title: Stability of cognitive functions under mitoxantrone therapy in patients with progressive multiple sclerosis: a pilot analysis.
abstract: OBJECTIVE
  Mitoxantrone (MX) is a potent immunosuppressant that is licensed as escalation therapy for the treatment of active multiple sclerosis (MS).
  
  
  METHODS
  In an open-label, retrospective analysis, we investigated effects of MX therapy on parameters of cognitive functions in patients with progressive MS and significant disability. Twenty patients received a total of 42 mg/m(2) MX in 4 cycles. Six patients who fulfilled the criteria for MX therapy, yet did not receive this treatment, served as controls. Before initiation of therapy and after a mean observation period of 24 months, neurological examination and a neuropsychological test battery were performed. Neuropsychological analyses comprised tests for cognitive flexibility as a part of executive functioning, and verbal as well as non-verbal tests for memory and attention. Additionally, intelligence and symptoms of depression were investigated.
  
  
  RESULTS
  While there was stability of EDSS over time, there were no differences in cognitive functions before and after MX treatment. In contrast, patients not receiving MX showed a worsening of verbal short term memory and cognitive flexibility over the same time period.
  
  
  CONCLUSIONS
  In conclusion, this preliminary observational study points at stability of cognitive functions under MX therapy in patients with progressive multiple sclerosis.
authors.affiliation: Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Gudrunstr. 56, 44791 Bochum, Germany.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Schröder
authors.forename: Peter
authors.initials: P
authors.lastname: Klotz
authors.forename: De-Hyung
authors.initials: DH
authors.lastname: Lee
authors.forename: Ralf
authors.initials: R
authors.lastname: Gold
authors.forename: Ralf A
authors.initials: RA
authors.lastname: Linker
mesh_terms: D000328:Adult; D003071:Cognition / Q000502:physiology*; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D056344:Executive Function / Q000187:drug effects / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007361:Intelligence Tests; D008297:Male; D008568:Memory / Q000187:drug effects / Q000502:physiology; D008875:Middle Aged; D008942:Mitoxantrone / Q000009:adverse effects / Q000627:therapeutic use*; D020528:Multiple Sclerosis, Chronic Progressive / Q000188:drug therapy* / Q000523:psychology*; D009483:Neuropsychological Tests; D012189:Retrospective Studies; D014706:Verbal Learning / Q000187:drug effects / Q000502:physiology
chemical_list: D007166:Immunosuppressive Agents; D008942:Mitoxantrone