Efficacy of a Computer-Assisted Cognitive Rehabilitation Intervention in Relapsing-Remitting Multiple Sclerosis Patients: A Multicenter Randomized Controlled Trial

Abstract

Cognitive impairment is frequently encountered in multiple sclerosis (MS) affecting between 40–65% of individuals, irrespective of disease duration and severity of physical disability. In the present multicenter randomized controlled trial, fifty-eight clinically stable RRMS patients with mild to moderate cognitive impairment and relatively low disability status were randomized to receive either computer-assisted (RehaCom) functional cognitive training with an emphasis on episodic memory, information processing speed/attention, and executive functions for 10 weeks (IG; n = 32) or standard clinical care (CG; n = 26). Outcome measures included a flexible comprehensive neuropsychological battery of tests sensitive to MS patient deficits and feedback regarding personal benefit gained from the intervention on four verbal questions. Only the IG group showed significant improvements in verbal and visuospatial episodic memory, processing speed/attention, and executive functioning from pre - to postassessment. Moreover, the improvement obtained on attention was retained over 6 months providing evidence on the long-term benefits of this intervention. Group by time interactions revealed significant improvements in composite cognitive domain scores in the IG relative to the demographically and clinically matched CG for verbal episodic memory, processing speed, verbal fluency, and attention. Treated patients rated the intervention positively and were more confident about their cognitive abilities following treatment.

Computerized Cognitive Training in Multiple Sclerosis: A Systematic Review and Meta-analysis

“…The weighted mean Expanded Disability Status Scale score across studies was 3.4 (median = 3.5). In all, 7 studies were from Italy, 28,29,39-43 7 from the United States, 27,44-49 2 from Austria, 50,51 and the others from the United Kingdom, 26 Switzerland, 52 Greece, 53 and Spain. 54 Among the studies, 13 used multidomain training, 4 provided attention training, and active control was confirmed in 11/20 studies.…”

A Pilot Study Examining Speed of Processing Training (SPT) to Improve Processing Speed in Persons With Multiple Sclerosis

“…Perez-Martin et al ( 40 ) similarly showed an improvement in memory, fluency and PS following treatment with a computer assisted neuropsychological training program in 30 treated participants as compared with 32 participants assigned to a control condition. The RehaCom cognitive training software has similarly demonstrated efficacy in its ability to treat PS specifically in several samples of persons with MS [e.g., ( 41 – 44 )]. Similarly, Covey et al ( 45 ) showed a n-back training program to results in improved functioning on working memory, PS, complex attention and reasoning.…”

Multimodal Molecular Imaging: Current Status and Future Directions

“…Both techniques enable whole body imaging of molecular targets/processes with high sensitivity. SPECT is mainly used for whole body bone imaging [ 78 – 80 ], myocardial blood flow imaging [ 81 – 84 ], cerebral blood flow imaging [ 85 – 89 ], and thyroid imaging [ 90 – 95 ]. PET is mainly used to detect dynamic changes in the metabolic function of substances (or drugs) in the human body, and it widely used for the nervous system, the cardiovascular system, and the oncology [ 96 – 101 ].…”