51
|
Gómez-Gastiasoro A, Peña J, Ibarretxe-Bilbao N, Lucas-Jiménez O, Díez-Cirarda M, Rilo O, Montoya-Murillo G, Zubiaurre-Elorza L, Ojeda N. A Neuropsychological Rehabilitation Program for Cognitive Impairment in Psychiatric and Neurological Conditions: A Review That Supports Its Efficacy. Behav Neurol 2019; 2019:4647134. [PMID: 31772682 PMCID: PMC6854258 DOI: 10.1155/2019/4647134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 07/05/2019] [Accepted: 08/05/2019] [Indexed: 11/21/2022] Open
Abstract
Neuropsychological rehabilitation has been the focus of much scientific research over the past decades due to its efficacy in different pathologies. Advances in the neuropsychology field have led to improvements and changes in neuropsychological interventions, which in turn have given rise to different approaches and rehabilitation programs. REHACOP is an integrative neuropsychological rehabilitation program designed by specialist neuropsychologists. With an integrated bottom-up and top-down approach, REHACOP includes neurocognition, social cognition, and daily living tasks hierarchically organized on an increasing level of difficulty. Task arrangement is addressed to maximize improvements and transfer effects into participant's daily living. To date, REHACOP has been implemented on different clinical samples such as patients with schizophrenia, multiple sclerosis (MS), and Parkinson's disease (PD). This manuscript presents the efficacy data of REHACOP across these three populations and discusses it in the context of the available literature. Overall, the magnitude of improvements obtained by means of REHACOP ranged from medium to high across samples. These changes were not restricted to specific neurocognitive domains since participants attending the REHACOP program also showed changes in social cognition and daily functioning variables by means of both direct and transfer effects. Results regarding REHACOP's efficacy in psychiatric and neurological conditions have contributed to expanding the existing evidence about the use of structured neuropsychological rehabilitation. In addition, the results obtained after its implementation highlighted the need and importance of designing and implementing integrative neuropsychological rehabilitation programs that are focused not only on cognition per se but also on participants' performance in daily living.
Collapse
Affiliation(s)
- Ainara Gómez-Gastiasoro
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Avenida de las Universidades, 24, 48007 Bilbao, Biscay, Spain
| | - Javier Peña
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Avenida de las Universidades, 24, 48007 Bilbao, Biscay, Spain
| | - Naroa Ibarretxe-Bilbao
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Avenida de las Universidades, 24, 48007 Bilbao, Biscay, Spain
| | - Olaia Lucas-Jiménez
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Avenida de las Universidades, 24, 48007 Bilbao, Biscay, Spain
| | - María Díez-Cirarda
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Avenida de las Universidades, 24, 48007 Bilbao, Biscay, Spain
| | - Oiane Rilo
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Avenida de las Universidades, 24, 48007 Bilbao, Biscay, Spain
| | - Genoveva Montoya-Murillo
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Avenida de las Universidades, 24, 48007 Bilbao, Biscay, Spain
| | - Leire Zubiaurre-Elorza
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Avenida de las Universidades, 24, 48007 Bilbao, Biscay, Spain
| | - Natalia Ojeda
- Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Avenida de las Universidades, 24, 48007 Bilbao, Biscay, Spain
| |
Collapse
|
52
|
Lampit A, Heine J, Finke C, Barnett MH, Valenzuela M, Wolf A, Leung IHK, Hill NTM. Computerized Cognitive Training in Multiple Sclerosis: A Systematic Review and Meta-analysis. Neurorehabil Neural Repair 2019; 33:695-706. [PMID: 31328637 DOI: 10.1177/1545968319860490] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
Background. Cognitive impairments are common in people with multiple sclerosis (MS). Systematic reviews reported promising evidence for various cognitive interventions in this population. Computerized cognitive training (CCT) has strong evidence for safety and efficacy in several populations, but its effects in MS have yet to be specified. Objective. We aimed to synthesize the evidence from randomized controlled trials (RCTs) investigating the effects of CCT on cognitive, psychosocial, and functional outcomes in adults with MS. Method. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and CENTRAL from inception to March 2019. We calculated standardized mean difference (Hedges' g) of change from baseline in untrained measures of cognition, individual domains, psychosocial functioning, and daily function between CCT and control groups using a random-effects model. Results. A total of 20 RCTs encompassing 982 participants (78% with relapsing-remitting MS) were included. The overall cognitive effect size was moderate (g = 0.30; 95% CI = 0.18-0.43), with no evidence of small-study effect or between-study heterogeneity (prediction interval = 0.17-0.44). Small to moderate effect sizes were found for attention/processing speed, executive functions, and verbal and visuospatial memory. Evidence for working memory, fatigue, and psychosocial and daily functioning were inconclusive. Cognitive effects waned without further training. Conclusions. CCT is efficacious for overall and key cognitive domains in adults with MS, but efficacy on other outcomes and in progressive subtypes remains unclear. Long-term and well-powered trials with diverse cohorts are needed to optimize and maintain the efficacy of CCT, investigate transfer to daily living, and determine who can benefit and whether CCT is a cost-effective strategy to attenuate cognitive decline in MS.
