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- Title
(NNN03) Preliminary Cognitive Outcomes Following Mesenchymal Stem Cell Therapy in Multiple Sclerosis.
- Authors
Walker, Lisa A. S.; Berard, Jason A.; Abu-AlHawa, Maha; Marrie, Ruth Ann; Marriott, James; Atkins, Harold; Courtman, David; Freedman, Mark S.
- Abstract
Background: Mesenchymal stem cells (MSCs) are being investigated as an alternative disease-modifying therapy for multiple sclerosis (MS) given their immunomodulatory and tissue repair properties. MSCs are multipotent progenitor cells that can differentiate into mesodermal cells with neuroprotective and pro-oligodendrogenic properties. Little is known about potential effects on cognition. Objectives: To evaluate cognition following MSC therapy over 48 weeks. Methods: 28 individuals with inflammatory MS (17 relapsing-remitting MS, 7 secondary progressive MS, 4 primary progressive MS) were enrolled in a randomized, double-blind, sham-controlled cross-over study of autologous MSC with the primary outcome determined at 24 weeks. Participants were randomized to receive either a single intravenous infusion of MSC or a sham infusion at week 0, then crossed over at 24 weeks to the alternate treatment arm for a further 24 weeks of observation. Participants underwent a comprehensive neuropsychological battery at weeks 0, 24, and 48. Cognitive domains assessed included attention/information processing speed, language, visual perception, learning, memory, and executive functioning. To account for potential practice effects associated with serial testing, data were analyzed using reliable change analyses at the individual level. Performance on any given cognitive task was considered improved or declined if most of those who demonstrated change (at least 3 or more) obtained significant RCI values (±1.64). Results: Participants were 15 females/13 males (Expanded Disability Status Scale score 4.27 [1.25], age 37.36 [5.21] years, education 13.64 [1.61] years). Immediately after treatment, relative stability was noted for most cognitive tasks. Nonetheless, some change was detected. Decline was observed in some aspects of attention/information processing speed, visual learning and memory, as well as language. Improvement was noted in verbal learning and memory, as well as visual perception. In the early-treatment group, where longer-term follow-up was possible, there was a trend for performance to return to pretreatment baseline, with the exception of visual learning and memory, which remained below baseline levels. Conclusions: Except for visual learning and memory, there appears to be little detrimental effect of MSC therapy on cognition. While some changes may occur in the initial period following treatment, these appear to be transient and, in general, return to baseline over time.
- Publication
International Journal of MS Care, 2020, Vol 22, Issue S2, p55
- ISSN
1537-2073
- Publication type
Academic Journal