Cooling:
In small studies, cooling techniques, or lowering the body temperature, has been reported to improve multiple symptoms among people with MS. In one such small study of eight patients, an improvement was seen in one patient’s ability to perform mental calculations. To clarify the possible benefits of cooling, a large clinical trial has recently been conducted by researchers at the National Aeronautics and Space Administration (NASA), the Rocky Mountain MS Center and 5 other clinical centers. The data from this study are currently being analyzed. Cooling is generally safe.
Cylert (pemoline):
Although there is little evidence to support the practice, Cylert is sometimes used to treat MS-related fatigue. It is also sometimes suggested as treatment for MS-cognitive dysfunction. One published study on the subject is available. That study, which involved 45 people with MS, failed to find a beneficial effect on cognition with Cylert. An additional study of Cylert for MS-related cognitive dysfunction is currently underway.
Since it was FDA approved, there have been fifteen cases of severe liver damage reported among users of Cylert. Twelve of these cases resulted in liver transplantation or death. The actual number of cases of liver damage may be greater than the number of cases reported. Accordingly, Cylert should be used with caution and with periodic blood monitoring.
Exercise:
As described above, there is evidence that exercise can prevent some forms of cognitive decline. To a lesser extent, there is also evidence that exercise can be used to improve cognitive problems. A preliminary report has shown an improvement in cognitive function among a small group of people treated with a course of exercise in the form of bicycling three times per week. After three months there was improvement reported in some measures of cognition, including memory. In addition, beneficial mood effects were observed. These benefits were noted among patients who could walk without assistance.
Furthermore, there is evidence to show that exercise can improve cognitive function among healthy people. In one small study of seven healthy people, regular jogging for 30 minutes, three times per week, over a 12-week period improved reaction times. Exercise may also help cognitive function among people with other diseases, such as people with respiratory problems (COPD).
Fatigue management strategies:
People with MS report that fatigue adversely affects their cognitive functioning. Although not all data has supported such a connection, this raises the possibility that cognitive function might be improved by treating fatigue. While this is an interesting idea, it has not been proven. A previous survey done through www.ms-cam.org has suggested that the treatments most often helpful for fatigue include Provigil (modafinil), cooling strategies, fatigue management strategies (such as nap taking), Symmetrel (amantadine), Cylert (Pemoline), exercise, yoga and coffee.
Ginkgo biloba:
Ginkgo biloba is an especially popular herb used by some to enhance memory. A detailed review of 33 studies found that ginkgo biloba improved cognition, activities of daily living, and mood among older patients with dementia. Dementia is a general term that includes primarily Alzheimer’s disease and other age-related causes of cognitive dysfunction.
There has been only one reported study of ginkgo biloba for MS-related cognitive problems. This recent preliminary study (26 people studied over 6 six months) addressed whether ginkgo might help people with MS with respect to cognitive problems. Those who received ginkgo supplements improved in some measures of thinking, such as attention and memory. Tests in other areas did not show a benefit.
In the review of 33 studies described above, reported side effects were the same in the group taking ginkgo as in the group taking placebo. Rarely, people taking this supplement have developed spontaneous bleeding. Accordingly, those who take "blood thinners" (e.g., warfarin, or Coumadin™), have bleeding disorders, or are undergoing surgery probably should not use this supplement. Also, there have been recent isolated reports that ginkgo may provoke seizures.
Ginseng:
Ginseng refers to a group of herbs that belong to the same plant family. One species of ginseng, panax ginseng, which is also known as Korean, Chinese, or Asian ginseng, has been shown to improve cognitive function in healthy people in a few clinical trials. However, one published review of these studies found flaws in each trial and concluded that ginseng’s efficacy “was not established beyond reasonable doubt.” Furthermore, there have been no reported studies of ginseng among people with MS and there are reports that ginseng may stimulate the immune system. In MS, such immune stimulation may be harmful. Accordingly, ginseng carries theoretical risks for people with MS.