Which is the goal of cognitive rehabilitation in multiple sclerosis: the improvement of cognitive performance or the perception of cognitive deficits?

2013 ◽  
Vol 20 (1) ◽  
pp. 124-125 ◽  
Author(s):  
Antonio Cerasa ◽  
Francesco Tomaiuolo ◽  
Aldo Quattrone
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Performance ◽  
Cognitive Deficits ◽  
Cognitive Rehabilitation

scholarly journals Cognition in multiple sclerosis

Neurology ◽  
2018 ◽  
Vol 90 (6) ◽  
pp. 278-288 ◽  
Author(s):  
James F. Sumowski ◽  
Ralph Benedict ◽  
Christian Enzinger ◽  
Massimo Filippi ◽  
Jeroen J. Geurts ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Deficits ◽  
Cognitive Rehabilitation ◽  
Clinical Care ◽  
Theoretical Models ◽  
Scientific Basis ◽  
Evidence Based ◽  
Extensive Literature ◽  
Current State ◽  
Neural Bases

Cognitive decline is recognized as a prevalent and debilitating symptom of multiple sclerosis (MS), especially deficits in episodic memory and processing speed. The field aims to (1) incorporate cognitive assessment into standard clinical care and clinical trials, (2) utilize state-of-the-art neuroimaging to more thoroughly understand neural bases of cognitive deficits, and (3) develop effective, evidence-based, clinically feasible interventions to prevent or treat cognitive dysfunction, which are lacking. There are obstacles to these goals. Our group of MS researchers and clinicians with varied expertise took stock of the current state of the field, and we identify several important practical and theoretical challenges, including key knowledge gaps and methodologic limitations related to (1) understanding and measurement of cognitive deficits, (2) neuroimaging of neural bases and correlates of deficits, and (3) development of effective treatments. This is not a comprehensive review of the extensive literature, but instead a statement of guidelines and priorities for the field. For instance, we provide recommendations for improving the scientific basis and methodologic rigor for cognitive rehabilitation research. Toward this end, we call for multidisciplinary collaborations toward development of biologically based theoretical models of cognition capable of empirical validation and evidence-based refinement, providing the scientific context for effective treatment discovery.

Neuropsychological rehabilitation does not improve cognitive performance but reduces perceived cognitive deficits in patients with multiple sclerosis: a randomised, controlled, multi-centre trial

2013 ◽  
Vol 20 (1) ◽  
pp. 99-107 ◽  
Author(s):  
Anu Mäntynen ◽  
Eija Rosti-Otajärvi ◽  
Keijo Koivisto ◽  
Arja Lilja ◽  
Heini Huhtala ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Performance ◽  
Cognitive Deficits ◽  
Intervention Group ◽  
Preliminary Evidence ◽  
Control Group ◽  
Neuropsychological Rehabilitation ◽  
Attentional Deficits ◽  
Positive Effects ◽  
Randomised Controlled

Background: There is preliminary evidence on the positive effects of neuropsychological rehabilitation on cognition in multiple sclerosis (MS), but the generalisability of the findings is limited by methodological problems. Objective: The aim of the present study was to determine the effects of strategy-oriented neuropsychological rehabilitation on MS. Methods: A total of 102 relapsing–remitting MS patients with subjective and objective attentional deficits were randomised into an intervention and a control group. Neuropsychological assessments were performed at baseline, at three months immediately after the intervention, and at six months. Patients in the intervention group received neuropsychological rehabilitation once a week in 60-minute sessions for 13 consecutive weeks. The control group received no intervention. Results: Neuropsychological rehabilitation including computer-based attention and working memory retraining, psychoeducation, strategy learning and psychological support did not improve cognitive performance but had a positive effect on perceived cognitive deficits. The intervention group perceived significantly fewer deficits than the control group both immediately after the intervention and at six months. The personal rehabilitation goals were also well achieved. Conclusions: Strategy-oriented neuropsychological rehabilitation did not improve cognitive performance but reduced perceived cognitive deficits in MS.

