A Randomised Controlled Trial of Efficacy of Cognitive Rehabilitation in Multiple Sclerosis: A Cognitive, Behavioural, and MRI Study

Aim. To explore the efficacy of home-based, computerised, cognitive rehabilitation in patients with multiple sclerosis using neuropsychological assessment and advanced structural and functional magnetic resonance imaging (fMRI). Methods. 38 patients with MS and cognitive impairment on the Brief Inte...

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Bibliographic Details
Published in:Neural plasticity Vol. 2016; no. 2016; pp. 1 - 9
Main Authors: Rashid, W., Cercignani, Mara, Langdon, D., Campbell, J.
Format: Journal Article
Language:English
Published: Cairo, Egypt Hindawi Publishing Corporation 01.01.2016
John Wiley & Sons, Inc
Wiley
Subjects:
Adult
Clinical Study
Cognition Disorders - diagnostic imaging
Cognition Disorders - psychology
Cognition Disorders - therapy
Cognitive ability
Cognitive Behavioral Therapy - methods
Female
Home Care Services
Humans
Intervention
Magnetic resonance imaging
Magnetic Resonance Imaging - methods
Male
Memory
Mental disorders
Middle Aged
Multiple sclerosis
Multiple Sclerosis - diagnostic imaging
Multiple Sclerosis - psychology
Multiple Sclerosis - therapy
Neurological Rehabilitation - methods
Neurological Rehabilitation - psychology
Neuropsychological Tests
Patients
Photic Stimulation - methods
Quality of life
Questionnaires
Rehabilitation
Software
Studies
Therapy, Computer-Assisted - methods
Treatment Outcome
ISSN:2090-5904, 1687-5443, 1687-5443
Online Access:Get full text
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Summary:Aim. To explore the efficacy of home-based, computerised, cognitive rehabilitation in patients with multiple sclerosis using neuropsychological assessment and advanced structural and functional magnetic resonance imaging (fMRI). Methods. 38 patients with MS and cognitive impairment on the Brief International Cognitive Assessment for MS (BICAMS) were enrolled. Patients were randomised to undergo 45 minutes of computerised cognitive rehabilitation using RehaCom software (n=19) three times weekly for six weeks or to a control condition (n=19). Neuropsychological and MRI data were obtained at baseline (time 1), following the 6-week intervention (time 2), and after a further twelve weeks (time 3). Cortical activations were explored using fMRI and microstructural changes were explored using quantitative magnetisation transfer (QMT) imaging. Results. The treatment group showed a greater improvement in SDMT gain scores between baseline and time 2 compared to the control group (p=0.005). The treatment group exhibited increased activation in the bilateral prefrontal cortex and right temporoparietal regions relative to control group at time 3 (p<0.05FWE corrected). No significant changes were observed on QMT. Conclusion. This study supports the hypothesis that home-based, computerised, cognitive rehabilitation may be effective in improving cognitive performance in patients with MS. Clinical trials registration is ISRCTN54901925.
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Academic Editor: Malgorzata Kossut
ISSN:2090-5904
1687-5443
1687-5443
DOI:10.1155/2016/4292585