The Impact of Cladribine Tablets on Cognition Over One Year in Patients With Multiple Sclerosis: A Preliminary Study.
4 affiliations
- 1Brigham MS Center, Department of Neurology, Brigham and Women's Hospital/Mass General Brigham, Harvard Medical School, Boston, Massachusetts, USA.
- 2Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
- 3Neurology Center of New England, Foxborough, Massachusetts, USA.
- 4Multiple Sclerosis Center of Rhode Island, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Abstract
Introduction
Cognitive impairment is common in multiple sclerosis (MS), affecting >40% of patients. Cladribine tablets are a high-efficacy MS disease-modifying therapy to prevent relapses and limit disease progression. Our previous study showed cortical gray matter lesion stability over one year after the start of cladribine, though its effect on cognition is not well known. This study aimed to investigate the one-year impact of cladribine tablets on cognition in multiple sclerosis.Methods
Fourteen MS subjects [age (mean ± SD) 50.2 ± 10.8, 7.14% men, 57.1% relapsing-remitting MS (n = 8), 42.9% secondary progressive (n = 6), expanded disability status scale 4.1 ± 2.1] were administered the Brief Repeatable Battery of Neuropsychological Tests (BRB-N) and the Stroop Color and Word Test (Stroop) at an average of 1.5 months from cladribine start. The BRB-N measures information processing speed (Symbol Digit Modalities Test, Paced Auditory Serial Addition Test [PASAT]), verbal memory (Selective Reminding Test [SRT]), visual-spatial memory (10/36 Spatial Recall Test), and verbal fluency (Word List Generation). Stroop assesses processing speed and executive function. When available, alternate versions of the individual cognitive tests were used at follow-up to reduce practice effects. Paired t-tests compared within-subject baseline and follow-up data.Results
After one year, no worsening was noted on any cognitive test. Furthermore, both PASAT 3-second total correct and SRT total delayed recall trended toward improved scores on-study, with an average 3.4 (p = 0.07) and 1.1 (p = 0.05) point increase, respectively.Conclusion
In this preliminary study, no clear decline in cognitive performance was detectable over one year in patients newly started on cladribine tablets.
Related
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- Long-Term Disease Control Following Completion of Cladribine Treatment in Multiple Sclerosis: Extended Follow-Up of the CladStop Cohort.
- Predicting follow-up cognition using estimated structural and functional connectivity networks and artificial intelligence in multiple sclerosis
- The Efficacy and Safety of Dalfampridine on Cognition and Fatigue in People With Multiple Sclerosis: A Systematic Review and Meta-Analysis
- Rest-activity and circadian rhythm parameters relate to cognition and disability outcomes in multiple sclerosis
BibTeX
@article{callen2026impact,
title = {{The Impact of Cladribine Tablets on Cognition Over One Year in Patients With Multiple Sclerosis: A Preliminary Study.}},
author = {Alexis M Callen and Bonnie I Glanz and Shahamat Tauhid and Brian C Healy and Ariele Jinich and Samar Khalil and Maria K Houtchens and Farrah J Mateen and Salvatore Napoli and Syed Rizvi and Tarun Singhal and Jonathan Zurawski and Rohit Bakshi},
journal = {Brain and behavior},
year = {2026},
month = oct,
doi = {10.1002/brb3.71844},
url = {https://europepmc.org/article/MED/42949125},
note = {CC BY},
}
RIS
TY - JOUR
TI - The Impact of Cladribine Tablets on Cognition Over One Year in Patients With Multiple Sclerosis: A Preliminary Study.
AU - Alexis M Callen
AU - Bonnie I Glanz
AU - Shahamat Tauhid
AU - Brian C Healy
AU - Ariele Jinich
AU - Samar Khalil
AU - Maria K Houtchens
AU - Farrah J Mateen
AU - Salvatore Napoli
AU - Syed Rizvi
AU - Tarun Singhal
AU - Jonathan Zurawski
AU - Rohit Bakshi
PY - 2026
DA - 2026/10/28
JO - Brain and behavior
DO - 10.1002/brb3.71844
UR - https://europepmc.org/article/MED/42949125
AB - Introduction Cognitive impairment is common in multiple sclerosis (MS), affecting >40% of patients. Cladribine tablets are a high-efficacy MS disease-modifying therapy to prevent relapses and limit disease progression. Our previous study showed cortical gray matter lesion stability over one year after the start of cladribine, though its effect on cognition is not well known. This study aimed to investigate the one-year impact of cladribine tablets on cognition in multiple sclerosis.Methods Fourteen MS subjects [age (mean ± SD) 50.2 ± 10.8, 7.14% men, 57.1% relapsing-remitting MS (n = 8), 42.9% secondary progressive (n = 6), expanded disability status scale 4.1 ± 2.1] were administered the Brief Repeatable Battery of Neuropsychological Tests (BRB-N) and the Stroop Color and Word Test (Stroop) at an average of 1.5 months from cladribine start. The BRB-N measures information processing speed (Symbol Digit Modalities Test, Paced Auditory Serial Addition Test [PASAT]), verbal memory (Selective Reminding Test [SRT]), visual-spatial memory (10/36 Spatial Recall Test), and verbal fluency (Word List Generation). Stroop assesses processing speed and executive function. When available, alternate versions of the individual cognitive tests were used at follow-up to reduce practice effects. Paired t-tests compared within-subject baseline and follow-up data.Results After one year, no worsening was noted on any cognitive test. Furthermore, both PASAT 3-second total correct and SRT total delayed recall trended toward improved scores on-study, with an average 3.4 (p = 0.07) and 1.1 (p = 0.05) point increase, respectively.Conclusion In this preliminary study, no clear decline in cognitive performance was detectable over one year in patients newly started on cladribine tablets.
SN - 2162-3279
ER -