Kessler Foundation Research Center, West Orange, NJ 07052, USA.
Mult Scler. 2011 Sep;17(9):1141-5. doi: 10.1177/1352458511404585. Epub 2011 May 11.
Memory impairment is prevalent in multiple sclerosis (MS), but no drugs are approved to treat these memory problems.
The objective of the study was to examine the effect of l-amphetamine versus placebo on auditory/verbal memory and visual/spatial memory in MS patients with and without baseline memory impairment.
We conducted a re-analysis of a previously published clinical trial in which MS patients were randomly assigned to treatment (30 mg l-amphetamine, N = 99) or placebo (N = 37) in a four-week, double-blind, parallel-group, dose titration trial. Auditory/verbal memory (CVLT-II: Long Delay Free Recall) and visual/spatial memory (BVMT-R: Delayed Recall) were assessed at baseline and follow-up across subgroups of patients with intact baseline memory (mean = 50th percentile) or impaired baseline memory (mean = 2nd percentile). Primary analyses: 2 (l-amphetamine, placebo) × 2 (baseline, follow-up), × 2 (baseline memory intact, baseline memory impaired) ANOVAs performed separately for auditory/verbal and visual/spatial memory.
For both auditory/verbal and visual/spatial memory, we observed significant 2 × 2 × 2 interactions whereby l-amphetamine improved memory more than placebo, and this effect was specific to patients with baseline memory impairment.
Among memory-impaired patients, memory improved about 48.5% for those on l-amphetamine, but only 1.0% on placebo. Treatment with l-amphetamine produced large memory gains among memory-impaired MS patients.
记忆障碍在多发性硬化症(MS)中很常见,但尚无药物被批准用于治疗这些记忆问题。
本研究旨在检查苯丙胺与安慰剂对有或无基线记忆障碍的 MS 患者的听觉/言语记忆和视觉/空间记忆的影响。
我们对先前发表的一项临床试验进行了重新分析,该试验将 MS 患者随机分配至治疗组(30mg 苯丙胺,N=99)或安慰剂组(N=37),进行为期四周的双盲、平行组、剂量滴定试验。在基线和随访时评估听觉/言语记忆(CVLT-II:长延迟自由回忆)和视觉/空间记忆(BVMT-R:延迟回忆),根据基线记忆正常(平均值=第 50 个百分位数)或基线记忆受损(平均值=第 2 个百分位数)的患者亚组进行评估。主要分析:对听觉/言语和视觉/空间记忆分别进行 2(苯丙胺,安慰剂)×2(基线,随访)×2(基线记忆正常,基线记忆受损)方差分析。
对于听觉/言语和视觉/空间记忆,我们观察到显著的 2×2×2 交互作用,即苯丙胺改善记忆的效果优于安慰剂,且这种效果仅针对基线记忆受损的患者。
在记忆受损的患者中,接受苯丙胺治疗的患者记忆改善了约 48.5%,而接受安慰剂治疗的患者仅改善了 1.0%。苯丙胺治疗可使记忆受损的 MS 患者获得较大的记忆改善。