Positive effects of fampridine on cognition, fatigue and depression in patients with multiple sclerosis over 2 years

Broicher, Sarah D.; Filli, Linard; Geisseler, Olivia; Germann, Nicole; Zörner, Björn; Brugger, Peter; Linnebank, Michael

doi:10.1007/s00415-018-8796-9

Cited by 43 publications

(24 citation statements)

References 35 publications

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“…Amphetamines significantly improved visuospatial memory and verbal memory [132], fampridine has shown to be able to improve cognitive fatigue, alertness, psychomotor speed, and verbal fluency [133,134], while no benefit on learning were found using modafinil [135].…”

Section: Treatment Of Cognitive Impairment In Msmentioning

confidence: 99%

Assessment and Impact of Cognitive Impairment in Multiple Sclerosis: An Overview

2019

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Cognitive impairment affects 40–60% of patients with multiple sclerosis. It may be present early in the course of the disease and has an impact on a patient’s employability, social interactions, and quality of life. In the last three decades, an increasing interest in diagnosis and management of cognitive impairment has arisen. Neuropsychological assessment and neuroimaging studies focusing on cognitive impairment are now being incorporated as primary outcomes in clinical trials. However, there are still key uncertainties concerning the underlying mechanisms of damage, neural basis, sensitivity and validity of neuropsychological tests, and efficacy of pharmacological and non-pharmacological interventions. The present article aimed to present an overview of the assessment, neural correlates, and impact of cognitive impairment in multiple sclerosis.

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Section: Treatment Of Cognitive Impairment In Msmentioning

confidence: 99%

Assessment and Impact of Cognitive Impairment in Multiple Sclerosis: An Overview

2019

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“…Both were class III due to a lack of equivalent treatment order groups at baseline and insufficient examination or accounting for carryover effects. One of the class III studies, the FAMPKIN extension trial, consisted of a 2-year observational period (when the whole sample received treatment) followed by a crossover RCT phase [51]. Only 20 of 32 patients from the extension trial completed the RCT phase, during which cognitive performance was superior during the dalfampridine condition compared with the placebo condition, on only one of eight measures.…”

Section: Dalfampridinementioning

confidence: 99%

Cognitive Efficacy of Pharmacologic Treatments in Multiple Sclerosis: A Systematic Review

et al. 2020

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Introduction Cognitive impairment is prevalent and debilitating among persons with multiple sclerosis (MS). While many pharmacologic treatments have shown good efficacy in reducing clinical relapses, brain lesions, and improving certain physical symptoms, their efficacy for improving cognitive function is not well understood. Objectives The current systematic review aimed to evaluate the efficacy of pharmacologic treatments for improving cognitive function among persons with MS. Methods A literature search was conducted through the PubMed and PsycINFO databases. Two independent reviewers assessed each paper, and a third reviewer weighed in if the two reviewers could not reach a consensus. Classification of evidence was determined using the 2017 American Academy of Neurology (AAN) criteria for therapeutic trials. Standardized effect sizes (Cohen's d) were calculated to compare across studies. Results Eighty-seven journal articles published between 1990 and January 2020 were included in the current review. Overall, there is insufficient evidence to support the use of pharmacologic treatments to improve cognitive function in persons with MS. There were many contradictory findings observed in this review, which may be due to possible unidentified moderating treatment response variables and/or lack of standardization in assessment procedures. There was also an overreliance on statistical significance (most papers did not provide sizes of treatment effects), which may not be clinically meaningful. Conclusions Higher-quality randomized controlled trials are needed to establish the cognitive efficacy of pharmacologic treatments for MS-related cognitive dysfunction, with cognition as the primary endpoint. Researchers are urged to use standardized criteria (such as the AAN criteria) to guide their research designs. Clinicians should consider effect sizes of studies before deciding whether to prescribe certain medications to ameliorate cognitive symptoms.

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“…Although no symptomatic treatment has provided adequate evidence for the treatment of cognitive dysfunction up to this point in time [ 84 ], preliminary data suggest a potential positive impact of fampridine in cognition and fatigue [ 85 , 86 ]. Furthermore, research regarding non pharmaceutical cognitive rehabilitation interventions has provided indications that MS patients may benefit cognitively [ 87 ].…”

Section: When To Measure and How To Deal With Findings?mentioning

confidence: 99%

The Rationale for Monitoring Cognitive Function in Multiple Sclerosis: Practical Issues for Clinicians

Bakirtzis

Ioannidis

Messinis

et al. 2018

TONEUJ

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About half of patients with multiple sclerosis exhibit cognitive impairment which negatively affects their quality of life. The assessment of cognitive function in routine clinical practice is still undervalued, although various tools have been proposed for this reason. In this article, we describe the potential benefits of implementing cognitive assessment tools in routine follow -ups of MS patients. Early detection of changes in cognitive performance may provide evidence of disease activity, could unmask depression or medication side-effects and provide suitable candidates for cognitive rehabilitation. Since apathy and cognitive deficiencies are common presenting symptoms in Progressive Multifocal Leukoencephalopathy, we discuss the utility of frequent monitoring of mental status in multiple sclerosis patients at increased risk. In addition, we propose a relevant algorithm aiming to incorporate a systematic evaluation of cognitive function in every day clinical practice in multiple sclerosis.

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Positive effects of fampridine on cognition, fatigue and depression in patients with multiple sclerosis over 2 years

Cited by 43 publications

References 35 publications

Assessment and Impact of Cognitive Impairment in Multiple Sclerosis: An Overview

Assessment and Impact of Cognitive Impairment in Multiple Sclerosis: An Overview

Cognitive Efficacy of Pharmacologic Treatments in Multiple Sclerosis: A Systematic Review

The Rationale for Monitoring Cognitive Function in Multiple Sclerosis: Practical Issues for Clinicians

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