title: Cognition and fatigue in multiple sclerosis: Potential effects of medications with central nervous system activity.
abstract: 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.
authors.affiliation: Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA. oken@ohsu.edu
authors.forename: Barry S
authors.initials: BS
authors.lastname: Oken
authors.forename: Kristin
authors.initials: K
authors.lastname: Flegal
authors.forename: Daniel
authors.initials: D
authors.lastname: Zajdel
authors.forename: Shirley S
authors.initials: SS
authors.lastname: Kishiyama
authors.forename: Jesus
authors.initials: J
authors.lastname: Lovera
authors.forename: Bridget
authors.initials: B
authors.lastname: Bagert
authors.forename: Dennis N
authors.initials: DN
authors.lastname: Bourdette
mesh_terms: 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