Therapeutic management of cognitive disorders in multiple sclerosis

• Published in: Revue neurologique 2007-06, Vol.163 (6-7), p.703-710
• Main Authors: Defer, G-L, Daniel, F, Derache, N
• Format: Article
• Language: fre
• Subjects: Adrenal Cortex Hormones; Adrenal Cortex Hormones - therapeutic use; Anti-Inflammatory Agents; Anti-Inflammatory Agents - therapeutic use; Cholinesterase Inhibitors; Cholinesterase Inhibitors - therapeutic use; Cognition Disorders; Cognition Disorders - drug therapy; Cognition Disorders - etiology; Cognition Disorders - psychology; Humans; Immunologic Factors; Immunologic Factors - therapeutic use; Immunosuppressive Agents; Immunosuppressive Agents - therapeutic use; Life Sciences; Multiple Sclerosis; Multiple Sclerosis - complications; Multiple Sclerosis - psychology; Neurons and Cognition
• ISSN: 0035-3787
• DOI: 10.1016/S0035-3787(07)90483-X

Taking in charge cognitive disorders is a new concept in the global care of MS patients. Cognitive disorders are observed in the all forms of the disease, sometimes early on in the evolution. These disorders can be evaluated in details even detected despite any complain in the patient. Because of the lack of clear demonstration that disease-modifying treatments could act on cognition, new specific therapeutic issues have emerged during last years. This article first discusses relationships between disease-modifying treatments and cognition for the different forms of the disease, then analyse the effects of symptomatic drug therapy especially the use of anticholinesterasics. In the last part of the article new issues about antagonists of excitatory amino-acids and individual or group cognitive training are discussed. Recent functional imaging data concerning cerebral adaptation and their modifications by drug or non-drug procedures in MS patients suggest interesting therapeutic development in a next future.