For Children With Neurofibromatosis Type 1, Statin Does Not Improve Cognitive Function

For children with neurofibromatosis type 1 (NF1), a genetic disorder
that often leads to learning disability, cognitive function is not
improved by the statin simvastatin, according to an article released on
July 15 in JAMA.



NF1 is characterized by the development of tumors in Schwann cells in
the nervous system. It is genetically transmitted with an autosomal
dominant pattern, which means that it is not linked to sex chromosome,
but only one parent needs to contribute the variant gene for a child to
develop the disorder.



These tumors can be harmless but can also compress nerve cells thus
causing damage. Clinically, the disease symptoms include skin
disorders, problems with small and large movement skills, and cognitive
disabilities. Some examples of this cognitive disability include loss
of visual-spatial skills, nonverbal long-term memory and attention
span.



Statins are a class of drugs presently used in adults to lower
cholesterol. Previously, some studies in mice have indicated that
therapy with statins could improve some cognitive deficits. To
investigate the potential effects of a specific statin, simvastatin, on
the cognitive function of children with neurofibromatosis type 1,
Lianne C. Krab, M.Sc., of Erasmus MC University Medical Center, Sophia
Children's Hospital, Rotterdam, The Netherlands, and colleagues
performed a randomized trial. A total 62 children received simvastatin
or a placebo treatment once daily for 12 weeks.



After the period of treatment, several cognitive tests were performed
to address nonverbal long-term memory, attention, and performance on
the prism adaptation task, which measures the adaptation of hand
movements in response to distortion of a prism glass. No advantage was
shown for the test group over the placebo in this respect. Secondary
outcomes were evaluated as well, including object assembly scores,
which showed some improvement in the test population. Other measures,
such as attention fluctuation and motor-visual integration showed no
improvement.



The authors conclude that simvastatin has no effect on the improvement
of cognitive problems developed in victims of neurofibromatosis type 1.
"The negative outcome of this trial suggests that simvastatin should
not
be prescribed to ameliorate the cognitive deficits associated with NF1.
Further studies to evaluate a longer treatment period and whether the
object assembly finding is spurious may be warranted," they conclude.



Effect of Simvastatin on Cognitive Functioning in Children
With Neurofibromatosis Type 1: A Randomized Controlled Trial

Lianne C. Krab; Arja de Goede-Bolder; Femke K. Aarsen; Saskia M. F.
Pluijm; Marlies J. Bouman; Jos N. van der Geest; Maarten Lequin;
Coriene E. Catsman; Willem Frans M. Arts; Steven A. Kushner; Alcino J.
Silva; Chris I. de Zeeuw; Henri?«tte A. Moll; Ype Elgersma

JAMA. 2008;300(3):287-294.

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Written by Anna Sophia McKenney