Centre researchers find cognition and mental health historically neglected in MND clinical trials

hand pressing a stethoscope to a white brain model

September 2020: The findings of a review published this week encourage future clinical trials to evaluate the impact of drugs on psychiatric health and cognition.

A team of researchers from the Euan MacDonald Centre, led by Centre PhD student Emily Beswick, have reviewed the use of neuropsychiatric and cognitive assessments in MND clinical trials over the last 25 years, since the licensing of Riluzole.

Neuropsychiatric symptoms are mental health disorders, such as anxiety and depression, which are linked to diseases of the nervous system. Cognition refers to learning, memory and behaviour. 

216 trials were reviewed by the researchers and only 3% of the trials looked at the impact of the possible new drug on neuropsychiatric symptoms, and 4% considered how participants’ cognition was affected.

Amongst people with the amyotrophic lateral sclerosis (ALS) form of MND, up to 50% of people can experience cognitive and behavioural changes. In 15% of individuals with ALS, the changes can be severe enough to lead to a diagnosis of frontotemporal dementia. Depression and anxiety are also commonly experienced amongst people diagnosed with MND. These symptoms affect people’s quality of life, and can be associated with increased disability and shorter life expectancy for those affected.  

Historically, outcomes in clinical trials have focussed on the effect of drugs on physical functioning and the importance of cognition and mental health has frequently been neglected.

Whilst the researchers acknowledge that how a potential drug can slow physical decline and improve survival must remain the focus of MND trials, they recommend that future trials also consider how these drugs affect the broader range of MND symptoms, including neuropsychiatric and cognitive health. 

Related links

Read the scientific article (open access): Beswick et al. A systematic review of neuropsychiatric and cognitive assessments used in clinical trials for amyotrophic lateral sclerosis. J Neurol, 2020. DOI: 10.1007/s00415-020-10203-z

Emily Beswick profile

This article was published on: Wednesday, September 09, 2020