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Pharmacologic treatment for memory disorder in multiple sclerosis.

Dian He¹, Hongyu Zhou, Duan Guo

¹Department of Neurology, Affiliated Hospital of Guiyang Medical College, No. 28, Gui Yi Street, Guiyang, Guizhou Province, China, 550004.

The Cochrane Database of Systematic Reviews

|October 7, 2011

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Transcranial Direct Current Stimulation (tDCS) for Memory Enhancement

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Area of Science:

Neurology
Clinical Pharmacology

Background:

Memory disorder is a common cognitive impairment in multiple sclerosis (MS) patients, significantly impacting quality of life.
Existing randomized controlled trials show limited efficacy of pharmacological agents for MS-related memory deficits.

Purpose of the Study:

To evaluate the efficacy, tolerability, and safety of pharmacological treatments for memory disorder in adult MS patients.
To compare different pharmacologic interventions for memory impairment in multiple sclerosis.

Main Methods:

Systematic search of multiple databases (Cochrane MS Group, PsycINFO, CBMdisc) and trial registers up to April 2011.
Inclusion of double-blind, randomized controlled trials (RCTs) of pharmacologic treatments versus placebo for memory disorder in MS patients (duration ≥12 weeks).
Independent assessment of trial quality and data extraction by two reviewers.

Main Results:

Four RCTs evaluated donepezil, Ginkgo biloba, memantine, and rivastigmine against placebo in MS patients with memory impairment.
No serious adverse events were reported; common side effects like nausea and diarrhea were infrequent.
Included studies were of low quality, with small sample sizes and short follow-up periods. Three additional RCTs are ongoing.

Conclusions:

There is currently insufficient evidence to support the use of pharmacological interventions for memory disorder in MS patients.
Donepezil, Ginkgo biloba, memantine, and rivastigmine demonstrated safety and good tolerability in the evaluated trials.
High-quality randomized controlled trials are necessary to establish the efficacy of these treatments for memory deficits in MS.