Natalizumab May Improve Cognition and Mood in Multiple Sclerosis

Abstract

Immunomodulating therapies may prevent relapses in multiple sclerosis and stabilize neurological status. However, little is known about the influence particularly of newer drugs on cognitive functions. We conducted an open-label prospective study to demonstrate whether natalizumab is apt to improve cognitive functions and mood in 29 patients tested psychometrically while under treatment for 6 months. We found improvements in some measures of attention, memory, mood, and well-being, but no deterioration, although patients suffered from their diseases for more than 10 years and had an EDSS score of 3.5. It is concluded that natalizumab is able to stabilize or improve cognition and mood even in longer-lasting multiple sclerosis.

Changes in Fatigue and Cognition in Patients with Relapsing Forms of Multiple Sclerosis Treated with Natalizumab

“…30 In addition, an open-label study showed that after 6 months of natalizumab therapy, patients demonstrated improved test scores on four of six different cognitive tests, with no deterioration in any test, despite disease duration of more than 10 years. 27 Our results using ANAM, a sensitive measure of multiple cognitive skills, support and extend these observations that cognitive function may be maintained and potentially improved with natalizumab. Because of potential practice effects with With natalizumab therapy, patients experienced significant improvements in fatigue, as measured by three patient-reported scales, and the improvements that were observed during the first 12 weeks of treatment were maintained for up to 48 weeks of treatment.…”

“…[26][27][28][29][30] A large Swedish study demonstrated a significant increase in mean Symbol Digit Modalities Test score at 2 years over baseline in natalizumab-treated relapsing-remitting MS patients. 26 A follow-up analysis comparing AFFIRM patients treated with natalizumab with those treated with placebo showed a significant improvement in Paced Auditory Serial Addition Test score at 2 years.…”

Long-term safety and efficacy of natalizumab in relapsing-remitting multiple sclerosis: impact on quality of life

“…In this study, treatment with natalizumab improved EDSS scores mainly in patients who had relapse-mediated worsening of EDSS 22. In addition, other studies also demonstrated an effect of treatment, with natalizumab improving visual acuity,23 visual evoked potential sum scores,24 and cognitive performance 25–27. In a small, prospective, magnetic resonance imaging (MRI) study,28 it was found that treatment with natalizumab over 2 years reduced cortical lesions and cortical atrophy when compared with untreated patients and patients treated with first-line therapies.…”

Cognitive functions over the course of 1 year in multiple sclerosis patients treated with disease modifying therapies

“…Lang and colleagues found stabilizing and improving effects of natalizumab on a selection of memory and attention tests, including PASAT [Lang et al 2012]. Wilken and colleagues observed a stabilization or improvement in computer-based assessed cognitive functions over 1 year in patients treated with natalizumab [Wilken et al 2013].…”