Posted by: Thixia | May 1, 2008

Nature of Cognitive Dysfunction in MS 6 of 6



There is a single clinical trial of MS that evaluated magnets for MS-related cognitive dysfunction.  That trial, which involved 30 people, evaluated cognition as one part of a battery of tests that also measured spasticity, bladder control, fatigue, mobility and vision.   As compared with sham magnets, the group receiving the actual magnetic therapy did better on the composite score.  There have also been a few published reports about individual cases in which magnet therapy improved cognitive function.



Music Therapy: 

Music, sometimes described in medical terms and an “aural stimulant,” can motivate, conjure memories, and affect mood.  Music therapy has received serious study in some medical conditions, especially Alzheimer’s disease and Parkinson’s disease, and, indeed, there is some evidence that music therapy can reduce the social, emotional, and physical disabilities that may accompany these diseases.  Whether music might help with cognitive function in MS has been the subject of one small and preliminary study.  Among people who complained of memory problems, information presented in the form of a melody may have been more easily remembered than information presented in spoken form.   However, the difference between the groups was small and may have been due to the effects of chance alone.



4-AP (4—aminopyridine):

4-AP is an experimental drug that has been studied to a limited extent among people with MS.  Technically, 4-AP blocks molecules on nerve cells known as potassium channels.  By this mechanism, 4-AP may improve nerve conduction along nerves that have been damaged by MS.   A small trial was conducted to determine whether 4-AP might improve cognitive function among people with MS.  No beneficial effect was observed in this trial.   Serious side effects of 4-AP treatment may include seizures, confusion, and liver damage.




VI.   Conclusion


Many people with MS will not experience cognitive problems.  Furthermore, when cognitive problems do occur, they are often mild and sometimes affect only certain aspects of cognition.  


There is both clinical evidence and a logical basis to assume that MS-related cognitive decline can be slowed by injectable medications.  Those with concerns about cognitive dysfunction should consult their health care providers.  Identifying the complex factors that might be involved is a critical step in treatment.  In addition, safety issues should sometimes be considered, and, in some cases, a driving evaluation should be conducted.  There are no well-established treatments for MS-related cognitive dysfunction, but there is preliminary evidence to show that some interventions, such as cognitive rehabilitation therapy, Aricept, ginkgo biloba, and exercise may be helpful.



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