[Therapeutic management of cognitive disorders in multiple sclerosis].
Taking in charge cognitive disorders is a new concept in the global care of MS patients. Cognitive disorders are observed in the all forms of the disease, sometimes early on in the evolution. These disorders can be evaluated in details even detected despite any complain in the patient. Because of the lack of clear demonstration that disease-modifying treatments could act on cognition, new specific therapeutic issues have emerged during last years. This article first discusses relationships between disease-modifying treatments and cognition for the different forms of the disease, then analyse the effects of symptomatic drug therapy especially the use of anticholinesterasics. In the last part of the article new issues about antagonists of excitatory amino-acids and individual or group cognitive training are discussed. Recent functional imaging data concerning cerebral adaptation and their modifications by drug or non-drug procedures in MS patients suggest interesting therapeutic development in a next future.
Defer
G-L
GL
Département de neurologie, CHU de Caen, 14033 Caen Cedex, France. defer-gi@chu-caen.fr
Daniel
F
F
Derache
N
N
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D003072:Cognition Disorders / Q000188:drug therapy* / Q000209:etiology* / Q000523:psychology; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D009103:Multiple Sclerosis / Q000150:complications* / Q000523:psychology
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D002800:Cholinesterase Inhibitors; D007155:Immunologic Factors; D007166:Immunosuppressive Agents