Lauren Krupp

..Nonetheless, further research and the development of more targeted therapies are needed to improve the management of fatigue...

..To determine whether post Lyme syndrome (PLS) is antibiotic responsive...

..High-dose cyclophosphamide is active in immune-mediated illnesses...

..The number of interim relapses (i.e., relapses occurring between baseline assessment and re-evaluation) showed a modest relationship to changes in cognitive function, but this did not reach statistical significance...

..Patients accurately perceived some changes in their level of cognitive dysfunction, though they were insensitive to the degree of their current dysfunction. Possible explanations of this pattern of results are discussed...

..The first-line agents include amantadine for mild fatigue and modafinil for more severe cases. Second-line agents include pemoline and antidepressant medications. Other pharmacologic agents have also shown some promise...

..Both medications have been studied with positive results in controlled clinical trials. Additional research towards measurement and pathogenesis of fatigue will hopefully lead to improved therapies...

..This article reviews what is known about the symptom, putting it into the context of fatigue in other disorders, and outlines a program for developing better understanding and therapy...

..On the whole, to date the research on AChEIs in MS must be considered preliminary, and it is premature to recommend the clinical use of this class of medications at the present time...

..Replication of results in a larger multi-center investigation is warranted in order to more definitively assess the efficacy of this intervention...

..2. To determine the pathogenesis for neurobehavioral deficits in chronic Lyme disease. 3. To identify the clinical and laboratory factors which predict health outcome in chronic Lyme disease. ..

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..It is hypothesized a greater proportion of MS patients treated with donepezil will show improvement in verbal memory that those treated with placebo. ..

..Learning and memory measures include the Selective Reminding Test (SRT), and WMS-R Logical memory Test, and the Continuous Visual Memory test (CVMT). ..

..If no difference between antibiotic and placebo therapy is observed, this will be important objective data suggesting the inappropriateness of repeated courses of antibiotic therapy for PLS. ..

..Using our model, we propose to define cognitive fatigue in two conditions in which cognitive dysfunction is a prominent feature: subjects with MS and healthy sleep-deprived subjects. ..

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..The investigators will also measure secondary outcomes assessing other areas of cognitive dysfunction (i.e., nonverbal memory, conceptual thinking, processing speed) which may improve with intervention. ..

..The study parameters will include clinical features, immune response, cerebrospinal fluid changes, neurocognitive disturbances, and psychosocial aspects of the disease. ..

..Specific Aim 2: To examine the relationship of treatment response to baseline subject characteristics, such as baseline neuropsychological performance, and MS subtype. ..