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Cognitive Impairment in MS (PART 4: improving treatment development)
Improving Treatment Development
Today’s method of drug development for cognitive impairment in patients with MS—evaluating drugs that have improved cognition related to other neurodegenerative diseases—does not work. While this approach was the obvious first step, other methodologies must be developed if effective treatments are to be found. A promising new avenue for cognition-enhancing drug development in MS involves the use of the animal model experimental autoimmune encephalomyelitis (EAE). EAE is not a novel model of disease; since 1933, it has helped scientists to learn about the disease process and to test treatments to improve physical symptoms. In 2010, researchers demonstrated that this model of MS, in addition to mimicking the disease with regard to lesion formation and induction of physical disability, also causes cognitive impairment.22 This was the first study that measured cognitive function in the EAE model, and it provides a valuable new method for the evaluation of novel treatments for MS-related cognitive impairment.
The awareness of cognitive impairment in MS is improving among physicians, researchers, and patients. Although past efforts to develop treatments for cognitive impairment in MS have largely been minimal or ineffective, improved research tools and imaging modalities and the emergence of more studies focusing on this problem are causes for optimism.
PART 1: http://activemsers.wssnoc.net/showthread.php?t=1163
PART 2: http://activemsers.wssnoc.net/showthread.php?t=1164
PART 3: http://activemsers.wssnoc.net/showthread.php?t=1165
References
1. Jambor, K. L. (1969). Cognitive functioning in multiple sclerosis. British Journal of Psychiatry, 115(524), 765–775.
2. Kaplin, A. I., & Williams, M. (2007). How common are the "common" neurologic disorders? Neurology, 69(4), 410; author reply 410–411.
3. Chiaravalloti, N. D., & DeLuca, J. (2008). Cognitive impairment in multiple sclerosis. Lancet Neurology, 7(12), 1139–1151.
4. Julian, L. J., Vella, L., Vollmer, T., Hadjimichael, O., & Mohr, D. C. (2008). Employment in multiple sclerosis. Exiting and re-entering the work force. Journal of Neurology, 255(9), 1354–1360.
5. Larocca, N., Kalb, R., Scheinberg, L., & Kendall, P. (1985). Factors associated with unemployment of patients with multiple sclerosis. Journal of Chronic Diseases, 38(2), 203–210.
6. Brissart, H., Morele, E., Baumann, C., & Debouverie, M. (2012). Verbal episodic memory in 426 multiple sclerosis patients: Impairment in encoding, retrieval or both? Neurological Sciences.
7. Pierrot-Deseilligny, C. (2009). Clinical implications of a possible role of vitamin D in multiple sclerosis. Journal of Neurology, 256(9), 1468–1479.
8. Buchanan, R. J., Zuniga, M. A., Carrillo-Zuniga, G., Chakravorty, B. J., Tyry, T., Moreau, R. L., . . . Vollmer, T. (2010). Comparisons of Latinos, African Americans, and Caucasians with multiple sclerosis. Ethnicity and Disease, 20(4), 451–457.
9. Wallin, M. T., Wilken, J. A., & Kane, R. (2006). Cognitive dysfunction in multiple sclerosis: Assessment, imaging, and risk factors. Journal of Rehabilitation Research and Development, 43(1), 63–72.
10. Ross, K. A., Schwebel, D. C., Rinker, J., 2nd, Ness, J., & Ackerson, J. (2010). Neurocognitive sequelae in African American and Caucasian children with multiple sclerosis. Neurology, 75(23), 2097–2102.
11. Savettieri, G., Messina, D., Andreoli, V., Bonavita, S., Caltagirone, C., Cittadella, R., . . . Quattrone, A. (2004). Gender-related effect of clinical and genetic variables on the cognitive impairment in multiple sclerosis. Journal of Neurology, 251(10), 1208–1214.
12. Tucker, A. M., & Stern, Y. (2011). Cognitive reserve in aging. Current Alzheimer Research, 8(4), 354–360.
13. Benedict, R. H., Morrow, S. A., Weinstock Guttman, B., Cookfair, D., & Schretlen, D. J. (2010). Cognitive reserve moderates decline in information processing speed in multiple sclerosis patients. Journal of the International Neuropsychological Society, 16(5), 829–835.
14. Batista, S., Zivadinov, R., Hoogs, M., Bergsland, N., Heininen-Brown, M., Dwyer, M. G., . . . Benedict, R. H. (2012). Basal ganglia, thalamus and neocortical atrophy predicting slowed cognitive processing in multiple sclerosis. Journal of Neurology, 259(1), 139–146.
