Cognitive training in MS: effects and relation to brain atrophy

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Clinical Neurology

Background:

• Cognitive disorders are prevalent in multiple sclerosis (MS) patients, often lacking standardized treatments.
• Neuroimaging reveals significant neuroplasticity alongside early brain atrophy in MS.
• Understanding cognitive rehabilitation's efficacy in MS is crucial.

Purpose of the Study:

• To evaluate the benefits of a home-based cognitive training program on memory and working memory in relapsing-remitting MS patients.
• To investigate the influence of whole brain and central brain atrophy on cognitive training outcomes.
• To assess the impact of cognitive training on quality of life, depression, and fatigue.

Main Methods:

• A single-blinded, controlled study involving 42 relapsing-remitting MS patients randomized into treatment and control groups.
• A 6-week home-based computer training program focused on memory and working memory, initiated after methylprednisolone discontinuation.
• Clinical and cognitive performance assessments, including quality of life, depression, and fatigue, conducted two weeks post-intervention.

Main Results:

• Cognitive training significantly improved verbal learning, long-delay verbal memory, and working memory performance.
• The positive impact on long-delay verbal memory was independent of brain atrophy extent.
• Brain atrophy played a significant role in the outcomes of other cognitive functions assessed.

Conclusions:

• An intensive, home-based cognitive training program effectively enhances cognitive functions in MS patients.
• The influence of brain atrophy on rehabilitation outcomes may vary across different cognitive domains.
• Home-based cognitive training represents a viable strategy for cognitive improvement in MS management.