Cognitive dysfunction in patients with multiple sclerosis treated with different types of interferon beta: a randomized clinical trial.
BACKGROUND
Multiple sclerosis (MS) is a chronic autoimmune disease that can deteriorate cognitive function in at least 50% of patients even in the early stages.


OBJECTIVE
We conducted a three-arm parallel study with balanced randomization to evaluate the effect of various disease-modifying therapies (DMTs) on cognitive function in MS.


METHODS
Ninety newly diagnosed, definite MS subjects referred to Ghaem Medical Center, Mashhad, Iran, were enrolled into this study between 2006 and 2009. They were randomly categorized into three DMT groups; Avonex, Rebif and Betaferon. Cognition status was assessed in MS patients at baseline and 12 months after treatment with DMTs using the 5 tests of the Brief Repeatable Battery of Neuropsychological Tests (BRB-N).


RESULTS
The Symbol Digit Modalities Test scores improved in all groups at 12 month vs. baseline (Avonex: 34.50 vs. 38.95, p=0.011; Rebif: 35.30 vs. 40.13, p=0.001; Betaferon: 26.18 vs. 29.32, p=0.029). The Selective Reminding Test (SRT)-Total, the 10/36-Delay, and the Paced Auditory Serial Addition Test-Easy were improved in Avonex and Rebif but not in Betaferon group. The SRT-Delay and Word List Generation were improved only in the Avonex group. There was no significant difference in other components of the BRB-N among these three treatment groups.


CONCLUSIONS
Different types of DMTs may improve some aspects of cognitive function in patients with MS. Treatment with Avonex and Rebif (Interferon beta-1a preparations) were more helpful in resolving the cognitive impairments in MS patients compared to Betaferon (Interferon beta-1b) as investigated in this study.
Department of Psychiatry, Avicenna Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Naghmeh
N
Mokhber
Department of Biological and Diagnostic Sciences, Faculty of Dentistry, University of Toronto, Canada; Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Canada; Toronto Health Economics and Technology Assessment Collaborative, University of Toronto, Canada.
Amir
A
Azarpazhooh
Department of Neurology, Ghaem Medical Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Elias
E
Orouji
Neurological Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
Stephen M
SM
Rao
Toronto, Canada.
Bita
B
Khorram
Department of Neurology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Mohammad Ali
MA
Sahraian
Department of Neurology, Ghaem Medical Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Mohsen
M
Foroghipoor
Department of Psychology, Avicenna Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Morteza Modares
MM
Gharavi
Mashhad University of Medical Sciences, Mashhad, Iran.
Sorayya
S
Kakhi
Department of Neurology, Ghaem Medical Center, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address: NikkhahK@mums.ac.ir.
Karim
K
Nikkhah
Department of Neurology, Ghaem Medical Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Mahmoud Reza
MR
Azarpazhooh
D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000328:Adult; D003072:Cognition Disorders / Q000150:complications / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D000068556:Interferon beta-1a; D000068576:Interferon beta-1b; D016899:Interferon-beta / Q000627:therapeutic use*; D008297:Male; D009103:Multiple Sclerosis / Q000150:complications / Q000188:drug therapy*; D009483:Neuropsychological Tests; D016896:Treatment Outcome; D055815:Young Adult
D000276:Adjuvants, Immunologic; D000068576:Interferon beta-1b; D016899:Interferon-beta; D000068556:Interferon beta-1a
Clinical trial; Cognitive dysfunction; Disease-modifying therapies; Memory; Multiple sclerosis; Processing speed