Protection against Cognitive Decline in MS: Longitudinal Investigation of Reserve
National Institutes of Health / National Institute of Child Health and Development
R01(HD082176) PI: JF Sumowski May 1, 2016 – April 30, 2021
Most studies of cognition in persons with MS are cross-sectional, meaning that they examine functional status at one point in time. This includes most studies on protective factors, such as cognitive reserve research on mentally active lifestyles. This R01 project will investigate cognition over three years in about 150 persons with early relapsing-remitting MS, and investigate lifestyle factors associated with preserved memory and cognitive efficiency.
Current R01: We recently earned an NIH grant for a longitudinal multivariate study that aims to better understand differential cognitive decline among patients with relapsing remitting multiple sclerosis (RRMS). We aim to identify predictors of future cognitive decline by looking at a number of variables among a large-scale subject pool at a baseline visit, and again at a 3-year follow-up. The aim is to look at variables for patients early in their diagnosis, and see how their trajectory of debilitation correlates to initial measurements. These variables include measures of maximal lifetime brain growth (MLBG) (acquired through MRI) and/or intellectually-enriching lifestyles. The R01 utilizes the “reserve hypothesis” in attempting to establish predictors for risk of cognitive decline over time. Other aims of this study include looking at markers in blood work, any ameliorating effects that could be due to diet, resting fMRI and possible contribution to cognitive reserve that could be made by recruitment of intact functional networks in the brain. Overall, the aim of the study is to look at whether the presence of factors that contribute to cognitive reserve can attenuate the negative relationship between MRI markers of disease burden (e.g., T2 lesion volume, cerebral atrophy) and cognitive decline over 3 years.
Phase II Clinical Trial – Strattera (atomoxetine): We are currently conducting a phase-two randomized controlled crossover trial of atomoxetine to treat memory impairment due to multiple sclerosis. We hypothesize that this drug, an FDA-approved drug to treat attention deficit hyperactivity disorder (ADHD), is capable of improving memory in MS patient’s experiencing memory deficit. Our subjects will perform a baseline memory evaluation, a 6-week follow-up evaluation after either drug or placebo, and a final 6-week evaluation after opposite trial (placebo if starting with drug, and drug if starting with placebo). We hypothesize that memory testing scores will improve after 6 weeks of atomoxetine as compared to placebo.
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