Impiego del modafinil nel trattamento dei disturbi cognitivi nella sclerosi multipla

Multiple Sclerosis (MS) is a chronic inflammatory disease with typical areas of demyelination and of axonal loss into CNS. MS presents a lot of symptoms, but Cognitive symptoms and Fatigue are very common and, at the moment, there are not specific therapies for cognitive and for fatigue. Aim of this study was to assess the effects of Modafinil on cognition and, secondary, on the fatigue. Modafinil is a memory improving and mood brightening psycostimulant; it enhances wakefulness and vigilance in part by its action in the anterior hipothalamus. It inhibits the reuptake of noradrenaline by the noradrenergic neurons, increase excitatory glutamatergic transmission, reduce GABA activity etc. Modafinil is already proving in the treatment of narcolepsy, and, experimentally, it is used in the treatment of fatigue in many diseases; also it’is studied in cognition deficit and in add-therapy in depression. Every patient included in this study was evalueted for cognitive deficits with a repeatible neuropsychological battery (at the baseline and after one month therapy). The same was evaluate for the efficacy on fatigue with a specific scale ( FSS ). All the patients were evalueted also for mood disturbances with the Montgomery Asberg Depression Rating Scale (MADRS). Our data seem show an efficacy on some cognitive skills (sustained attention and working memory) in the PASAT test during therapy , but there’s not improvement on fatigue. The MADRS shows an improvement on mood with decreasing of depression.