patients suffer from cognitive deficits, and that cognitive decline has a disadvantageous impact on lifestyle and quality of life in affected persons. So far, cognitive deficits in subjects with MS have been described as rather isolated, specific cognitive disturbances with otherwise intact intellectual abilities, while global deterioration of mental skills in terms of dementia is considered as being rather rare. In the present article, we describe cognitive domains which are typically impaired in subjects with MS and reflect on the question if the diagnosis of dementia might be underrepresented in MS patients due to several reasons (e.g., progression of cognitive deficits in the course of the disorder, adhering very closely to memory deficits as cardinal symptom of dementia, lack of longitudinal studies of cognitive performance levels). Furthermore, we recommend a multistage neuropsychological diagnostic procedure for clinical practice which aims at diagnosing cognitive deficits already in early stages of the illness. In so doing, practitioners may be able to offer adequate therapies to affected persons in all stages of the disorder in order to improve psychosocial functional levels.

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Influences on cognition by immunosuppression and immunomodulation in multiple sclerosis

Cited by 8 publications

References 38 publications

The relationship of cognitive impairment with neurological and psychiatric variables in multiple sclerosis patients

The relationship of cognitive impairment with neurological and psychiatric variables in multiple sclerosis patients

White matter dementia

Kognitive Teilleistungsstörungen und Demenz bei Patienten mit Multipler Sklerose: Status quo und offene Fragen

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