Single dose of methylphenidate improves cognitive performance in multiple sclerosis patients with impaired attention process

Harel, Yermi; Appleboim, Nava; Lavie, Mor; Achiron, Anat

doi:10.1016/j.jns.2008.08.025

Cited by 55 publications

(27 citation statements)

References 19 publications

(21 reference statements)

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“…However, anecdotal evidence and patient reports suggest that there is a possibility that patients may get some relief from fatigue when treated with methylphenidate. As expected, Harel et al found that even administration of a single dose of methylphenidate significantly improved symptoms such as attention in MS patients [93]. However, given its side-effect profile, more studies are required to correlate a benefit in MS fatigue.…”

Section: Treatmentmentioning

confidence: 65%

Fatigue in multiple sclerosis — A brief review

Induruwa

Constantinescu

Gran

2012

Journal of the Neurological Sciences

187

145

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Section: Treatmentmentioning

confidence: 65%

Fatigue in multiple sclerosis — A brief review

Induruwa

Constantinescu

Gran

2012

Journal of the Neurological Sciences

187

145

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“…Another possible therapeutic option for managing cognitive disorders in MS encompasses the use of medications for clinical symptoms. For example, recent studies suggest that psycho-stimulants present an opportunity for adjunctive symptomatic therapy for slowed information processing and deficits of attention in MS, even if the their results need to be replicated in larger samples of patients [32]–[33]. Another promising therapeutic option is represented by cognitive rehabilitation.…”

Section: Discussionmentioning

confidence: 99%

Presence and Significant Determinants of Cognitive Impairment in a Large Sample of Patients with Multiple Sclerosis

et al. 2013

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ObjectivesTo investigate the presence and the nature of cognitive impairment in a large sample of patients with Multiple Sclerosis (MS), and to identify clinical and demographic determinants of cognitive impairment in MS.Methods303 patients with MS and 279 healthy controls were administered the Brief Repeatable Battery of Neuropsychological tests (BRB-N); measures of pre-morbid verbal competence and neuropsychiatric measures were also administered.ResultsPatients and healthy controls were matched for age, gender, education and pre-morbid verbal Intelligence Quotient. Patients presenting with cognitive impairment were 108/303 (35.6%). In the overall group of participants, the significant predictors of the most sensitive BRB-N scores were: presence of MS, age, education, and Vocabulary. The significant predictors when considering MS patients only were: course of MS, age, education, vocabulary, and depression. Using logistic regression analyses, significant determinants of the presence of cognitive impairment in relapsing-remitting MS patients were: duration of illness (OR = 1.053, 95% CI = 1.010–1.097, p = 0.015), Expanded Disability Status Scale score (OR = 1.247, 95% CI = 1.024–1.517, p = 0.028), and vocabulary (OR = 0.960, 95% CI = 0.936–0.984, p = 0.001), while in the smaller group of progressive MS patients these predictors did not play a significant role in determining the cognitive outcome.ConclusionsOur results corroborate the evidence about the presence and the nature of cognitive impairment in a large sample of patients with MS. Furthermore, our findings identify significant clinical and demographic determinants of cognitive impairment in a large sample of MS patients for the first time. Implications for further research and clinical practice were discussed.

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“…This study represents the third large double-blind placebo-controlled trial of a therapy thought be effective in AD that has failed to improve cognitive performance in MS. Donepezil, memantine, and now ginkgo all have Class I data indicating that they are ineffective in improving cognitive performance in MS. 5,6 In AD, donepezil is believed to improve cognitive impairment by increasing acetylcholine, whereas memantine works by antagonizing glutamate effects on the NMDA receptors in a usedependent manner. Ginkgo antagonizes PAF and thus may have an effect similar to that of memantine on glutamate neurotransmission.…”

Section: (2) 0 (0)mentioning

confidence: 99%

Ginkgo biloba does not improve cognitive function in MS

et al. 2012

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Objective: To determine whether Ginkgo biloba extract (ginkgo) improves cognitive function in persons with multiple sclerosis (MS). were randomly assigned to receive either one 120-mg tablet of ginkgo (EGb-761; Willmar Schwabe GmbH & Co, Germany) or one placebo tablet twice a day for 12 weeks. As the primary outcome, we compared the performance of the 2 groups on the 4 tests at exit after adjusting for baseline performance. MethodsResults: Fifty-nine subjects received placebo and 61 received ginkgo; 1 participant receiving placebo and 3 receiving ginkgo were lost to follow-up. Two serious adverse events (AEs) (myocardial infarction and severe depression) believed to be unrelated to the treatment occurred in the ginkgo group; otherwise, there were no significant differences in AEs. The differences (ginkgo Ϫ placebo) at exit in the z scores for the cognitive tests were as follows: PASAT Ϫ0.2 (95% confidence interval [CI] Ϫ0.5 to 0.1); Stroop Test Ϫ0.5 (95% CI Ϫ0.9 to Ϫ0.1); COWAT 0.0 (95% CI Ϫ0.2 to 0.3); and CVLT-II 0.0 (95% CI Ϫ0.3 to 0.3); none was statistically significant. Conclusions:Treatment with ginkgo 120 mg twice a day did not improve cognitive performance in persons with MS. Classification of evidence:This study provides Class I evidence that treatment with ginkgo 120 mg twice a day for 12 weeks does not improve cognitive performance in people with MS.

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Single dose of methylphenidate improves cognitive performance in multiple sclerosis patients with impaired attention process

Cited by 55 publications

References 19 publications

Fatigue in multiple sclerosis — A brief review

Fatigue in multiple sclerosis — A brief review

Presence and Significant Determinants of Cognitive Impairment in a Large Sample of Patients with Multiple Sclerosis

Ginkgo biloba does not improve cognitive function in MS

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