Anticholinesterasics in the treatment of cognitive impairment in multiple sclerosis

Neuropsychological impairment is a common manifestation in multiple sclerosis (MS) and is found in 40-60% of patients. The pattern of cognitive impairment in MS is characterized by difficulties in recent memory, sustained attention, executive functions and information processing speed. These cognitive deficits have a significant impact on the patients' daily activities. However, there is no specific treatment available at present for cognitive disorders in MS patients. Treatment with acetylcholinesterase inhibitors (AChEI) has shown a positive effect on cognitive functions of patients with Alzheimer's disease and other conditions such as Lewy Body dementia, subcortical vascular dementia and Parkinson's disease. In this paper we review the results from studies and clinical trials aiming to demonstrate that AChEI could be a potential treatment for cognitive disorders in MS patients. Finally, we discuss future issues to take into consideration for AChEI treatments in the context of MS.