title: Natalizumab Significantly Improves Cognitive Impairment over Three Years in MS: Pattern of Disability Progression and Preliminary MRI Findings.
abstract: Previous studies reported that Multiple Sclerosis (MS) patients treated with natalizumab for one or two years exhibit a significant reduction in relapse rate and in cognitive impairment, but the long term effects on cognitive performance are unknown. This study aimed to evaluate the effects of natalizumab on cognitive impairment in a cohort of 24 consecutive patients with relapsing remitting MS treated for 3 years. The neuropsychological tests, as well as relapse number and EDSS, were assessed at baseline and yearly for three years. The impact on cortical atrophy was also considered in a subgroup of them, and are thus to be considered as preliminary. Results showed a significant reduction in the number of impaired neuropsychological tests after three years, a significant decrease in annualized relapse rate at each time points compared to baseline and a stable EDSS. In the neuropsychological assessment, a significant improvement in memory, attention and executive function test scores was detected. Preliminary MRI data show that, while GM volume did not change at 3 years, a significantly greater parahippocampal and prefrontal gray matter density was noticed, the former correlating with neuropsychological improvement in a memory test. This study showed that therapy with Natalizumab is helpful in improving cognitive performance, and is likely to have a protective role on grey matter, over a three years follow-up.
authors.affiliation: Neuropsychology Unit, Spedali Civili of Brescia, Brescia, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Mattioli
authors.affiliation: Neuropsychology Unit, Spedali Civili of Brescia, Brescia, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Stampatori
authors.affiliation: Neuropsychology Unit, Spedali Civili of Brescia, Brescia, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Bellomi
authors.affiliation: Neuropsychology Unit, Spedali Civili of Brescia, Brescia, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Scarpazza
authors.affiliation: Multiple Sclerosis Center of the Spedali Civili of Brescia, Montichiari, Italy.
authors.forename: Ruggero
authors.initials: R
authors.lastname: Capra
mesh_terms: D000328:Adult; D001284:Atrophy / Q000188:drug therapy; D003072:Cognition Disorders / Q000188:drug therapy*; D004185:Disability Evaluation; D006233:Persons with Disabilities; D018450:Disease Progression; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008568:Memory / Q000187:drug effects; D009103:Multiple Sclerosis / Q000188:drug therapy*; D000069442:Natalizumab / Q000627:therapeutic use*; D009483:Neuropsychological Tests
chemical_list: D007155:Immunologic Factors; D000069442:Natalizumab