PMID- 33085811
OWN - NLM
STAT- MEDLINE
DCOM- 20210812
LR  - 20210812
IS  - 1468-1331 (Electronic)
IS  - 1351-5101 (Linking)
VI  - 28
IP  - 3
DP  - 2021 Mar
TI  - Course of neuropsychological impairment during natalizumab-associated progressive 
      multifocal leukoencephalopathy.
PG  - 921-927
LID - 10.1111/ene.14604 [doi]
AB  - BACKGROUND AND PURPOSE: Progressive multifocal leukoencephalopathy (PML), an 
      opportunistic infection of the central nervous system from the John Cunningham 
      virus (JCV), is a side effect of natalizumab (NTZ) treatment for 
      relapsing-remitting multiple sclerosis (RRMS), potentially leading to a 
      substantial increase of physical and mental disability. Nevertheless, data of 
      neuropsychological impairment during the NTZ-PML disease course are missing. Our 
      objective was to evaluate the neuropsychological disease course of NTZ-PML 
      patients and to compare neuropsychological deficits of NTZ-PML patients with two 
      different non-PML multiple sclerosis (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 [IRIS], and [iii] post-IRIS/PML) were retrospectively analyzed and 
      compared to those of NTZ-treated RRMS or secondary progressive MS patients with 
      and without immunotherapy. RESULTS: Compared to controls, NTZ-PML patients 
      performed worse in neuropsychological examinations during all stages of disease, 
      mainly affecting visuospatial ability and working memory. Furthermore, failure to 
      eliminate the JCV from the central nervous system was associated with a 
      progredient decline of cognition, especially working memory. CONCLUSIONS: Working 
      memory and visuospatial abilities are the core neuropsychological deficits of 
      NTZ-PML patients in long-term follow-up. Our findings should be implemented in 
      neurorehabilitation strategies.
CI  - (c) 2020 The Authors. European Journal of Neurology published by John Wiley & Sons 
      Ltd on behalf of European Academy of Neurology.
FAU - Kinner, Markus
AU  - Kinner M
AUID- ORCID: 0000-0001-5790-4164
AD  - Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, 
      Germany.
FAU - Prehn, Christian
AU  - Prehn C
AD  - Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, 
      Germany.
FAU - Schneider, Ruth
AU  - Schneider R
AD  - Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, 
      Germany.
FAU - Schroeder, Christoph
AU  - Schroeder C
AD  - Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, 
      Germany.
FAU - Kolb, Eva
AU  - Kolb E
AD  - Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, 
      Germany.
FAU - Gold, Ralf
AU  - Gold R
AD  - Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, 
      Germany.
FAU - Hoepner, Robert
AU  - Hoepner R
AD  - Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, 
      Germany.
AD  - Department of Neurology, Inselspital, Bern University Hospital, University of 
      Bern, Bern, Switzerland.
FAU - Chan, Andew
AU  - Chan A
AD  - Department of Neurology, St. Josef Hospital, Ruhr University Bochum, Bochum, 
      Germany.
AD  - Department of Neurology, Inselspital, Bern University Hospital, University of 
      Bern, Bern, Switzerland.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20201208
PL  - England
TA  - Eur J Neurol
JT  - European journal of neurology
JID - 9506311
RN  - 0 (Immunologic Factors)
RN  - 0 (Natalizumab)
SB  - IM
MH  - Humans
MH  - Immunologic Factors/adverse effects
MH  - *JC Virus
MH  - *Leukoencephalopathy, Progressive Multifocal/chemically induced
MH  - *Multiple Sclerosis
MH  - *Multiple Sclerosis, Relapsing-Remitting/drug therapy
MH  - Natalizumab/adverse effects
MH  - Retrospective Studies
OTO - NOTNLM
OT  - PML
OT  - Tysabri
OT  - cognition
OT  - natalizumab
OT  - progressive multifocal leukoencephalopathy
OT  - psychiatry
OT  - relapsing-remitting multiple sclerosis
EDAT- 2020/10/22 06:00
MHDA- 2021/08/13 06:00
CRDT- 2020/10/21 15:37
PHST- 2020/06/16 00:00 [received]
PHST- 2020/10/15 00:00 [accepted]
PHST- 2020/10/22 06:00 [pubmed]
PHST- 2021/08/13 06:00 [medline]
PHST- 2020/10/21 15:37 [entrez]
AID - 10.1111/ene.14604 [doi]
PST - ppublish
SO  - Eur J Neurol. 2021 Mar;28(3):921-927. doi: 10.1111/ene.14604. Epub 2020 Dec 8.