15. Lotrich, F. E., El-Gabalawy, H., Guenther, L. C., & Ware, C. F. (2011). The role of inflammation in the pathophysiology of depression: Different treatments and their effects. Journal of Rheumatology. Supplement, 88, 48–54.
16. He, D., Zhou, H., Guo, D., Hao, Z., & Wu, B. (2011). Pharmacologic treatment for memory disorder in multiple sclerosis. Cochrane Database of Systematic Reviews(10), CD008876.
17. Messinis, L., Kosmidis, M. H., Lyros, E., & Papathanasopoulos, P. (2010). Assessment and rehabilitation of cognitive impairment in multiple sclerosis. International Review of Psychiatry, 22(1), 22–34.
18. Goretti, B., Portaccio, E., Zipoli, V., Hakiki, B., Siracusa, G., Sorbi, S., & Amato, M. P. (2010). Impact of cognitive impairment on coping strategies in multiple sclerosis. Clinical Neurology and Neurosurgery, 112(2), 127–130.
19. Velikonja, O., Curic, K., Ozura, A., & Jazbec, S. S. (2010). Influence of sports climbing and yoga on spasticity, cognitive function, mood and fatigue in patients with multiple sclerosis. Clinical Neurology and Neurosurgery, 112(7), 597–601.
20. Motl, R. W., Gappmaier, E., Nelson, K., & Benedict, R. H. (2011). Physical activity and cognitive function in multiple sclerosis. Journal of Sport and Exercise Psychology, 33(5), 734–741.
21. Kacar, K., Rocca, M. A., Copetti, M., Sala, S., Mesaros, S., Stosic Opincal, T., . . . Filippi, M. (2011). Overcoming the clinical-MR imaging paradox of multiple sclerosis: MR imaging data assessed with a random forest approach. AJNR. American Journal of Neuroradiology, 32(11), 2098–2102.
22. Ziehn, M. O., Avedisian, A. A., Tiwari-Woodruff, S., & Voskuhl, R. R. (2010). Hippocampal CA1 atrophy and synaptic loss during experimental autoimmune encephalomyelitis, EAE. Laboratory Investigation, 90(5), 774–786.
Today’s method of drug development for cognitive impairment in patients with MS—evaluating drugs that have improved cognition related to other neurodegenerative diseases—does not work. While this approach was the obvious first step, other methodologies must be developed if effective treatments are to be found. A promising new avenue for cognition-enhancing drug development in MS involves the use of the animal model experimental autoimmune encephalomyelitis (EAE). EAE is not a novel model of disease; since 1933, it has helped scientists to learn about the disease process and to test treatments to improve physical symptoms. In 2010, researchers demonstrated that this model of MS, in addition to mimicking the disease with regard to lesion formation and induction of physical disability, also causes cognitive impairment.22 This was the first study that measured cognitive function in the EAE model, and it provides a valuable new method for the evaluation of novel treatments for MS-related cognitive impairment.
The awareness of cognitive impairment in MS is improving among physicians, researchers, and patients. Although past efforts to develop treatments for cognitive impairment in MS have largely been minimal or ineffective, improved research tools and imaging modalities and the emergence of more studies focusing on this problem are causes for optimism.
PART 1: http://activemsers.wssnoc.net/showthread.php?t=1163
PART 2: http://activemsers.wssnoc.net/showthread.php?t=1164
PART 3: http://activemsers.wssnoc.net/showthread.php?t=1165
References
1. Jambor, K. L. (1969). Cognitive functioning in multiple sclerosis. British Journal of Psychiatry, 115(524), 765–775.
2. Kaplin, A. I., & Williams, M. (2007). How common are the "common" neurologic disorders? Neurology, 69(4), 410; author reply 410–411.
3. Chiaravalloti, N. D., & DeLuca, J. (2008). Cognitive impairment in multiple sclerosis. Lancet Neurology, 7(12), 1139–1151.
4. Julian, L. J., Vella, L., Vollmer, T., Hadjimichael, O., & Mohr, D. C. (2008). Employment in multiple sclerosis. Exiting and re-entering the work force. Journal of Neurology, 255(9), 1354–1360.
5. Larocca, N., Kalb, R., Scheinberg, L., & Kendall, P. (1985). Factors associated with unemployment of patients with multiple sclerosis. Journal of Chronic Diseases, 38(2), 203–210.
