Skip to main content
SpringerLink
Log in

The effect of natalizumab on cognitive function in patients with relapsing-remitting multiple sclerosis: preliminary results of a 1-year follow-up study

  • Original Article
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

The objective of the study was to assess the natalizumab effect on the course of cognitive impairment in patients with relapsing-remitting multiple sclerosis (MS). Patients with active relapsing-remitting MS (n = 17) were treated with natalizumab for 1 year. The quasi control group included patients (n = 7) with clinically stable MS. Assessment of disease course [expanded disability status scale (EDSS); number of relapses] and neuropsychological impairment [Wisconsin card sorting test (WCST); controlled oral word associations; verbal/non-verbal memory tests; paced auditory serial addition test] was conducted at baseline and after 1 year. Natalizumab-treated patients experienced significantly fewer relapses compared with the previous year (P < 0.05). At 1-year follow-up, EDSS score was unchanged and neuropsychological assessments of memory/executive functions showed a significant improvement in natalizumab-treated patients (all P < 0.05). No changes were observed in the quasi control group. This preliminary study suggests that natalizumab could be effective in ameliorating cognitive functions in patients with active relapsing-remitting MS, over 1-year follow-up.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. IFNB Multiple Sclerosis Study Group (1993) Interferon beta-1b is effective in relapsing-remitting multiple sclerosis. I. Clinical results of a multicenter, randomized, double-blind, placebo-controlled trial. The IFNB Multiple Sclerosis Study Group. Neurology 43:655–661

    Google Scholar 

  2. Johnson KP, Brooks BR, Cohen JA, Ford CC, Goldstein J, Lisak RP et al (1995) Copolymer 1 reduces relapse rate and improves disability in relapsing-remitting multiple sclerosis: results of a phase III multicenter, double-blind placebo-controlled trial. The Copolymer 1 Multiple Sclerosis Study Group. Neurology 45:1268–1276

    CAS  PubMed  Google Scholar 

  3. Yednock TA, Cannon C, Fritz LC, Sanchez-Madrid F, Steinman L, Karin N (1992) Prevention of experimental autoimmune encephalomyelitis by antibodies against alpha 4 beta 1 integrin. Nature 356:63–66

    Article  CAS  PubMed  Google Scholar 

  4. Rudick RA, Sandrock A (2004) Natalizumab: alpha 4-integrin antagonist selective adhesion molecule inhibitors for MS. Expert Rev Neurother 4:571–580

    Article  CAS  PubMed  Google Scholar 

  5. Polman CH, O’Connor PW, Havrdova E, Hutchinson M, Kappos L, Miller DH et al (2006) A randomized, placebo-controlled trial of natalizumab for relapsing multiple sclerosis. N Engl J Med 354:899–910

    Article  CAS  PubMed  Google Scholar 

  6. Havrdova E, Galetta S, Hutchinson M, Stefoski D, Bates D, Polman CH et al (2009) Effect of natalizumab on clinical and radiological disease activity in multiple sclerosis: a retrospective analysis of the Natalizumab Safety and Efficacy in Relapsing-Remitting Multiple Sclerosis (AFFIRM) study. Lancet Neurol 8:254–260

    Article  PubMed  Google Scholar 

  7. Rudick RA, Miller D, Hass S, Hutchinson M, Calabresi PA, Confavreux C et al (2007) Health-related quality of life in multiple sclerosis: effects of natalizumab. Ann Neurol 62:335–346

    Article  CAS  PubMed  Google Scholar 

  8. Rudick RA, Stuart WH, Calabresi PA, Confavreux C, Galetta SL, Radue EW et al (2006) Natalizumab plus interferon beta-1a for relapsing multiple sclerosis. N Engl J Med 354:911–923

    Article  CAS  PubMed  Google Scholar 

  9. Deloire MS, Salort E, Bonnet M, Arimone Y, Boudineau M, Amieva H et al (2005) Cognitive impairment as marker of diffuse brain abnormalities in early relapsing remitting multiple sclerosis. J Neurol Neurosurg Psychiatry 76:519–526

    Article  CAS  PubMed  Google Scholar 

  10. Patti F, Amato MP, Trojano M, Bastianello S, Tola MR, Goretti B et al (2009) Cognitive impairment and its relation with disease measures in mildly disabled patients with relapsing-remitting multiple sclerosis: baseline results from the Cognitive Impairment in Multiple Sclerosis (COGIMUS) study. Mult Scler 15:779–788

    Article  CAS  PubMed  Google Scholar 

  11. Miller DH, Soon D, Fernando KT, MacManus DG, Barker GJ, Yousry TA et al (2007) MRI outcomes in a placebo-controlled trial of natalizumab in relapsing MS. Neurology 68:1390–1401

