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 In General Medicine

Researchers, led by Dr Jeremy Chataway (UCL Institute of Neurology), previously reported the effect of a high dosage of simvastatin, a type of statin widely used to reduce cholesterol and already known to be safe, on brain atrophy (shrinkage) in SPMS in 2014.

Now, after studying the same cohort of patients from that trial, the team have confirmed a positive effect of simvastatin on frontal lobe function and physical quality of life.

This study used simvastatin at 80mg versus a placebo in 140 people with secondary progressive MS (SPMS). A range of cognitive assessments were carried out in this substudy, including the National Adult Reading Test, the Visual Object and Space Perception battery (cube analysis) and the Frontal Assessment Battery.

The Frontal Assessment Battery is a bedside assessment often used to assess some forms of frontal dementia. It encompasses features such as concepts and mental flexibility which reflect the way we interact with the world and modulate our decision-making.

Cognitive, neuropsychiatric, and health-related quality of life was assessed by neuropsychologists as well as self-reporting by the participants at 12 and 24 months.

At 24 months, the Frontal Assessment Battery score was 1.2 points higher in the simvastatin-treated group than in the placebo group. The simvastatin group also had a 2.5 points better mean physical component score of self-reports.

Dr Chataway explained, ‘The study is clinically important because patients with MS, in particular those with progressive MS, have a significant but under-reported, cognitive burden, such as memory, processing and mental flexibility. We have shown in this early work that simvastatin can help that part of it.’
There are approximately 100,000 people in the UK with MS. At about 10 to 15 years into the disease, at least half will become secondary progressive, characterised by greater disability, and gradual worsening of the condition. There are very few treatments that stop this worsening.

Dr Chataway said, ‘This study is an important small step in reinforcing the need to study cognition in MS and to continue to advance its treatment. Following on from this study we would recommended focusing the study on those aspects of cognition which are most frequently affected.’

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