Can supplementation with antioxidants improve cognitive functions in patients with multiple sclerosis? A literature review.

IF 1.7 Q2 MEDICINE, GENERAL & INTERNAL
Annals of Medicine and Surgery Pub Date : 2025-04-16 eCollection Date: 2025-05-01 DOI:10.1097/MS9.0000000000003124
Ali Rezaei, Majid Hamidi, Homa Seyedmirzaei, Abdorreza Naser Moghadasi
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引用次数: 0

Abstract

Multiple sclerosis (MS) is a chronic neuroinflammatory and neurodegenerative disease of the central nervous system (CNS) with a complex and multifactorial pathophysiology. Although these mechanisms are not yet fully elucidated, it is established that oxidative stress (OS) plays a key role in driving neurodegeneration in MS. These pathological mechanisms contribute to a wide range of symptoms, including motor and sensory deficits, as well as cognitive impairment. The impairments in cognitive functions can cause a major burden for these patients and significantly affect their quality of life. For example, memory is one of the most frequently impaired cognitive domains in MS. These deficits often correlate with biomarkers of neurodegeneration and disease progression. Despite the substantial burden of cognitive impairment in MS, no established treatments currently exist to prevent or mitigate cognitive decline in these patients, aside from the disease-modifying treatments. Several clinical trials have investigated the potential of antioxidant supplementation to improve cognitive outcomes in MS patients. However, their findings are often controversial. This review discusses trials evaluating the effects of supplementation with various antioxidants, including Ginkgo biloba, melatonin, omega-3 fatty acids, vitamins A, N-acetylcysteine, lipoic acid, xanthophylls, and crocin, on cognitive performance. We discuss the findings of these studies, highlight methodological limitations, and explore the underlying mechanisms by which these compounds may modulate cognition. These mechanisms range from mitigating OS, inflammation, and glutamate-induced neurotoxicity in the CNS to addressing secondary symptoms such as depression and fatigue, which are often linked to cognitive decline. By reviewing the current evidence, this review not only underscores the therapeutic potential and limitations of antioxidant supplementation but also provides guidance for future research to optimize study design and advance our understanding of cognitive preservation strategies in MS.

补充抗氧化剂能改善多发性硬化症患者的认知功能吗?文献综述。
多发性硬化症(MS)是一种中枢神经系统(CNS)的慢性神经炎症和神经退行性疾病,具有复杂的多因素病理生理。虽然这些机制尚未完全阐明,但已经确定氧化应激(OS)在ms的神经退行性变中起关键作用。这些病理机制导致了广泛的症状,包括运动和感觉缺陷,以及认知障碍。认知功能的损害会给这些患者带来沉重的负担,并严重影响他们的生活质量。例如,记忆是多发性硬化症中最常受损的认知领域之一,这些缺陷通常与神经变性和疾病进展的生物标志物相关。尽管多发性硬化症患者认知功能障碍带来了巨大的负担,但除了改善疾病的治疗外,目前还没有确定的治疗方法来预防或减轻这些患者的认知功能下降。一些临床试验已经研究了补充抗氧化剂改善多发性硬化症患者认知结果的潜力。然而,他们的发现经常是有争议的。这篇综述讨论了评估补充各种抗氧化剂对认知能力影响的试验,包括银杏叶、褪黑素、omega-3脂肪酸、维生素A、n -乙酰半胱氨酸、硫辛酸、叶黄素和西红花素。我们讨论了这些研究的发现,强调了方法上的局限性,并探讨了这些化合物可能调节认知的潜在机制。这些机制包括减轻OS、炎症和谷氨酸诱导的中枢神经系统神经毒性,以及解决继发性症状,如抑郁和疲劳,这些症状通常与认知能力下降有关。通过对现有证据的回顾,本综述不仅强调了抗氧化剂补充的治疗潜力和局限性,而且为未来的研究提供了指导,以优化研究设计,促进我们对MS认知保护策略的理解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of Medicine and Surgery
Annals of Medicine and Surgery MEDICINE, GENERAL & INTERNAL-
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5.90%
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1665
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