Cognitive Strategy Use for Functional Compensation in Multiple Sclerosis: A Systematic Review
Rachel Nicholson1, Aaron P Turner2, Elizabeth S Gromisch3
1Department of Physical Medicine and Rehabilitation, University of Rochester Medical Center, Rochester, NY.
Archives of Physical Medicine and Rehabilitation
|April 17, 2026
Summary
Visualization/imagery mnemonics are most used and supported for people with multiple sclerosis (PwMS). These cognitive strategies show promise for improving learning, memory, and processing speed in PwMS.
Area of Science:
- Neurorehabilitation
- Cognitive Psychology
- Clinical Neurology
Background:
- Multiple sclerosis (MS) frequently causes cognitive impairments, impacting daily functioning.
- Compensatory cognitive strategies offer potential interventions for managing these deficits.
Purpose of the Study:
- To systematically review the evidence for specific compensatory cognitive strategies in people with multiple sclerosis (PwMS).
- To identify the most frequently used and effective cognitive strategies for PwMS.
Main Methods:
- A comprehensive literature search was conducted across PubMed, MEDLINE, PsycINFO, and CINAHL databases.
- Included studies were clinical trials and observational studies of adults with MS using defined cognitive strategies with quantifiable cognitive outcomes.
- Data extraction and evidence grading were performed by two independent reviewers.
Main Results:
- Sixty-four studies (n=3,759) were included, with visualization/imagery mnemonics being the most common strategy (34.9%).
- Attentional, internal memory, and external memory strategies demonstrated small-to-medium improvements in learning and memory.
- Attentional and relaxation strategies showed small, significant effects on processing speed.
Conclusions:
- Visualization/imagery mnemonics are the most utilized and evidence-supported cognitive strategy for PwMS.
- Findings can guide clinicians in selecting appropriate cognitive rehabilitation approaches for individuals with MS.
Keywords:
Cognitive dysfunctionCognitive trainingMindfulnessMultiple sclerosisRehabilitationSystematic reviewMore Related Videos
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