Collapse
Affiliation(s)
- Amit Lampit
- 1 University of Melbourne, Parkville, Victoria, Australia
- 2 Charité-Universitätsmedizin Berlin, Germany
- 3 Humboldt-Universität zu Berlin, Germany
- 4 The University of Sydney, Camperdown, New South Wales, Australia
| | | | - Carsten Finke
- 2 Charité-Universitätsmedizin Berlin, Germany
- 3 Humboldt-Universität zu Berlin, Germany
| | | | | | - Anna Wolf
- 1 University of Melbourne, Parkville, Victoria, Australia
| | | | | |
Collapse
|
53
|
Fuchs TA, Ziccardi S, Dwyer MG, Charvet LE, Bartnik A, Campbell R, Escobar J, Hojnacki D, Kolb C, Oship D, Pol J, Shaw MT, Wojcik C, Yasin F, Weinstock-Guttman B, Zivadinov R, Benedict RH. Response heterogeneity to home-based restorative cognitive rehabilitation in multiple sclerosis: An exploratory study. Mult Scler Relat Disord 2019; 34:103-111. [DOI: 10.1016/j.msard.2019.06.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 06/13/2019] [Accepted: 06/19/2019] [Indexed: 11/29/2022]
|
54
|
Ajtahed SS, Rezapour T, Etemadi S, Moradi H, Habibi Asgarabad M, Ekhtiari H. Efficacy of Neurocognitive Rehabilitation After Coronary Artery Bypass Graft Surgery in Improving Quality of Life: An Interventional Trial. Front Psychol 2019; 10:1759. [PMID: 31440180 PMCID: PMC6694840 DOI: 10.3389/fpsyg.2019.01759] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 07/15/2019] [Indexed: 12/22/2022] Open
Abstract
Introduction Cognitive deficits are frequent after coronary artery bypass graft (CABG) surgery and consequently could lead to a decrease in quality of life. This is the first study that has been conducted with the aim of examining the efficacy of a computerized cognitive rehabilitation therapy (CCRT) in improving quality of life in patients after CABG surgery. Methods In this study, an interventional trial with pre-, post-, and follow-up assessments in active (CCRT), active control and control groups was conducted. Seventy-five patients after CABG surgery were selected and assigned to the groups (n = 25 for each group). CCRT consists of four modules of attention, working memory, response inhibition and processing speed training with graded schedule in 20-min sessions three times per week within 8 weeks. Cognitive functions (attention and working memory) were assessed by the tests of continuous performance, Flanker, useful field of view and digit span at three time points: pre- and post-intervention (T0 and T1) and 6-month follow-up (T2). Quality of life was assessed by the SF-36 questionnaire at the same time points. The CCRT group received the cognitive rehabilitation for 2 months, active control group received a sham version of CCRT in an equal time duration and control group did not receive any cognitive intervention. Results Repeated measures analysis of variance (ANOVA) revealed a time by group interaction on cognitive functions, with CCRT producing a significant improvement at T1 (p < 0.01) and these improvements were maintained at T2. Moreover, in CCRT and active control groups, quality of life (QoL) improved at T1 and these improvements remained stable throughout follow-up (T2). However, improvement of QoL in CCRT group was greater than improvement of QoL in the other two groups at T1. Pearson’s correlation analysis shows a positive correlation between QoL improvement and sustained attention and working memory enhancement (p < 0.05). Conclusion Cognitive rehabilitation can lead to a significant improvement in the cognitive functions that have been trained in patients receiving CABG. Interestingly enough, cognitive rehabilitation can also improve quality of life in patients after CABG surgery and this improvement is maintained for at least 6 months.