Strengthening Mental Abilities with Relational Training (SMART) in Multiple Sclerosis (MS): Study Protocol for a Feasibility Randomised Controlled Trial

2021 ◽  
Author(s):  
Nima Moghaddam ◽  
David L Dawson ◽  
Nikos Evangelou ◽  
James Turton ◽  
Annie Hawton ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Functioning ◽  
Cognitive Deficits ◽  
Cognitive Rehabilitation ◽  
Retention Rates ◽  
Feasibility Trial ◽  
Trial Participant ◽  
Attention And Memory ◽  
Definitive Trial ◽  
Brain Functions

Abstract Background Multiple Sclerosis (MS) is a chronic condition of the central nervous system, affecting around 1 in every 600 people in the UK, with 130 new diagnoses every week. Cognitive difficulties are common amongst people with MS, with up to 70% experiencing deficits in higher-level brain functions – such as planning and problem-solving, attention, and memory. Cognitive deficits make it difficult for people with MS to complete everyday tasks and limit their abilities to work, socialise, and live independently. There is a clear need – and recognised research priority – for treatments that can improve cognitive functioning in people with MS. The absence of effective cognitive interventions exacerbates burdens on the services accessed by people with MS – requiring these services to manage sequelae of untreated cognitive deficits, including reduced quality of life, greater disability and dependence, and poorer adherence to disease-modifying treatments. Our planned research will fill the evidence gap through developing – and examining the feasibility of trialling – a novel online cognitive rehabilitation programme for people with MS (SMART). Methods The primary objective of this study aims to conduct a feasibility study to inform development of a definitive trial of SMART for improving cognitive functioning in people with MS. Secondary objectives include accessing the acceptability to participants of the intervention, delivery format, inclusion/exclusion criteria, baselines and outcome measures, randomisation protocol, and the study procedures. It will further assess the framework for a cost-effectiveness analysis alongside a definitive trial; participant recruitment and retention rates, sample-size needed for a fully powered trial, and signal of efficacy. Discussion As a feasibility trial, outcomes are unlikely to immediately effect changes to NHS practice. However, this is a necessary step towards developing a definitive trial – and will give us a signal of efficacy, a prerequisite for progression to a definitive trial. If found to be clinically- and cost-effective, the latter trial could create a step-change in MS cognitive rehabilitation – improving service-delivery and optimising support with limited additional resources. Trial Registration: Registration ID: ClnicalTrials.gov: NCT04975685 – registered on July 23rd, 2021 Protocol version: 2.0, 25 November 2021

scholarly journals Cognitive outcomes in meningioma patients undergoing surgery: individual changes over time and predictors of late cognitive functioning

2019 ◽  
Vol 21 (7) ◽  
pp. 911-922 ◽  
Author(s):  
Sophie J M Rijnen ◽  
Ikram Meskal ◽  
Marjan Bakker ◽  
Wouter De Baene ◽  
Geert-Jan M Rutten ◽  
...  
Keyword(s):  
Cognitive Functioning ◽  
Cognitive Performance ◽  
Cognitive Deficits ◽  
Cognitive Rehabilitation ◽  
Cognitive Outcomes ◽  
Cognitive Outcome ◽  
Normative Sample ◽  
Before And After ◽  
Preoperative Predictors ◽  
Over Time

Abstract Background Meningioma patients are known to face cognitive deficits before and after surgery. We examined individual changes in cognitive performance over time and identified preoperative predictors of cognitive functioning 12 months after surgery in a large sample of meningioma patients. Methods Patients underwent neuropsychological assessment (NPA) using CNS Vital Signs 1 day before (T0) and 3 (T3) and 12 (T12) months after surgery. Patients’ sociodemographically corrected scores on 7 cognitive domains were compared with performance of a normative sample using one-sample z tests and chi-square tests of independence. Reliable change indices with correction for practice effects were calculated for individual patients. Linear mixed effects models were used to identify preoperative predictors of performance at T12. Results At T0, 261 patients were assessed, and 229 and 82 patients were retested at T3 and T12, respectively. Patients showed impaired cognitive performance before and after surgery, and although performance improved on the group level, cognitive scores remained significantly lower than in the normative sample up to T12. On the individual level, performance remained stable in the majority of patients. Better preoperative performance, younger age, male sex, and higher educational level predicted better late cognitive performance. Conclusions Meningioma patients face serious and persistent pre- and postsurgical cognitive deficits. A preoperative NPA together with sociodemographic characteristics may provide valuable information on the late cognitive outcome of individual meningioma patients. These results can help to inform patients and clinicians on late cognitive outcomes at an early stage, and emphasizes the importance of presurgical NPA and timely cognitive rehabilitation.

