b'spreading myelin across many axons. The due to the treatment. Secondary endpointsfindingswerepublishedinthejournal showed improvements in cognitive fatigue,Nature Communications. but not for some other areas of cognitiveDr. Thrower: For decades and decades, we have impairment.relied on the mouse to be our animal surrogate The ndings were published in the journalin MS research. Maybe the mouse will have a Neurology.partner now in the zebrash. Schwann cells Dr. Thrower: Ampyra (dalfampridine) isare the producers of myelin in the peripheral sometimes referred to as the walking drugnervous system, whereas oligodendrocytes since it is FDA-approved to improve walkingproduce myelin in the central nervous system. speed in all forms of MS. Prior to the FDA-Past research has looked at reprogramming approvalofdalfampridine,wefrequentlySchwann cells to act like oligodendrocytes. prescribed 4-AP (4-aminopyridine). This drugCouldthiszebrashmyelindiscoverybe is made by a compounding pharmacist andcombinedwithpriorresearchtobringus is not FDA-approved. 4-AP is the immediatecloser to the goal of a neural repair strategy? release form of dalfampridine. DalfampridineObviously, this research is preliminary, but and 4-AP work on potassium channels onevery step counts.Study: Dalfampridine may improve demyelinatedaxonsandmayimproveinformation processing speed in people electrical conduction. They dont actuallywith MS repair the damage, they just make the damagednerve ber work better. While dalfampridineA new study found dalfampridine (Ampyra) was studied to improve walking, we neverimprovedcognitioninvolvinginformation thought of 4-AP as just a walking drug. Inprocessing speed in a controlled clinical trial theory, any MS symptom that worsens withinvolving 120 people with multiple sclerosis. exertion or heat is likely the result of aAmpyra is a symptomatic therapy that is phenomenon called nerve ber fatigue. Anyapproved by the FDA to improve walking in symptom that results from nerve ber fatiguepeople with MS. such as walking, visual changes, cognitiveInvestigators at the MS Center SantAndrea dysfunction, arm weakness, etc, couldHospital, Rome, Italy, randomly assigned 120 improve with dalfampridine or 4-AP.people with MS to take extended-release So, its not too surprising to see the resultsdalfampridine 10 mg or inactive placebo by of this trial where cognitive processing speedmouth twice daily for 12 weeks. Before and improved with dalfampridine. As noted inaftertreatment,participantsunderwenta the conclusion, the drug may not work forbattery of cognitive and behavioral tests. everyone.Experiencewith4-APandParticipants treated with dalfampridine dalfampridinesuggeststhatabout40-50improved signicantly more than those on percentofpeoplewillseebenet.Aoneplacebo on the Symbol Digit Modalities Test, month trial is long enough to determine yourascalemeasuringprocessingspeed.This response. People with seizure disorders orimprovement disappeared four weeks after signicant renal impairment should not takethe treatment was stopped, suggesting it was dalfampridine or 4-AP.59 msfocusmagazine.org'