Verbal Fluencies and Fampridine Treatment in Multiple Sclerosis

Abstract

Background/Aims: Fampridine is sometimes reported to improve cognition and especially the information-processing speed. Motor improvement might be a confounding factor. The aim of this study was to evaluate the effects of fampridine on verbal fluencies in patients with multiple sclerosis (MS). Methods: Fifty MS patients were included in a prospective monocentric open label trial with a mean Expanded Disability Status Scale of 5.3 ± 1.1. Assessments of verbal phonological and semantic fluencies were repeated twice (within 1 week) before fampridine treatment and twice after fampridine treatment in order to have the maximal practice effect. Gait velocity and fatigue (visual analogical scale) were also assessed. Distribution into gait responders, gait non-responders, fluency responders and fluency non-responders, was described. Results: Verbal fluencies were significantly higher after fampridine treatment. No correlation was observed between phonological fluency improvement and semantic fluency improvement. Gait responders and gait non-responders did not present significant differences in verbal fluency performance and fatigue score. No correlation between gait velocity improvement and fatigue improvement compared with verbal fluency improvement was observed. Conclusion: Our results suggest that fampridine could have a selective procognitive effect on phonological fluency in MS, even in the gait non-responder patients.

Dalfampridine effects on cognition, fatigue, and dexterity

“…Furthermore, Magnin et al. (2015) reported increased verbal fluency in dalfampridine responders as well as nonresponders. On the contrary, Pavsic et al.…”

“…However, regarding the assumed effects on conduction, action‐potentials, and synaptic and neuromuscular transmission, it would be very likely that the compound also has an effect on other parts of the central nervous system and therefore on other neurological functions such as vision, fatigue, or cognition (Kim, Goldner, & Sanders, 1980; Shi & Blight, 1997; Smith, Felts, & John, 2000). Indeed, studies investigating whether or not dalfampridine or 4‐aminopyridine exert beneficial effects on other neurological function in MS patients described positive effects on measures of cognitive function, upper limb function, fatigue, and vision (Horton et al., 2013; Jensen, Ravnborg, Mamoei, Dalgas, & Stenager, 2014; Limone, Sidovar, & Coleman, 2013; Magnin et al., 2015; Pavsic, Pelicon, Ledinek, & Sega, 2015; Prugger & Berger, 2013; Rossini et al., 2001; Ruck et al., 2014). …”

Effects of a Training Program Involving Body Cooling on Physical and Cognitive Capacities and Quality of Life in Multiple Sclerosis Patients: A Pilot Study

“…For example, Gossmann et al [12] reported that body cooling had no effect on cognitive fatigue and vigilance, whereas Kinnman et al [9] found a significant relationship between a decrease in body temperature and an increase in executive ability. As with fampridine [13], we may assume that cooling, by improvement of axonal conduction, should have a positive effect on cognition in addition to walking distance and fatigue.…”

Assessment of motor outcomes in multiple sclerosis patients with walking impairment treated with Fampridine using motor evoked potentials

“…It is not only the positive effect of Fampridine in improving walking that deserves to be mentioned, but also improvement of the psychological status (22)(23)(24)(25). Either in double blind placebocontrolled studies or prospective monocentric open label trials, Fampridine has been proved to have effect upon patient self-reported psychological impact of MS, as well as a precognitive effect on verbal fluencies even in non-respondent to gait benefit patients, respectively (26). Therefore, by improving not only the physical-related issues in MS, but also cognitive fatigue and mood, Fampridine positively impacts QoL (24,25).…”