Neuropsychological Training of Attention Improves MS-Related Fatigue: Results of a Randomized, Placebo-Controlled, Double-Blind Pilot Study

Abstract

Background: Attentional deficits may be pathophysiologically relevant in MS-associated fatigue. Patients and Methods: Thirty MS patients with fatigue and attentional deficits in neuropsychological testing participated in this randomized, placebo-controlled, double-blind trial. The intervention group (IG; n = 14) was treated with 10 h of computerized, specific neuropsychological training performing simple reaction time tasks, whereas the control group (CG; n = 16) also runs through computerized, but unspecific neuropsychological training using tasks without time components. The subjective feeling of fatigue was assessed with the Würzburg Fatigue Inventory for Multiple Sclerosis (WEIMuS) questionnaire, and testing of alertness was used as an objective measure at baseline and after the 2-week study period. Results: Reaction times of alertness were significantly decreased in IG but not CG after 2 weeks. The subjective feeling of fatigue was ameliorated in both groups but more pronounced in IG. Effect sizes were below 0.7 for alertness and WEIMuS scores in CG but large and clinically meaningful in IG for both measures. Conclusions: Our pilot study suggests that neuropsychological training of attention may improve both measures of fatigue. The parallel improvement of attentional deficits and subjective fatigue after specific neuropsychological training support previous findings that fatigue may be at least partially caused by impaired intensity of attention.

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“…Note: Studies that were included in the review but not mentioned in the main text are the following . 76 …”

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Focus on neglected features of cognitive rehabilitation in MS: Setting and mode of the treatment

“…2 Furthermore, evidence suggests that the positive effects of CR may be more widespread, including quality of life, mood, and fatigue. [29][30][31][32][33][34][35] However, at this moment, more high-quality randomized trials are needed to draw conclusion about the effectiveness of CR for PwMS. 2,8,10,36 To achieve this, precise and complete reports of interventions are strongly recommended to facilitate replication by other researchers and to enable implementation into clinical practice.…”

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