Course of neuropsychological impairment during Natalizumab associated progressive multifocal leukoencephalopathy.

Kinner, M; Prehn, C; Schneider, R; Schroeder, C; Kolb, E; Gold, R; Hoepner, R; Chan, A (2021). Course of neuropsychological impairment during Natalizumab associated progressive multifocal leukoencephalopathy. European journal of neurology, 28(3), pp. 921-927. Wiley 10.1111/ene.14604

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BACKGROUND

Progressive multifocal leukoencephalopathy (PML) - an opportunistic infection of the central nervous system with the John Cunningham virus (JCV) - is a side-effect of Natalizumab (NTZ) treatment for relapsing remitting (RR) multiple sclerosis (MS), potentially leading to a substantial increase of physical and also mental disability. Nevertheless, data of neuropsychological impairment during NTZ-PML disease course is missing.

OBJECTIVE

To evaluate the neuropsychological disease course of NTZ-PML patients and to compare neuropsychological deficits of NTZ-PML patients with two different non-PML MS cohorts.

METHODS

Neuropsychological examinations of 28 NTZ-PML patients performed during different phases of the disease (I. at PML-diagnosis, II. during immune reconstitution inflammatory syndrome and III. post-IRIS/PML) were retrospectively analyzed and compared to those of NTZ treated RRMS or SPMS patients with and without immunotherapy.

RESULTS

Compared to controls, NTZ-PML patients performed worse in neuropsychological examinations during all stages of disease mainly affecting visuo-spatial abilitiy and working memory. Furthermore, failure to eliminate the JCV from the central nervous system (CNS) was associated with a progredient decline of cognition, especially working memory.

CONCLUSION

Working-memory and visuospatial ability are the core neuropsychological deficits of NTZ-PML patients even in long-term-follow-up. Our finding should be implemented in neurorehabilitation strategies.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Hoepner, Robert and Chan, Andrew Hao-Kuang

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1468-1331

Publisher:

Wiley

Language:

English

Submitter:

Chantal Kottler

Date Deposited:

06 Nov 2020 11:50

Last Modified:

10 Feb 2021 01:32

Publisher DOI:

10.1111/ene.14604

PubMed ID:

33085811

Uncontrolled Keywords:

PML Tysabri cognition natalizumab progressive multifocal leukoencephalopathy psychiatry relapsing remitting multiple sclerosis

BORIS DOI:

10.7892/boris.147711

URI:

https://boris.unibe.ch/id/eprint/147711

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