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

Mattioli, Flavia; Stampatori, Chiara; Scarpazza, Cristina; Parrinello, Giovanni; Capra, Ruggero

doi:10.1016/j.msard.2012.06.004

Cited by 44 publications

(25 citation statements)

References 42 publications

(42 reference statements)

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“…Our results are not much different from previously published studies Rosti-Otajarvi and Hamalainen, 2011;Thomas et al, 2006). Regarding longitudinal effects, there are promising findings from Mattioli, Stampatori et al (2012) who found improvements of short duration cognitive training to remain stable at 6 months after the end of the program; and from another group (Rosti-Otajarvi et al, 2013a) who displayed positive effects of cognitive intervention on perceived cognitive deficits that were maintained for nine months. However, since up to now only few studies include follow-up assessments, it is still too soon to assume that (all) cognitive intervention effects can be maintained afterwards.…”

Section: Discussionsupporting

confidence: 51%

Are cognitive interventions for Multiple Sclerosis effective and feasible?

Magalhães

Alves

Chiaravalloti

et al. 2014

Restorative Neurology and Neuroscience

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Purpose: Fifty percent of patients with Multiple Sclerosis (MS) are estimated to have cognitive impairments leading to considerable decline in productivity and quality of life. Cognitive intervention has been considered to complement pharmacological treatments. However, a lack of agreement concerning the efficacy of cognitive interventions in MS still exists. A systematic review and meta-analysis was conducted to assess the effects of cognitive interventions in MS. Methods: To overcome limitations of previous meta-analyses, several databases were searched only for Randomized Clinical Trials (RCTs) with low risk of bias. Results: Five studies (total of 139 participants) met our eligibility criteria. Although good completion and adherence rates were evident, we found no evidence of intervention effects on cognition or mood in post-intervention or follow-up assessments. Conclusions: This is the first meta-analysis assessing the effects of cognitive intervention in MS including only RCTs with comparable conditions. Research regarding efficacy, cost-effectiveness and feasibility is still in its infancy. Caution is advised when interpreting these results due to the small number of RCTs meeting the inclusion criteria. Considering the costs of disease, good completion and adherence rates of this approach, further research is warranted. Recommendations concerning improved research practices in the field are presented as well.

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Section: Discussionsupporting

confidence: 51%

Are cognitive interventions for Multiple Sclerosis effective and feasible?

Magalhães

Alves

Chiaravalloti

et al. 2014

Restorative Neurology and Neuroscience

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show abstract

“…Emotionally salient contexts and mood are known to affect FC at rest (34). Results in the literature (35,36) suggest that cognitive rehabilitation in patients with MS induces a clinically relevant neuropsychological improvement lasting up to 9 months and that changes in FC of cognitive-related networks at rest help to explain the persistence of the effects of cognitive rehabilitation (37). Unfortunately, we have not verified those rehabilitation-induced cognitive improvement.…”

Section: Neuroradiology: Thalamic Resting-state Functional Connectivimentioning

confidence: 99%

Multiple Sclerosis: Changes in Thalamic Resting-State Functional Connectivity Induced by a Home-based Cognitive Rehabilitation Program

Giglio¹,

Tona²,

Luca³

et al. 2016

Radiology

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Purpose To investigate thalamic connectivity changes after use of a video game-based cognitive rehabilitation program, as thalamic damage and alterations in thalamocortical functional connectivity (FC) are important factors in cognitive dysfunction in patients with multiple sclerosis (MS). Materials and Methods This prospective study was approved by the local ethical committee. Twenty-four patients with MS and cognitive impairment were randomly assigned to either an intervention or a wait-list group. Patients were evaluated with cognitive tests and 3-T resting-state functional magnetic resonance (MR) imaging at baseline and after an 8-week period. In addition, 11 healthy subjects underwent baseline resting-state functional MR imaging. Patients in the intervention group performed the video game-based cognitive rehabilitation program, while those in the wait-list group served as control subjects. Repeated measures analysis of variance was used to test efficacy of the intervention. The thalamic resting-state network was identified with a seed-based method; both first-level and high-level analyses were performed by using software tools. Results Patients showed lower baseline FC compared with healthy subjects. A significant improvement was seen in results of the Paced Auditory Serial Addition Test and the Stroop Test after 8 weeks of cognitive rehabilitation (F = 6.616, [P = .018] and F = 5.325 [P = .030], respectively). At follow-up, the intervention group had an increased FC in the cingulum, precuneus, and bilateral parietal cortex and a lower FC in the cerebellum and in left prefrontal cortex compared with the wait-list group (P < .05, family-wise error corrected); correlations were found between FC changes in these regions and cognitive improvement (P < .05, family-wise error corrected). Conclusion The results of this study show the relevance of thalamic regulation of the brain networks involved in cognition and suggest that changes in thalamic resting-state network connectivity may represent a functional substrate for cognitive improvement associated with a video game-based cognitive rehabilitation program. (©) RSNA, 2016.

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“…3 A recent neuropsychological re-assessment of these patients showed that the positive effect on neuropsychological performance was still detectable six months after treatment termination and resulted in an improvement measured on quality of life and depression scales. 11 The aim of this study was to investigate the relationship between fMRI changes observed during the rehabilitation period, and neuropsychological performance at six-month follow-up.…”

Section: Introductionmentioning

confidence: 99%