scholarly journals Reporting interventions in trials evaluating cognitive rehabilitation in people with multiple sclerosis: a systematic review

2017 ◽  
Vol 32 (2) ◽  
pp. 243-254 ◽  
Author(s):  
Jacqueline R Mhizha-Murira ◽  
Avril Drummond ◽  
Olga A Klein ◽  
Roshan dasNair
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Deficits ◽  
Cognitive Rehabilitation ◽  
Grey Literature ◽  
Executive Dysfunction ◽  
Control Group ◽  
Delivery Mode ◽  
Quality Of Reporting ◽  
Author Citations

Objective: To determine the quantity and quality of description of cognitive rehabilitation for cognitive deficits in people with multiple sclerosis, using a variety of published checklists, and suggest ways of improving the reporting of these interventions. Data sources: A total of 10 electronic databases were searched, including MEDLINE, EMBASE, CINAHL and PsycINFO, from inception to May 2017. Grey literature databases, trial registers, reference lists and author citations were also searched. Review methods: Papers were included if participants were people with multiple sclerosis aged 18 years and over and if the effectiveness of cognitive rehabilitation in improving functional ability for memory, attention or executive dysfunction, with or without a control group, was being evaluated. Results: A total of 54 studies were included in this review. The reporting of a number of key aspects of cognitive rehabilitation was poor. This was particularly in relation to content of interventions (reported completely in 26 of the 54 studies), intervention procedures (reported completely in 16 of the 54 studies), delivery mode (reported completely in 24 of the 54 studies) and intervention mechanism of action (reported completely in 21 of the 54 studies). Conclusion: The quality of reporting of cognitive rehabilitation for memory, attention and executive function for multiple sclerosis, across a range of study designs, is poor. Existing reporting checklists do not adequately cover aspects relevant to cognitive rehabilitation, such as the approaches used to address cognitive deficits. Future checklists could consider these aspects we have identified in this review.

Cognitive functioning in children with multiple sclerosis

2008 ◽  
Vol 15 (2) ◽  
pp. 266-268 ◽  
Author(s):  
C Montiel-Nava ◽  
JA Peña ◽  
S González-Pernía ◽  
E Mora-La Cruz
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Functioning ◽  
Cognitive Performance ◽  
Cognitive Deficits ◽  
Neuropsychological Test ◽  
Common Occurrence ◽  
Neuropsychological Test Battery ◽  
Verbal Skills ◽  
Iq Scores ◽  
The Moment

Objective To examine the cognitive functioning of children with multiple sclerosis (MS). Methods Six children with a diagnosis of clinically definite MS were evaluated using a neuropsychological test battery. Results The majority of the children showed deficits in at least two of the administered subtests, with IQ scores within the deficient classification. Conclusions Verbal and non-verbal skills were equally impaired, and patients who were older at the moment of the onset of the disease had a better cognitive performance. Cognitive deficits should be regarded as a common occurrence in the course of MS in children.

scholarly journals Improved cognitive performance and event-related potential changes following working memory training in patients with multiple sclerosis

2018 ◽  
Vol 4 (1) ◽  
pp. 205521731774762 ◽  
Author(s):  
Thomas J Covey ◽  
Janet L Shucard ◽  
Ralph HB Benedict ◽  
Bianca Weinstock-Guttman ◽  
David W Shucard
Keyword(s):  
Multiple Sclerosis ◽  
Working Memory ◽  
Cognitive Performance ◽  
Cognitive Rehabilitation ◽  
Event Related Potential ◽  
Working Memory Training ◽  
Memory Training ◽  
Before And After ◽  
Component Amplitude ◽  
Back Task

