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Effects of Rivastigmine on Memory and Cognition in Multiple Sclerosis

Published online by Cambridge University Press:  02 December 2014

Vahid Shaygannejad ,
Mohsen Janghorbani ,
Fereshteh Ashtari ,
Hamid Afshar Zanjani  and
Naser Zakizade
Vahid Shaygannejad
Affiliation:
Department of Neurology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
Mohsen Janghorbani*
Affiliation:
Medical School Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
Fereshteh Ashtari
Affiliation:
Department of Neurology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
Hamid Afshar Zanjani
Affiliation:
Department of Psychiatry, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
Naser Zakizade
Affiliation:
Department of Neurology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
*
Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran.
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Abstract

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Background:

Cognitive dysfunction is one of the common clinical symptoms in multiple sclerosis (MS), but there is no effective treatment for it.

Objective:

The aim of this study was to evaluate the effect of rivastigmine in treating memory and cognitive dysfunction in MS.

Methods:

A single-center double-blind placebo-controlled randomized clinical trial conducted from October 2005 to February 2007. Sixty definite MS patients with cognitive impairment age 16 to 54 years were randomly allocated to receive a 12-week treatment course of either rivastigmine (1.5 mg once a day increment over 4 weeks to 3 mg twice daily) or placebo. Response to treatment was assessed by the Wechsler Memory Scale (WMS) at baseline and 12 weeks after start of therapy.

Results:

A slight, but significant memory improvement occurred in both groups. Of the 30 patients treated with rivastigmine, the mean (SD) WMS general memory score increased from 60.3 (4.2) at baseline to 64.9 (5.3) at the end of study period (P<0.001). Correspondingly, in the 30 patients treated with placebo, the mean (SD) WMS general memory score increased from 60.5 (4.9) to 64.5 (3.7) (P < 0.001). The average WMS general memory score at the end of trial did not changed between rivastigmine and placebo group (mean difference, 0.4; 95% CI, -2.0, 2.8).

Conclusion:

No significant differences were seen between rivastigmine and placebo on the mean (SD) WMS general memory score. A larger multicenter study of rivastigmine in MS is warranted in order to more definitely assess the efficacy of this intervention.

Résumé:

RÉSUMÉ:Contexte:

La dysfonction cognitive est l’un des symptômes cliniques fréquents dans la sclérose en plaques (SEP), pour lequel il n’existe aucun traitement efficace. Objectif : Le but de cette étude était d’évaluer l’effet de la rivastigmine dans le traitement de la dysfonction mnésique et cognitive de la SEP.

Méthodes:

Nous avons effectué un essai clinique randomisé à double insu, contrôlé par placebo, dans un seul centre entre octobre 2005 et février 2007. Soixante patients atteints de SEP certaine avec atteinte cognitive, âgés de 16 à 54 ans, ont été randomisés à recevoir un traitement par la rivastigmine (1,5 mg une fois par jour avec augmentation progressive de la dose sur une période de 4 semaines jusqu’à une dose de 3 mg deux fois par jour) ou un placebo pendant 12 semaines. Le Wechsler Memory Scale (WMS) utilisé en début d’étude et après 12 semaines de traitement a servi à évaluer la réponse au traitement.

Résultats:

Une amélioration a été observée dans les deux groupes. Cette amélioration, bien que légère, était significative. Chez les 30 patients sous rivastigmine, le score général moyen pour la mémoire auWMS est passé de 60,3 (ÉT 4,2) avant traitement à 64,9 (ÉT 5,3) à la fin de la période de traitement (p < 0,01). Chez les 30 patients sous placebo, le score général moyen pour la mémoire au WMS est passé de 60,5 (4,9) à 64,5 (ÉT 3,7) (p < 0,001). La moyenne du score général pour la mémoire au WMS à la fin de l’étude n’avait pas changé significativement entre les deux groupes (différence moyenne 0,4; IC à 95% : –2,0 à 2,8).

Conclusion:

Aucune différence significative du score général pour la mémoire au WMS n’a été observée entre les patients qui ont reçu la rivastigmine et ceux qui ont reçu le placebo. Une étude multicentres de plus grande envergure sur l’utilité de la rivastigmine dans la SEP est justifiée, afin d’évaluer de façon définitive l’efficacité de cette intervention.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 35 , Issue 4 , September 2008 , pp. 476 - 481
Copyright
Copyright © The Canadian Journal of Neurological 2008

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