    Article  CAS  PubMed  Google Scholar 

  12. Chiaravalloti ND, DeLuca J (2008) Cognitive impairment in multiple sclerosis. Lancet Neurol 7:1139–1151

    Article  PubMed  Google Scholar 

  13. Patti F (2009) Cognitive impairment in multiple sclerosis. Mult Scler 15:2–8

    Article  CAS  PubMed  Google Scholar 

  14. Poser CM, Paty DW, Scheinberg L, McDonald WI, Davis FA, Ebers GC et al (1983) New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol 13:227–231

    Article  CAS  PubMed  Google Scholar 

  15. Kurtzke JF (1983) Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 33:1444–1452

    CAS  PubMed  Google Scholar 

  16. Gronwall DM (1977) Paced auditory serial-addition task: a measure of recovery from concussion. Percept Mot Skills 44:367–373

    CAS  PubMed  Google Scholar 

  17. Berg EA (1948) A simple objective technique for measuring flexibility in thinking. J Gen Psychol 39:15–22

    Article  CAS  PubMed  Google Scholar 

  18. Novelli G, Papagno C, Capitani E, Laiacona N, Vallar G, Cappa SF (1986) Tre test clinici di ricerca e produzione lessicale.Taratura su soggetti normali. Arch Psicol Neurol Psichiatr 47:477–506

    Google Scholar 

  19. Spinnler H, Tognoni G (1987) Standardizzazione e taratura italiana di test neuropsicologici. Ital J Neurol Sci 8(Suppl):1–120

    Google Scholar 

  20. Rao SM, Cognitive Function Study Group N (1990) A manual for the brief repeatable battery of neuropsychological tests in multiple sclerosis. National Multiple Sclerosis Society, New York

  21. Meyers J, Meyers K (1995) Rey complex figure and recognition trial: professional manual. Psychological Assessment Resources, Odessa

    Google Scholar 

  22. Christodoulou C, MacAllister WS, McLinskey NA, Krupp LB (2008) Treatment of cognitive impairment in multiple sclerosis: is the use of acetylcholinesterase inhibitors a viable option? CNS Drugs 22:87–97

    Article  CAS  PubMed  Google Scholar 

  23. Fischer JS, Priore RL, Jacobs LD, Cookfair DL, Rudick RA, Herndon RM et al (2000) Neuropsychological effects of interferon beta-1a in relapsing multiple sclerosis. Multiple Sclerosis Collaborative Research Group. Ann Neurol 48:885–892

    Article  CAS  PubMed  Google Scholar 

  24. Patti F, Amato MP, Tola MR, Trojano M, Ferrazza P, Bastianello S (2008) Effects of subcutaneous interferon beta on disease parameters and cognition in patients with early relapsing-remitting multiple sclerosis: longitudinal clinical and cognitive result from the COGIMUS (Cognitive Impairment in Multiple Sclerosis) study. Neurology 70:A87

    Google Scholar 

  25. Pliskin NH, Hamer DP, Goldstein DS, Towle VL, Reder AT, Noronha A et al (1996) Improved delayed visual reproduction test performance in multiple sclerosis patients receiving interferon beta-1b. Neurology 47:1463–1468

    CAS  PubMed  Google Scholar 

  26. Barak Y, Achiron A (2002) Effect of interferon-beta-1b on cognitive functions in multiple sclerosis. Eur Neurol 47:11–14

    Article  CAS  PubMed  Google Scholar 

  27. Flechter S, Vardi J, Finkelstein Y, Pollak L (2007) Cognitive dysfunction evaluation in multiple sclerosis patients treated with interferon beta-1b: an open-label prospective 1 year study. Isr Med Assoc J 9:457–459

    CAS  PubMed  Google Scholar 

  28. Weinstein A, Schwid SR, Schiffer RB, McDermott MP, Giang DW, Goodman AD (1999) Neuropsychologic status in multiple sclerosis after treatment with glatiramer. Arch Neurol 56:319–324

    Article  CAS  PubMed  Google Scholar 

  29. Schwid SR, Goodman AD, Weinstein A, McDermott MP, Johnson KP (2007) Cognitive function in relapsing multiple sclerosis: minimal changes in a 10-year clinical trial. J Neurol Sci 255:57–63

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank Wolters Kluwer (Auckland, New Zealand), who provided medical writing support funded by Biogen Idec.

Author information

Authors and Affiliations

  1. Clinical Neuropsychology Unit, Spedali Civili of Brescia, Via Nikolajewka, 13, 25123, Brescia, Italy

    Flavia Mattioli & C. Stampatori

  2. Multiple Sclerosis Centre, Spedali Civili of Brescia, Brescia, Italy

    R. Capra

Authors
  1. Flavia Mattioli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Stampatori
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. Capra
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Flavia Mattioli.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mattioli, F., Stampatori, C. & Capra, R. The effect of natalizumab on cognitive function in patients with relapsing-remitting multiple sclerosis: preliminary results of a 1-year follow-up study. Neurol Sci 32, 83–88 (2011). https://doi.org/10.1007/s10072-010-0412-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-010-0412-4

Keywords

Search

Navigation