title: Treatment of cognitive impairment in patients with multiple sclerosis.
abstract: BACKGROUND
  Identifying and treating cognitive impairment in patients with multiple sclerosis (MS) is increasingly recognized as a crucial step in selecting the most appropriate treatment for the individual. Currently, the neuropsychological tests used to assess patients are time-consuming and require specialist training to administer; consequently, cognitive impairment in MS is underdiagnosed. Many treatments are available for MS, including disease-modifying drugs (DMDs) and symptomatic therapies, but what are their effects on cognitive performance?
  
  
  METHODS
  This article will review published studies describing the cognitive effects of DMDs and symptomatic treatments for MS.
  
  
  CONCLUSIONS
  Some DMDs may improve cognitive performance in patients with MS. None of the symptomatic drug treatments reviewed showed positive effects on cognitive performance, with the possible exception of L-amphetamine, which may improve memory in patients with existing deficits, and methylphenidate, on which more data are needed. Cognitive rehabilitation can improve cognitive performance, but experience with these techniques is limited. Treatment for patients with MS and cognitive impairment should, therefore, include a DMD in combination with a pharmacological or perhaps non-pharmacological cognitive-enhancement strategy. However, the methods used to diagnose cognitive impairment, and to assess the effect of treatment on function over time and need to be refined.
authors.affiliation: University Hospital Catania, Multiple Sclerosis Centre Sicilia Region, First Neurology Clinic, Neuroscience Section, GF Ingrassia Department, Via Santa Sofia 78, 95123 Catania, Italy. patti@unict.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Patti
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000627:therapeutic use; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D009103:Multiple Sclerosis / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D009483:Neuropsychological Tests
chemical_list: D000276:Adjuvants, Immunologic; D007166:Immunosuppressive Agents