Background Few studies of cognitive rehabilitation in multiple sclerosis (MS) have targeted working memory specifically. Objective We examined the effects of n-back working memory training on cognitive performance and brain function in patients with MS. Methods Patients with MS ( n = 12) and healthy controls (HC; n = 12) underwent 20 sessions of n-back working memory training. Before and after training (pre- and posttest) cognitive event-related potential (ERP) measures were obtained during a 3-back task. In addition, a battery of cognitive tests was administered. Results Following n-back training, both MS patients and HCs showed significant improvement on tests of working memory, processing speed, complex attention, and reasoning ability. MS and HCs also exhibited an enhancement of N2 ERP component amplitude, and earlier N2 and P3 latencies, following n-back training. Conclusions Targeted training of working memory with the n-back task may improve cognitive function in MS. Enhancement of N2 ERP component amplitude and shorter N2 and P3 latency following training in patients with MS is consistent with plasticity of neural processes that are involved in working memory.

Self-generated learning in people with multiple sclerosis

2006 ◽  
Vol 12 (5) ◽  
pp. 640-648 ◽  
Author(s):  
MICHAEL R. BASSO ◽  
NATASHA LOWERY ◽  
COURTNEY GHORMLEY ◽  
DENNIS COMBS ◽  
JAY JOHNSON
Keyword(s):  
Multiple Sclerosis ◽  
Activities Of Daily Living ◽  
Cognitive Deficits ◽  
Present Experiment ◽  
Daily Living ◽  
Cognitive Rehabilitation ◽  
Memory Impairment ◽  
Object Locations ◽  
Abstract Words

Memory impairment is among the most common cognitive deficits in people with multiple sclerosis (MS). To remediate this problem, recent research has evaluated the benefits of self-generated encoding. These nascent investigations reveal that people with MS who have mild memory impairment demonstrate a significant memory benefit from self-generated encoding compared with didactic learning. To extend prior research, the present experiment included MS patients with moderate–severe, rather than just mild, memory impairment. Additionally, the experiment evaluated whether self-generated encoding improves memory for activities of daily living instead of abstract words. Specifically, the experiment determined whether self-generated encoding enhanced memory for names, appointments, and object locations. In agreement with and extending prior research, MS patients remembered more information if it was self-generated rather than didactically presented, and this finding occurred despite moderate–severe memory impairment. Furthermore, compared with didactic encoding, self-generation enhanced recall of activities of daily living. Implications of these findings for cognitive rehabilitation and the nature of memory impairment in MS are discussed (JINS, 2006, 12, 640–648.)

Adaptational Approach to Cognitive Rehabilitation in Multiple Sclerosis: Description of Three Models of Care

1999 ◽  
Vol 1 (2) ◽  
pp. 12-22
Author(s):  
Päivi Hämäläinen ◽  
Arja Seinelä ◽  
Juhani Ruutiainen
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Deficits ◽  
Cognitive Rehabilitation ◽  
Cognitive Impairments ◽  
Models Of Care ◽  
Cognitively Impaired ◽  
Individual Counseling ◽  
Rehabilitation Centre ◽  
Individual Level ◽  
Group Rehabilitation

Abstract Cognitive deficits are among the most harmful symptoms in multiple sclerosis (MS). Neuropsychological assessment methods have been extensively developed in MS, but rehabilitation of cognition is still in its infancy. At the Masku Neurological Rehabilitation Centre, we have developed 3 models of neuropsychological group rehabilitation in MS.Information/family weekends for MS patients who are concerned about cognitive deficits1-week inpatient cognitive rehabilitation courses for MS patients and their spouses3-week inpatient cognitive rehabilitation courses for MS patientsWe used an adaptational approach to help participants live with cognitive impairments. Instead of retraining affected cognitive functions, we tried to help patients find better ways of coping with existing cognitive deficits in daily life. The course consisted of information at a general and at an individual level, neuropsychological evaluation and feedback, individual counseling, and group meetings. We evaluated the participants’ experiences in the course by means of questionnaires. The participants reported that they received information and support they thought could help them to live with cognitive impairments. The experiences of these participants suggest that these types of rehabilitation interventions may be useful in treating patients with cognitive deficits and their family members. In this article, we report 3 models of care for cognitively impaired MS patients and an evaluation of participants’ experiences on these rehabilitation courses.

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