Cognitive Rehabilitation in Multiple Sclerosis in the Period from 2013 and 2021: A Narrative Review

Background: In recent years, several blinded randomized controlled trials (RCT) have been conducted on cognitive rehabilitation (CR) in adults with multiple sclerosis (MS). Objective: To review all blinded RCTs on CR in MS published since 2013. Methods: The National Library of Medicine database (Medline) and PSYCINFO were searched using the keywords MS and CR or cognitive training or NP rehabilitation or memory rehabilitation or attention rehabilitation. Results: After the exclusion of some papers not specifically focused on CR, a final list of 26 studies was established. The papers belong to three main categories: individual specific rehabilitation (8studies), group rehabilitation (4 studies), and computerized training (CT) (14 studies), while one study combined group rehabilitation and CT. Among the individual rehabilitation studies, 5 were devoted to memory, and most of the 19 other selected studies were about several cognitive domains. Most of the studies mainly concerned RRMS patients, except for 2 studies that were carried out exclusively in progressive forms. Despite the methodological limitations of some studies and the great heterogeneity of the protocols, the results are generally in favor of the efficacy of CR in neuropsychological tests. Conclusion: Recent blinded RCTs about CR in MS show promising results.

Rehabilitation organisch bedingter Gedächtnisstörungen: Was, wann, für welche Betroffenen?

The aim of this paper is to provide an overview of treatment strategies and methods as well as a practical decision support, based on the current version of the guideline on memory rehabilitation [55] and the authorsʼ views. We show that the choice of a method for efficient neuropsychological treatment depends on the type and severity of the memory disorder as well as on the previous therapy experience of the affected person and the defined therapy goal: e.g., what it means to work with implicit »errorless learning« methods; which form of external memory aids can be used with which patients; that methods for improving memory performance are available for persons with moderate to mild memory disorders; and that PC therapy is also likely to help younger and more mildly affected persons. The aim is also to provide a broad overview of current studies on memory rehabilitation, some with very promising results. However, many questions remain unanswered to date, some of which have been highlighted in this paper with the aim of stimulating future research to enable those affected by memory impairment to achieve the best possible rehabilitation and the greatest possible independence

Building Embodied Spaces for Spatial Memory Neurorehabilitation with Virtual Reality in Normal and Pathological Aging

Along with deficits in spatial cognition, a decline in body-related information is observed in aging and is thought to contribute to impairments in navigation, memory, and space perception. According to the embodied cognition theories, bodily and environmental information play a crucial role in defining cognitive representations. Thanks to the possibility to involve body-related information, manipulate environmental stimuli, and add multisensory cues, virtual reality is one of the best candidates for spatial memory rehabilitation in aging for its embodied potential. However, current virtual neurorehabilitation solutions for aging and neurodegenerative diseases are in their infancy. Here, we discuss three concepts that could be used to improve embodied representations of the space with virtual reality. The virtual bodily representation is the combination of idiothetic information involved during virtual navigation thanks to input/output devices; the spatial affordances are environmental or symbolic elements used by the individual to act in the virtual environment; finally, the virtual enactment effect is the enhancement on spatial memory provided by actively (cognitively and/or bodily) interacting with the virtual space and its elements. Theoretical and empirical findings will be presented to propose innovative rehabilitative solutions in aging for spatial memory and navigation.

Demographic Characteristics, Motivation and Perception of Change as Determinants of Memory Compensation Self-Reports After Acquired Brain Injury

IntroductionIndividuals with brain injuries experience cognitive and emotional changes that have long-lasting impacts on everyday life. In the context of rehabilitation, surveys have stressed the importance of compensating for memory disturbances to ease the impact of disorders on day-to-day autonomy. Despite extensive research on the nature of neurocognitive impairments following brain injury, few studies have looked at patients’ perceptions of these day-to-day compensations. This study examines these perceptions; in particular, what brain-injured people believe they do to compensate for memory deficiencies in everyday life. It also investigates the determinants of reported compensation strategies (age, gender, perceived stress, change awareness and motivation to succeed).MethodsEighty patients and 80 controls completed the French Memory Compensation Questionnaire, a self-report measure of everyday memory compensation. Five forms of compensation were investigated: External and Internal strategies, Reliance on social help, and investments in Time and Effort, along with two general factors: the degree of importance attached to Success (motivation) and perceptions of Change. Participants also completed measures of demographic and emotional aspects that may affect everyday compensation perceptions.ResultsThe brain-injured group reported significantly more frequent use of memory compensation strategies than controls, with the exception of External aids. Large effects were observed for Reliance and Effort. Demographic, motivation and perception of change determinants were found to have different effects depending on the compensation strategy, and mediated the direct effect of brain injury on reported compensation.ConclusionClinical and rehabilitation neuropsychologists often seek to have a better sense of how their patients perceive their compensatory behaviors. In practice, such an understanding is needed to help select appropriate methods and improve the long-term impact of rehabilitation programs: memory rehabilitation will fail if neuropsychologists do not deal, first and foremost, with the emotional and metacognitive issues surrounding traumatic brain injury (TBI), rather than focusing on cognitive efficiency.

