Doctors Test Memory Drug For Multiple Sclerosis Patients
June 13, 2001
The University of Rochester Medical Center is leading the first large-scale clinical study ever to address the same kinds of cognitive symptoms in patients with multiple sclerosis as those that may affect President Jeb Bartlet (played by Martin Sheen) on future episodes of the TV show West Wing.
While symptoms like muscle weakness and fatigue are widely recognized as part of MS, the cognitive problems that affect up to 60 percent of patients are not. But having trouble remembering events or conversations, an inability to concentrate, or difficulty finding words, all due to the subtle damage MS causes in the brain, are a big part of the disease for many patients.
"When MS was first described 100 years ago, there was a lot of discussion about cognitive impairment. Somehow doctors lost touch with that aspect of the disease until recent years, when we're recognizing again that it's a significant problem," says Steven Schwid, M.D., assistant professor of neurology, who is lead investigator for the study.
The study will include 240 patients at 21 hospitals and medical centers around the country, including at least a dozen patients at Strong Memorial Hospital in Rochester. The drug being studied is currently approved only for the treatment of mild to moderate dementia from Alzheimer's disease.
About 350,000 people in the United States have the disease, which almost always strikes in young adulthood; besides trauma, it's the top cause of disability in young adults. MS is an autoimmune disease in which the body attacks its own tissues, damaging nerve pathways in the brain and spinal cord.
Symptoms vary greatly, depending on what nerves are damaged, but generally include muscle weakness, cognitive problems, problems with touch and vision, and difficulty with bladder control. Early in the course of MS, symptoms can go into remission for years, then suddenly cause sudden and severe attacks; in others, symptoms worsen gradually over the years. Cognitive problems are unpredictable: Some patients never have a problem, while others have tremendous difficulties with memory, attention, and concentration soon after being diagnosed.
"In the last few years several medicines have become available to treat MS," Schwid says. "These medications help slow the progression of the disease, holding symptoms more stable, but they do not help symptoms that are already present. Right now there is nothing to treat the difficulties with memory that many patients experience."
It's largely due to research by University of Rochester physicians that such a treatment is being considered for MS. Last year Pierre Tariot, M.D., professor of psychiatry, medicine, and neurology, initiated a preliminary study of 17 patients at Monroe Community Hospital and found that a drug approved for the treatment of Alzheimer's patients may be effective in treating cognitive problems in MS patients. The study, published in the Journal of Clinical Psychopharmacology, helped provide data that convinced Schwid and his colleagues to conduct the current study.
People with MS who are having memory problems may be eligible for the study. Participants will have a 50/50 chance of receiving either the medication or a placebo during the study. They will visit doctors at Strong Memorial Hospital seven times over four months for evaluation. Anyone interested in participating study should call (716) 273-1743.