Cognition and fatigue in multiple sclerosis: Potential effects of medications with central nervous system activity.
To evaluate the potential effects of medications with central nervous system (CNS) activity on cognitive function and fatigue in multiple sclerosis (MS), we performed a retrospective analysis of medication use among 70 subjects with MS who were participating in a clinical trial for evaluation of the effects of yoga and exercise programs on cognition and fatigue. Among these MS subjects, 74% were taking at least one potentially CNS-active medication. These 70 subjects were divided into two groups: those taking at least one CNS-active medication (n = 52) and those not on any medications with potential CNS activity (n = 18). We compared assessments of cognitive function and fatigue using an analysis of covariance. MS subjects on CNS-active medication had greater impairment on measures of processing speed, sustained attention, and fatigue than those not on these medications. While these findings do not establish a causal relationship between medication use and cognitive impairment and fatigue, the data indicate that researchers need to control for use of CNS-active medications when conducting studies of cognitive impairment and fatigue in MS subjects.
Oken
Barry S
BS
Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA. oken@ohsu.edu
Flegal
Kristin
K
Zajdel
Daniel
D
Kishiyama
Shirley S
SS
Lovera
Jesus
J
Bagert
Bridget
B
Bourdette
Dennis N
DN
D000328:Adult; D017677:Age Distribution; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D004359:Drug Therapy, Combination; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008606:Mental Processes / Q000187:drug effects; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000453:epidemiology* / Q000523:psychology; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D011336:Probability; D011379:Prognosis; D011788:Quality of Life; D018570:Risk Assessment; D017678:Sex Distribution; D016896:Treatment Outcome