Collapse
Affiliation(s)
| | - Tara Rezapour
- Department of Psychology, University of Tehran, Tehran, Iran
| | | | - Hadi Moradi
- School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
| | - Mojtaba Habibi Asgarabad
- Department of Health Psychology, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hamed Ekhtiari
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran.,Translational Neuroscience Program, Institute for Cognitive Science Studies, Tehran, Iran.,Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
55
|
Repeated Working Memory Training Improves Task Performance and Neural Efficiency in Multiple Sclerosis Patients and Healthy Controls. Mult Scler Int 2019; 2019:2657902. [PMID: 31139470 PMCID: PMC6500632 DOI: 10.1155/2019/2657902] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 03/06/2019] [Accepted: 04/04/2019] [Indexed: 11/18/2022] Open
Abstract
Background/Objective To explore the effectiveness of a specific working memory (WM) training program in MS patients and healthy controls (HC). Method 29 MS patients and 29 matched HC were enrolled in the study. MS and HC were randomly split into two groups: nontraining groups (15HC/14 MS) and training groups (14 HC/15 MS). Training groups underwent adaptive n-back training (60 min/day; 4 days). Functional magnetic resonance imaging (fMRI) was used to monitor brain activity during n-back performance (conditions: 0-back, 2-back, and 3-back) at 3 time points: (1) baseline, (2) post-training (+7days), and (3) follow-up (+35days). Results In post-training and follow-up fMRI sessions, trained groups (HC and MS patients) exhibited significant reaction time (RT) reductions and increases in Correct Responses (CRs) during 2-back and 3-back performance. This improvement of task performance was accompanied by a decrease in brain activation in the WM frontoparietal network. The two effects were significantly correlated. Conclusions After WM training, both cognitively preserved MS patients and HC participants showed task performance improvement made possible by neuroplastic processes that enhanced neural efficiency.
Collapse
|
56
|
Realdon O, Serino S, Savazzi F, Rossetto F, Cipresso P, Parsons TD, Cappellini G, Mantovani F, Mendozzi L, Nemni R, Riva G, Baglio F. An ecological measure to screen executive functioning in MS: the Picture Interpretation Test (PIT) 360°. Sci Rep 2019; 9:5690. [PMID: 30952936 PMCID: PMC6450934 DOI: 10.1038/s41598-019-42201-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 03/21/2019] [Indexed: 11/22/2022] Open
Abstract
Executive functions are crucial for performance of everyday activities. In Multiple Sclerosis (MS), executive dysfunctions can be apparent from the early onset of the disease. Technology-based time-efficient and resource-saving tools for early evaluation of executive functions using an ecological approach are needed to assess functional performance in real-life. The aim was to compare the efficiency of the Picture Interpretation Test 360° (PIT 360°) with traditional measures on executive dysfunction in Persons with Multiple Sclerosis (PwMS) and Healthy Controls (HC). Participants were 31 patients with Relapsing-Remitting MS (mean age = 44.323 ± 13.149; mean Expanded Disability Status Scale = 2) and 39 HC (mean age = 39.538 ± 15.728). All were tested with standard neuropsychological tests of executive functions, PIT 360°, and measures of user experience. While standard neuropsychological tests failed to differentiate between PwMS and HC group, the PIT 360° was successful in detecting executive dysfunction in PwMS. All participants reported the PIT 360° to be an engaging tool and endorsed positive reactions to their experience. Overall, the PIT 360° is a quick, sensitive, and ecological tool that captures real-world executive dysfunction in PwMS. This engaging measure is sensitive for the detection of executive deficits since the early phases of the disease.
Collapse
Affiliation(s)
- Olivia Realdon
- Università degli Studi di Milano-Bicocca, Department of Human Sciences for Education, Piazza Ateneo Nuovo 1, 20126, Milan, Italy
| | - Silvia Serino
- Università Cattolica del Sacro Cuore, Department of Psychology, Largo Gemelli 1, 20123, Milan, Italy.,IRCCS Istituto Auxologico Italiano, Applied Technology for Neuro-Psychology LAB, via Magnasco 2, 20149, Milan, Italy
| | - Federica Savazzi
- IRCCS, Fondazione Don Carlo Gnocchi, Neurorehabilitation Unit and Imaging in Rehabilitation LAB, Via Capecelatro, 66, 20148, Milan, Italy
| | - Federica Rossetto
- IRCCS, Fondazione Don Carlo Gnocchi, Neurorehabilitation Unit and Imaging in Rehabilitation LAB, Via Capecelatro, 66, 20148, Milan, Italy
| | - Pietro Cipresso
- Università Cattolica del Sacro Cuore, Department of Psychology, Largo Gemelli 1, 20123, Milan, Italy.,IRCCS Istituto Auxologico Italiano, Applied Technology for Neuro-Psychology LAB, via Magnasco 2, 20149, Milan, Italy
| | - Thomas D Parsons
- University of North Texas, Computational Neuropsychology and Simulation Laboratory, 1155 Union Circle #311280, Denton, Texas, 76203-5017, USA
| | - Giacomo Cappellini
- National Research Council of Italy, Institute for the Dynamics of Environmental Processes, Piazza della Scienza, 1, 20126, Milan, Italy
| | - Fabrizia Mantovani
- Università degli Studi di Milano-Bicocca, Department of Human Sciences for Education, Piazza Ateneo Nuovo 1, 20126, Milan, Italy
| | - Laura Mendozzi
- IRCCS, Fondazione Don Carlo Gnocchi, Multiple Sclerosis Unit, Via Capecelatro, 66, 20148, Milan, Italy
| | - Raffaello Nemni
- IRCCS, Fondazione Don Carlo Gnocchi, Neurorehabilitation Unit, Via Capecelatro, 66, 20148, Milan, Italy.,Università degli Studi di Milano, Department of Pathophysiology and Transplantation, Via Francesco Sforza 35, 20122, Milan, Italy
| | - Giuseppe Riva
- Università Cattolica del Sacro Cuore, Department of Psychology, Largo Gemelli 1, 20123, Milan, Italy.,IRCCS Istituto Auxologico Italiano, Applied Technology for Neuro-Psychology LAB, via Magnasco 2, 20149, Milan, Italy
| | - Francesca Baglio
- IRCCS, Fondazione Don Carlo Gnocchi, Neurorehabilitation Unit and Imaging in Rehabilitation LAB, Via Capecelatro, 66, 20148, Milan, Italy.
