Evaluation of cognitive functions in multiple sclerosis patients under treatment

The Statement of Problem and the Objectives: Multiple Sclerosis (MS) is an inflammatory disease of the central nervous system. Cognitive impairment and depression are the most common psychiatric symptoms. Cognitive impairment is evident in 40-65% among MS patients and it is most common in memory, attention and information processing functions. Dalfampridine has been approved for the symptomatic treatment of gait disorders in patients with MS. It is possible that dalfampridine could improve the cognitive functions, as well. The aim of this study is to examine the effects of dalfampridine treatment on cognitive functions. Methods and Procedures: Twelve MS patients, who were on follow-up at the Neurology Outpatient Clinic of Istanbul University Istanbul Faculty of Medicine, were recruited for the study. All were planned to start on dalfampridine and were applied the following neuropsychological tests at baseline (pretest) and at the 10th week (posttest) of the treatment. The cognitive functions were assessed using the Multiple Sclerosis Functional Composite (MSFC), Benton Judgement of Line Orientation Test (JLO), Word List Generation (WLG), Auditory Verbal Learning Tedst, Stroop Color Word Interference Test (ST), Symbol Digit Modalities Test (SDMT). The Center of Epidemiologic Studies Depression Scale (CES-D) and the Hospital Anxiety and Depression Scale (HADS) were also applied. All pre- and post-treatment meausures were compared. Results and Conclusions: The mean age of the sample (7 females, 5 males) was 42,75±10,58. At the 10th week of treatment significant improvements were observed at the SDMT (p=0,005), PASAT 3" (p=0,009), PASAT 2'' (p=0,033), JLO (p=0,01), WLG (p=0,003), 9 HPT Dominant hand right (p=0,005), T25FW (p=0,007) and two subcategories of Stroop Test "Color Word" (p=0,002), Enterferance (p=0,005). Dalfampridine shows promising results in improving cognition and depression in MS patients. Future studies with larger samples and longer follow-ups are needed in order to evaluate the effects of dalfampridine treatment on cognitive functions in MS patients. Key words: Multiple sclerosis, cognitive functions, dalfampridine, depression, neuropsychological assessment.