The goal of this clinical trial is to know if rituximab can improve cognitive and hand functions in secondary progressive multiple sclerosis (SPMS) patients with high disability (EDSS 6.5 or more). The main questions it aims to answer are: Can rituximab improve cognitive and hand functions in SPMS patients? Can rituximab improve the quality of life and the Expanded Disability Status Scale (EDSS) in SPMS patients? Researchers will compare patients who receive rituximab to patient who receive placebo to see the effects of rituximab on cognition, hand functions, quality of life and EDSS. Demographic and clinical data as age, gender, disease duration and EDSS will be obtained from each participant. Participants will perform The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS), The Nine-Hole Peg Test (9-HPT) and The MS-QLQ27 questionnaire at baseline and after one year of receiving either rituximab or placebo.
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The effect of rituximab on cognitive functions assessed by The Symbol Digit Modalities Test
Timeframe: One year
The effect of rituximab on cognitive functions assessed by The Brief Visuospatial Memory Test-Revised
Timeframe: One year
The effect of rituximab on cognitive functions assessed by The California Verbal Learning Test-II
Timeframe: One year
The effect of rituximab on hand functions assessed by The Nine-Hole Peg Test
Timeframe: One year
Amgad Mahmoud Elmeligy, MSc Neurology