Hugh Laurence, 75, and his son Jack, 38, are meeting
after a 20-year estrangement. There aren't many fond memories, so both father
and son agree it's maybe not so bad that Hugh's Alzheimer's and Jack's multiple
sclerosis prevent them from remembering the bad times. But both of them may share
more than memory loss. Though their diseases apparently have as little in common
as Jack and Hugh, donepezil — Hugh's Alzheimer's treatment — may be
beneficial in MS as well. The drug could improve memory in cognitively impaired
MS patients like Jack. Researchers from New York
State University's Stony Brook Hospital tested donepezil in 69 MS patients with
cognitive impairment. Half were randomized to the drug, while the rest took placebo
in a double-blinded trial that lasted six months. The research is published in
the November 9 issue of Neurology. The patients
were scored at the beginning of the study and at the end using the Selective Reminding
Test, which gauges their verbal memory. Subjects were also assessed on a range
of other neuropsychological tests. While, donepezil didn't affect scores on most
cognitive tests, those taking it did show significant memory enhancement. Their
scores on the Selective Reminding Test went up 14% over the study period, compared
to a 3% improvement among patients on placebo. The patients
taking donepezil were also more than twice as likely to self-report improvement
in memory as those taking the placebo. Similarly, clinicians blinded to the treatment
regimes were twice as likely to report cognitive improvement in their donepezil
patients. HEAD SCRATCHER
The
findings are doubly interesting because there's no theoretical basis for believing
that donepezil should help MS patients. In Alzheimer's disease this acetylcholinesterase
inhibitor blocks the breakdown of acetylcholine. But acetylcholine is not considered
an important player in MS symptoms. Lead author Dr Lauren
Krupp comments: "MS is not known to result in the reduction of acetylcholine.
But evidence suggests that there's a decrease in cholinergic activity, likely
resulting from the disruption of cholinergic pathways by the demyelination and
axonal damage to the nerves that occurs in MS." She
did, however, advise caution before making any clinical decisions. "MS patients
typically take several drugs already, so before any new treatment is added for
symptoms, we should have strong evidence that it will truly be beneficial."
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