By Michael Wentzel
Democrat and Chronicle
(Thursday, June 14, 2001) -- University of Rochester Medical Center doctors are leading the first large-scale clinical study of a drug that could treat the loss of memory and ability to concentrate experienced by some people with multiple sclerosis.
A small study by UR Medical Center doctors found that several patients with MS improved while on a medicine currently used to treat memory problems in patients with Alzheimer's disease.
"In the last few years several medicines have become available to treat MS," said Dr. Steven Schwid, UR assistant professor of neurology, who is lead investigator for the new study. "These medications help slow the progression of the disease, holding symptoms more stable, but they do not improve symptoms that are already present. Right now there is nothing to treat the difficulties with memory that many patients experience."
The study will include 240 patients at 21 hospitals and medical centers around the country. The drug under study, Aricept, currently is approved only for the treatment of mild to moderate dementia from Alzheimer's disease.
About 350,000 people in the United States have MS, an autoimmune disease in which the body attacks its own tissues, damaging nerve pathways in the brain and spinal cord.
Symptoms generally include muscle weakness, touch and vision problems, and difficulty with bladder control. Many MS patients also develop cognitive problems.
Aricept appears to work by boosting the amount of acetylcholine, a chemical present in the brain that is crucial to memory and possibly other cognitive functions.
The causes of cognitive problems are different in people with Alzheimer's and MS, but researchers believe the drug could help both.
"It is conceivable that with the brain lesions caused by MS, the distribution of acetylcholine might be disrupted," Schwid said.
"Anything we can do to augment the remaining acetylcholine could help."
The idea for a study of the drug can be traced to an MS patient who consulted four years ago with Dr. Pierre Tariot about his sense that he was losing some of his memory and other cognitive abilities. The patient asked whether medication used for Alzheimer's might help.
"It was unconventional but he had a real damn-the-torpedoes attitude. He wanted to go ahead," said Tariot, a UR professor of psychiatry, medicine and neurology.
Tariot agreed to prescribe the drug and the results were dramatic.
In all, Tariot, assisted by Schwid and others, tested the drug on 17 people in the Rochester area with serious problems.
"Half the patients showed clearly observable improvement," Tariot said. "You could tell simply by chatting with them that they were thinking more clearly. In many patients, we also saw changes in temperament. They were often less irritable, depressed or agitated."
Conclusions from the small study, however, were limited by its size. Each patient and doctor knew what drug was being given.
"This could have affected the results," Schwid said.
People with MS who are having memory problems may be eligible for the study. Participants will receive either the drug or a placebo during the study. They will visit doctors at Strong Memorial Hospital seven times over four months for evaluation.
The manufacturer of Aricept is providing funding for the study. Results will be known in about two years, Schwid said.
Anyone interested in participating, should call 273-1743.