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) |
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Division/Institute: |
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology |
UniBE Contributor: |
Hoepner, Robert, 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: |
05 Dec 2022 15:41 |
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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