Efficacy of an executive function intervention programme in MS: a placebo-controlled and pseudo-randomized trial

Abstract

We evaluated a rehabilitation programme for executive deficits in multiple sclerosis patients by comparing outcome scores of a cognitive intervention group (CIG; n = 11) with those of a placebo group (n = 14) and an untreated group (n = 15). Executive functioning and verbal learning improved significantly more in the CIG. The treatment effect on verbal learning was still present at 1-year follow-up. Baseline brain atrophy, quantified by the brain parenchymal fraction, was associated with treatment effects for one aspect of executive functioning. Consequently, cognitive intervention may be beneficial and baseline brain atrophy has some predictive value in determining treatment outcome for executive functioning.

Persistence of the effects of attention and executive functions intensive rehabilitation in relapsing remitting multiple sclerosis

“…They were not able to find a neuropsychological improvement and quality of life was not assessed. Fink et al (2010) also longitudinally examined MS patients within a controlled trial, but functional scales were not used and neuropsychological improvement was not specific for the trained cognitive ability (executive function).…”

“…Unfortunately, only attention has been studied and a short follow up has been provided. Fink et al (2010) compared in a controlled study, a cognitive intervention on executive functions with placebo compared to no therapy and found, at one year follow up, a significant improvement on verbal learning in treated patients. Depression and quality of life were not assessed.…”

Cognitive rehabilitation in multiple sclerosis: A systematic review

“…The difference between these results and those from previous studies could be explained by the difference in the methodological approach: the treatment was very specific for divided attention, information processing and executive functions, and the frequency and duration was intense. Furthermore, Fink et al 23 showed that their specific executive function intervention programme was effective in treating some aspects of executive disturbance in MS. This treatment effect was stable over 1 year illustrating that their findings were lasting and not just transitory.…”

“…Historically, most of the intervention implemented for use with MS patients involved learning and memory-based interventions, 15 but recently the focus has moved to other domains such as executive function and attention 21,23,30,31,32,47,48,49 , since these are the cognitive functions that have been shown to be most affected by MS. Interventions based on these functions appear to lead to more consistent results.…”

Principes de rééducation dans la sclérose en plaques

“…En cas de doute lors d'une consultation de préadmission, ils justifient une évaluation neuropsychologique, car pris en charge tôt (orthophonie), les troubles peuvent s'améliorer et les objectifs de rééducation peuvent alors être réévalués [3] ;…”