Title
Treatment of cognitive deficits in MS
Background
Despite the high prevalence of cognitive impairment in Multiple Sclerosis (MS) and its tremendous effects on working ability and quality of life, evidence-based and effective treatment strategies are still an unmet need and solutions urgently requested.
Objectives
To provide an overview on the efficacy of pharmacological and non-pharmacological approaches in managing cognitive deficits in MS.
Methods
This part of the teaching course will review and critically discuss whether pharmacological and non-pharmacological treatment options have the potential to treat cognitive impairment in MS.
Results
Overall, patients receiving immunotherapy show better cognitive performance than patients under placebo. Since head-to-head studies are missing no clear statement about superiority can be given. Non-pharmacological treatment strategies (e.g. exercise, cognitive training, cognitive behavioral approaches, meditation) have the potential to support cognitive reserve and self-efficacy which in turn helps to manage cognitive impairment.
Conclusions
Immunotherapies are able to stabilize cognitive performance over time or even to improve cognitive status by targeting on inflammation. From all data available it can be assumed that the earlier we treat, the better the cognitive outcome in the long run.
Non-pharmacological treatment strategies offer the opportunity to improve patients’ self-efficacy and cognitive performance, do not have considerable side-effects, are cost-efficient and therefore highly recommendable in treating MS patients with cognitive problems.