6. Brissart, H., Morele, E., Baumann, C., & Debouverie, M. (2012). Verbal episodic memory in 426 multiple sclerosis patients: Impairment in encoding, retrieval or both? Neurological Sciences.
7. Pierrot-Deseilligny, C. (2009). Clinical implications of a possible role of vitamin D in multiple sclerosis. Journal of Neurology, 256(9), 1468–1479.
8. Buchanan, R. J., Zuniga, M. A., Carrillo-Zuniga, G., Chakravorty, B. J., Tyry, T., Moreau, R. L., . . . Vollmer, T. (2010). Comparisons of Latinos, African Americans, and Caucasians with multiple sclerosis. Ethnicity and Disease, 20(4), 451–457.
9. Wallin, M. T., Wilken, J. A., & Kane, R. (2006). Cognitive dysfunction in multiple sclerosis: Assessment, imaging, and risk factors. Journal of Rehabilitation Research and Development, 43(1), 63–72.
10. Ross, K. A., Schwebel, D. C., Rinker, J., 2nd, Ness, J., & Ackerson, J. (2010). Neurocognitive sequelae in African American and Caucasian children with multiple sclerosis. Neurology, 75(23), 2097–2102.
11. Savettieri, G., Messina, D., Andreoli, V., Bonavita, S., Caltagirone, C., Cittadella, R., . . . Quattrone, A. (2004). Gender-related effect of clinical and genetic variables on the cognitive impairment in multiple sclerosis. Journal of Neurology, 251(10), 1208–1214.
12. Tucker, A. M., & Stern, Y. (2011). Cognitive reserve in aging. Current Alzheimer Research, 8(4), 354–360.
13. Benedict, R. H., Morrow, S. A., Weinstock Guttman, B., Cookfair, D., & Schretlen, D. J. (2010). Cognitive reserve moderates decline in information processing speed in multiple sclerosis patients. Journal of the International Neuropsychological Society, 16(5), 829–835.
14. Batista, S., Zivadinov, R., Hoogs, M., Bergsland, N., Heininen-Brown, M., Dwyer, M. G., . . . Benedict, R. H. (2012). Basal ganglia, thalamus and neocortical atrophy predicting slowed cognitive processing in multiple sclerosis. Journal of Neurology, 259(1), 139–146.
15. Lotrich, F. E., El-Gabalawy, H., Guenther, L. C., & Ware, C. F. (2011). The role of inflammation in the pathophysiology of depression: Different treatments and their effects. Journal of Rheumatology. Supplement, 88, 48–54.
16. He, D., Zhou, H., Guo, D., Hao, Z., & Wu, B. (2011). Pharmacologic treatment for memory disorder in multiple sclerosis. Cochrane Database of Systematic Reviews(10), CD008876.
17. Messinis, L., Kosmidis, M. H., Lyros, E., & Papathanasopoulos, P. (2010). Assessment and rehabilitation of cognitive impairment in multiple sclerosis. International Review of Psychiatry, 22(1), 22–34.
18. Goretti, B., Portaccio, E., Zipoli, V., Hakiki, B., Siracusa, G., Sorbi, S., & Amato, M. P. (2010). Impact of cognitive impairment on coping strategies in multiple sclerosis. Clinical Neurology and Neurosurgery, 112(2), 127–130.
19. Velikonja, O., Curic, K., Ozura, A., & Jazbec, S. S. (2010). Influence of sports climbing and yoga on spasticity, cognitive function, mood and fatigue in patients with multiple sclerosis. Clinical Neurology and Neurosurgery, 112(7), 597–601.
20. Motl, R. W., Gappmaier, E., Nelson, K., & Benedict, R. H. (2011). Physical activity and cognitive function in multiple sclerosis. Journal of Sport and Exercise Psychology, 33(5), 734–741.
21. Kacar, K., Rocca, M. A., Copetti, M., Sala, S., Mesaros, S., Stosic Opincal, T., . . . Filippi, M. (2011). Overcoming the clinical-MR imaging paradox of multiple sclerosis: MR imaging data assessed with a random forest approach. AJNR. American Journal of Neuroradiology, 32(11), 2098–2102.
22. Ziehn, M. O., Avedisian, A. A., Tiwari-Woodruff, S., & Voskuhl, R. R. (2010). Hippocampal CA1 atrophy and synaptic loss during experimental autoimmune encephalomyelitis, EAE. Laboratory Investigation, 90(5), 774–786.
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