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Natalizumab Significantly Improves Cognitive Impairment over Three Years in MS: Pattern of Disability Progression and Preliminary MRI Findings.

Mattioli F, Stampatori C, Bellomi F, Scarpazza C, Capra R - PLoS ONE (2015)

Bottom Line: Results showed a significant reduction in the number of impaired neuropsychological tests after three years, a significant decrease in annualized relapse rate at each time points compared to baseline and a stable EDSS.Preliminary MRI data show that, while GM volume did not change at 3 years, a significantly greater parahippocampal and prefrontal gray matter density was noticed, the former correlating with neuropsychological improvement in a memory test.This study showed that therapy with Natalizumab is helpful in improving cognitive performance, and is likely to have a protective role on grey matter, over a three years follow-up.

View Article: PubMed Central - PubMed

Affiliation: Neuropsychology Unit, Spedali Civili of Brescia, Brescia, Italy.

ABSTRACT
Previous studies reported that Multiple Sclerosis (MS) patients treated with natalizumab for one or two years exhibit a significant reduction in relapse rate and in cognitive impairment, but the long term effects on cognitive performance are unknown. This study aimed to evaluate the effects of natalizumab on cognitive impairment in a cohort of 24 consecutive patients with relapsing remitting MS treated for 3 years. The neuropsychological tests, as well as relapse number and EDSS, were assessed at baseline and yearly for three years. The impact on cortical atrophy was also considered in a subgroup of them, and are thus to be considered as preliminary. Results showed a significant reduction in the number of impaired neuropsychological tests after three years, a significant decrease in annualized relapse rate at each time points compared to baseline and a stable EDSS. In the neuropsychological assessment, a significant improvement in memory, attention and executive function test scores was detected. Preliminary MRI data show that, while GM volume did not change at 3 years, a significantly greater parahippocampal and prefrontal gray matter density was noticed, the former correlating with neuropsychological improvement in a memory test. This study showed that therapy with Natalizumab is helpful in improving cognitive performance, and is likely to have a protective role on grey matter, over a three years follow-up.

No MeSH data available.


Related in: MedlinePlus

Mean number of impaired tests in patients starting natalizumab with EDSS>3 or<3.Columns represent mean (± SD) number of failed cognitive tests in patients starting natalizumab with EDSS ≤3 (black) or >3 (grey). *, p<0.005 vs. baseline; #, p<0.01 vs. baseline; °, p<0.05 vs. EDSS >3.
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pone.0131803.g001: Mean number of impaired tests in patients starting natalizumab with EDSS>3 or<3.Columns represent mean (± SD) number of failed cognitive tests in patients starting natalizumab with EDSS ≤3 (black) or >3 (grey). *, p<0.005 vs. baseline; #, p<0.01 vs. baseline; °, p<0.05 vs. EDSS >3.

Mentions: Cognitive functions resulted to be globally improved after three years therapy with natalizumab (Table 3). The number of pathological tests resulted significantly lower at 1 year compared to baseline (1.06 vs 2; p = .005), at 2 years compared to baseline (0.67 vs 2; p = .0002) and 3 years compared to baseline (0.61 vs 2, p = .0001), without significant differences in comparisons between the year intervals (p = n.s.). Patients with baseline EDSS <3 compared to patients with baseline EDSS>3 resulted to have a significantly lower number of impaired neuropsychological tests at 1 year (mean number of pathological tests 0.14 vs 1.64; p = .04). No differences were found between groups at subsequent follow ups, although both groups resulted to reduce the number of impaired tests. (Fig 1).


Natalizumab Significantly Improves Cognitive Impairment over Three Years in MS: Pattern of Disability Progression and Preliminary MRI Findings.

Mattioli F, Stampatori C, Bellomi F, Scarpazza C, Capra R - PLoS ONE (2015)

Mean number of impaired tests in patients starting natalizumab with EDSS>3 or<3.Columns represent mean (± SD) number of failed cognitive tests in patients starting natalizumab with EDSS ≤3 (black) or >3 (grey). *, p<0.005 vs. baseline; #, p<0.01 vs. baseline; °, p<0.05 vs. EDSS >3.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4492934&req=5

pone.0131803.g001: Mean number of impaired tests in patients starting natalizumab with EDSS>3 or<3.Columns represent mean (± SD) number of failed cognitive tests in patients starting natalizumab with EDSS ≤3 (black) or >3 (grey). *, p<0.005 vs. baseline; #, p<0.01 vs. baseline; °, p<0.05 vs. EDSS >3.
Mentions: Cognitive functions resulted to be globally improved after three years therapy with natalizumab (Table 3). The number of pathological tests resulted significantly lower at 1 year compared to baseline (1.06 vs 2; p = .005), at 2 years compared to baseline (0.67 vs 2; p = .0002) and 3 years compared to baseline (0.61 vs 2, p = .0001), without significant differences in comparisons between the year intervals (p = n.s.). Patients with baseline EDSS <3 compared to patients with baseline EDSS>3 resulted to have a significantly lower number of impaired neuropsychological tests at 1 year (mean number of pathological tests 0.14 vs 1.64; p = .04). No differences were found between groups at subsequent follow ups, although both groups resulted to reduce the number of impaired tests. (Fig 1).

Bottom Line: Results showed a significant reduction in the number of impaired neuropsychological tests after three years, a significant decrease in annualized relapse rate at each time points compared to baseline and a stable EDSS.Preliminary MRI data show that, while GM volume did not change at 3 years, a significantly greater parahippocampal and prefrontal gray matter density was noticed, the former correlating with neuropsychological improvement in a memory test.This study showed that therapy with Natalizumab is helpful in improving cognitive performance, and is likely to have a protective role on grey matter, over a three years follow-up.

View Article: PubMed Central - PubMed

Affiliation: Neuropsychology Unit, Spedali Civili of Brescia, Brescia, Italy.

ABSTRACT
Previous studies reported that Multiple Sclerosis (MS) patients treated with natalizumab for one or two years exhibit a significant reduction in relapse rate and in cognitive impairment, but the long term effects on cognitive performance are unknown. This study aimed to evaluate the effects of natalizumab on cognitive impairment in a cohort of 24 consecutive patients with relapsing remitting MS treated for 3 years. The neuropsychological tests, as well as relapse number and EDSS, were assessed at baseline and yearly for three years. The impact on cortical atrophy was also considered in a subgroup of them, and are thus to be considered as preliminary. Results showed a significant reduction in the number of impaired neuropsychological tests after three years, a significant decrease in annualized relapse rate at each time points compared to baseline and a stable EDSS. In the neuropsychological assessment, a significant improvement in memory, attention and executive function test scores was detected. Preliminary MRI data show that, while GM volume did not change at 3 years, a significantly greater parahippocampal and prefrontal gray matter density was noticed, the former correlating with neuropsychological improvement in a memory test. This study showed that therapy with Natalizumab is helpful in improving cognitive performance, and is likely to have a protective role on grey matter, over a three years follow-up.

No MeSH data available.


Related in: MedlinePlus