What is the future for immersive virtual reality in memory rehabilitation? A systematic review

BACKGROUND: A growing interest in non-pharmacological approaches aimed at cognitive rehabilitation and cognitive enhancement pointed towards the application of new technologies. The complex virtual reality (VR) presented using immersive devices has been considered a promising approach. OBJECTIVE: The article provides a systematic review of studies aimed at the efficacy of VR-based rehabilitation. First, we shortly summarize literature relevant to the role of immersion in memory assessment and rehabilitation. METHODS: We searched Web of Science, ScienceDirect, and PubMed with the search terms “memory rehabilitation”, “virtual reality”, “memory deficit”. Only original studies investigating the efficacy of complex three-dimensional VR in rehabilitation and reporting specific memory output measures were included. RESULTS: We identified 412 citations, of which 21 met our inclusion criteria. We calculated appropriate effect sizes for 10 studies including control groups and providing descriptive data. The effect sizes range from large to small, or no effect of memory rehabilitation was present, depending on the control condition applied. Summarized studies with missing control groups point out to potential positive effects of VR but do not allow any generalization. CONCLUSIONS: Even though there are some theoretical advantages of immersive VE over non-immersive technology, there is not enough evidence yet to draw any conclusions.

Memory rehabilitation: Restorative, specific knowledge acquisition, and compensatory approaches

Memory impairment following an acquired brain injury can negatively impact daily living, quality of life, and progression to dementia—but can be reduced by memory rehabilitation. Here we review the literature on three approaches for memory rehabilitation and their associated strategies: (1) the restorative approach, aimed at a return to pre-morbid functioning, (2) the knowledge acquisition approach, involving training on specific information relevant to daily life, and (3) the compensatory approach, targeted at improving daily functioning. Each memory rehabilitation approach includes specific strategies such as drill and practice (restorative), spaced retrieval (knowledge acquisition), and memory aids (compensatory). Past research has demonstrated little support for the use of restorative strategies to improve memory function whereas knowledge acquisition strategies show promising results on trained tasks but require intensive and time-consuming training. Finally, compensatory strategies remain widely used but there is limited information on training individuals to use them effectively. Considerations for future research to improve the applicability of strategies for memory rehabilitation include assessing memory impairment severity, examining memory needs in daily life, and exploring the long-term effects of memory rehabilitation.

The Effect of Working Memory Rehabilitation on Visual Memory and Memory Span

Introduction: Age-related cognitive decline or cognitive aging is largely the result of structural and functional decline in specific areas of the brain, but lifestyle also contributes to this cognitive decline. The aim of this study was to investigate the effect of working memory rehabilitation on visual memory and memory span in ageing. Methods: This was a quasi-experimental study with pretest-posttest design and a control group. The study population included all elderly people who lived in Bukan Nursing Home from April to July 2019 (N = 120). Among these individuals, 30 elderly people were selected by convenience sampling method and then randomly assigned to two experimental and control groups (two groups of 15 people). Kim Karad Visual Memory Test and Wechsler Memory Span Test were taken from the groups in pretest. The working memory rehabilitation was performed in 18 sessions (each sessions 60-minute) and after which the test was performed again. The data were analyzed by multivariate covariance test according to its assumptions. Results: The results showed that after the rehabilitation of working memory, in the experimental group, the mean of short, medium and long components of visual memory were 12.00, 10.8 and 12.33, respectively, and the direct and inverse of memory span were 11.66 and 9.66, respectively. In the control group, the average of short, medium and long components of visual memory is 7.00, 6.70 and 9.00, respectively, and direct and inverse of memory span is 8.33 and 6.46, respectively. The difference in the mean scores between the two groups in the components of visual memory and memory span after the intervention was significant (p < 0.001). Conclusion: The results showed that working memory rehabilitation can improve visual memory and memory span, and it is recommended that this rehabilitation method be used to improve the cognitive functions of the elderly.

Post-Diagnostic Support and Occupational Therapy Program for Community-Based Dementia Services

Service gaps and the absence of a clear-cut care/symptom management pathway for people recently diagnosed with dementia and their family carepartners motivated LiveWell Dementia Specialists to implement a multi-service post diagnostic support program including three occupational therapy (OT) interventions. Program services include an education series on ‘Resilient Living with Dementia’, family coaching and topical education sessions, and OT services including Care of Persons with Dementia in their Environments (COPE), Skills2Care®, and Home Based Memory Rehabilitation. Program services promote adoption of adaptive strategies and action steps to increase carepartner capacity and enhance quality of life among people with dementia. Participants complete assessments at baseline, program completion, and 4- and/or 10-month follow-up. Carepartners show improvements in dementia knowledge (mean baseline score = 24.6, 4-month = 26.0) and preparedness for caregiving (mean baseline score = 18.1, 4-month = 21.9). Program elements and adaptations of COPE for real world practice are discussed.