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Cognitive functioning following one-year natalizumab treatment : A non-randomized clinical trial

Rorsman, I. LU ; Petersen, C and Nilsson, P.C. (2018) In Acta Neurologica Scandinavica 137(1). p.117-124
Abstract

Objectives: Cognitive impairment is common in multiple sclerosis (MS) and can have serious impact on social and occupational functioning. Natalizumab reduces relapse rates, magnetic resonance imaging (MRI) lesions, and progression of disability. Previous studies on cognitive functioning have not based inclusion on cognitive performance criteria. The aim of the present study was to determine any potential natalizumab-related cognitive effects on MS patients performing below normal limits on neuropsychological testing. Materials and methods: Patients starting natalizumab (n = 21) and a quasi-control group of stable MS patients (n = 13) on first line disease modifying treatment were included following neuropsychological assessment... (More)

Objectives: Cognitive impairment is common in multiple sclerosis (MS) and can have serious impact on social and occupational functioning. Natalizumab reduces relapse rates, magnetic resonance imaging (MRI) lesions, and progression of disability. Previous studies on cognitive functioning have not based inclusion on cognitive performance criteria. The aim of the present study was to determine any potential natalizumab-related cognitive effects on MS patients performing below normal limits on neuropsychological testing. Materials and methods: Patients starting natalizumab (n = 21) and a quasi-control group of stable MS patients (n = 13) on first line disease modifying treatment were included following neuropsychological assessment demonstrating subnormal cognitive performance. Assessment, using ten cognitive variables, was repeated after 12 months. Symptoms of fatigue, anxiety and depression were also examined. Raw scores on the cognitive tests were transformed into Z-scores based on published age-corrected normative data. Results: Between-group analyses on difference Z-scores (baseline - follow-up) yielded significant results on Paced Auditory Serial Addition Test-2 (PASAT-2) (P = .008), with the natalizumab group showing larger improvement than quasi control patients. On PASAT-2, 28,5% from the natalizumab group demonstrated >1 SD improvement, indicative of clinically meaningful change, compared with none in the quasi control group. Patients receiving natalizumab showed within-group improvements on six of the ten cognitive variables. There were no group differences in symptoms of fatigue, anxiety or depression. Conclusions: The results demonstrate improvement in information processing speed following 12-months of natalizumab treatment. The results are interpreted as reflection of anti-inflammatory properties of natalizumab rather than retest- or long-term restorative effects.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Addition test, Cognitive function, Multiple sclerosis, Natalizumab, Neuropsychology, Paced auditory serial, Paced Auditory Serial Addition Test
in
Acta Neurologica Scandinavica
volume
137
issue
1
pages
117 - 124
publisher
Wiley-Blackwell
external identifiers
  • scopus:85029389871
ISSN
0001-6314
DOI
10.1111/ane.12833
language
English
LU publication?
yes
id
3ab8dbc9-519a-4b06-8472-0bd991606033
date added to LUP
2017-10-09 11:16:35
date last changed
2018-05-29 11:41:47
@article{3ab8dbc9-519a-4b06-8472-0bd991606033,
  abstract     = {<p>Objectives: Cognitive impairment is common in multiple sclerosis (MS) and can have serious impact on social and occupational functioning. Natalizumab reduces relapse rates, magnetic resonance imaging (MRI) lesions, and progression of disability. Previous studies on cognitive functioning have not based inclusion on cognitive performance criteria. The aim of the present study was to determine any potential natalizumab-related cognitive effects on MS patients performing below normal limits on neuropsychological testing. Materials and methods: Patients starting natalizumab (n = 21) and a quasi-control group of stable MS patients (n = 13) on first line disease modifying treatment were included following neuropsychological assessment demonstrating subnormal cognitive performance. Assessment, using ten cognitive variables, was repeated after 12 months. Symptoms of fatigue, anxiety and depression were also examined. Raw scores on the cognitive tests were transformed into Z-scores based on published age-corrected normative data. Results: Between-group analyses on difference Z-scores (baseline - follow-up) yielded significant results on Paced Auditory Serial Addition Test-2 (PASAT-2) (P = .008), with the natalizumab group showing larger improvement than quasi control patients. On PASAT-2, 28,5% from the natalizumab group demonstrated &gt;1 SD improvement, indicative of clinically meaningful change, compared with none in the quasi control group. Patients receiving natalizumab showed within-group improvements on six of the ten cognitive variables. There were no group differences in symptoms of fatigue, anxiety or depression. Conclusions: The results demonstrate improvement in information processing speed following 12-months of natalizumab treatment. The results are interpreted as reflection of anti-inflammatory properties of natalizumab rather than retest- or long-term restorative effects.</p>},
  author       = {Rorsman, I. and Petersen, C and Nilsson, P.C.},
  issn         = {0001-6314},
  keyword      = {Addition test,Cognitive function,Multiple sclerosis,Natalizumab,Neuropsychology,Paced auditory serial,Paced Auditory Serial Addition Test},
  language     = {eng},
  number       = {1},
  pages        = {117--124},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Neurologica Scandinavica},
  title        = {Cognitive functioning following one-year natalizumab treatment : A non-randomized clinical trial},
  url          = {http://dx.doi.org/10.1111/ane.12833},
  volume       = {137},
  year         = {2018},
}