| |
Collapse
|
57
|
Pineau F, Socha J, Corvol JC, Louapre C, Assouad R, Maillart E, Lubetzki C, Papeix C. Impact of an adaptive program for cognitive and emotional deficits (ADACOG program) in multiple sclerosis patients with cognitive impairments. Rev Neurol (Paris) 2019; 175:305-312. [PMID: 30910222 DOI: 10.1016/j.neurol.2018.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 07/05/2018] [Accepted: 08/01/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cognitive impairment is frequent in multiple sclerosis (MS), affecting approximately 40 to 70% of patients. We developed a psycho-educational program (ADACOG program) to allow patients to cope with cognitive deficits. The purpose of this exploratory study was to investigate the impact of the ADACOG program on subjective self-reported cognitive impairments, quality of life, anxiety, depression and self-esteem in MS patients. METHODS ADACOG program is a psycho-educational program focusing on cognitive and emotional dysfunctions in MS consisting of three modules in small groups lasting two hours every two weeks. Forty-five MS patients with self-reported cognitive impairments and objective cognitive deficits were enrolled consecutively in two groups: (i) the ADACOG group (N=24) and (ii) the control group (N=21). Both groups of patients completed questionnaires evaluating self-reported cognitive impairments (Multiple Sclerosis Neuropsychological Screening Questionnaire), quality of life (Multiple Sclerosis Impact Scale), anxiety and depression (Hospital Anxiety and Depression Scale, HAD) and self-esteem (Rosenberg Scale) at inclusion (M0), one month later (M1) and seven months after inclusion (M7). The evolution of outcomes within ADACOG group and between both groups was analyzed. RESULTS The analyses within the ADACOG group showed that patients reported better quality of life and fewer anxiety symptoms at M1 compared to M0 (respectively P=0.03 and P=0,04). Moreover, patients presented less subjective self-reported cognitive deficits at M7 compared to M0 (P=0.003). Score evolution for HAD depression and self-esteem were not significant within the ADACOG group. The change M1-M0 for MSIS-29 and HAD anxiety scores was significantly different between both groups (respectively P=0.04 and P=0.008), with improvement of quality of life and anxiety in the ADACOG group. The evolution of scores between groups was not significant for the other outcomes. DISCUSSION This study showed a small effect of a psycho-educational program focusing on cognitive and emotional disorders in MS patients with subjective self-reported cognitive deficits and objective cognitive deficits. Interest of psycho-education focusing on cognition in MS patients is discussed.
Collapse
Affiliation(s)
- F Pineau
- Assistance publique hôpitaux de Paris, département de neurologie, hôpital Pitié-Salpêtrière, 75013 Paris, France; UMR S1127, Sorbonne université, université Pierre et Marie Curie Paris 06, institut de la Moelle Épinière, 75013 Paris, France; UMR S1127 and centre d'investigation clinique, institut national de santé et en recherche médicale, 1422, 75013 Paris, France; UMR 7225, centre national de la recherche scientifique, 75013 Paris, France.
| | - J Socha
- Assistance publique hôpitaux de Paris, département de neurologie, hôpital Pitié-Salpêtrière, 75013 Paris, France; UMR S1127, Sorbonne université, université Pierre et Marie Curie Paris 06, institut de la Moelle Épinière, 75013 Paris, France; UMR S1127 and centre d'investigation clinique, institut national de santé et en recherche médicale, 1422, 75013 Paris, France; UMR 7225, centre national de la recherche scientifique, 75013 Paris, France
| | - J-C Corvol
- Assistance publique hôpitaux de Paris, département de neurologie, hôpital Pitié-Salpêtrière, 75013 Paris, France; UMR S1127, Sorbonne université, université Pierre et Marie Curie Paris 06, institut de la Moelle Épinière, 75013 Paris, France; UMR S1127 and centre d'investigation clinique, institut national de santé et en recherche médicale, 1422, 75013 Paris, France; UMR 7225, centre national de la recherche scientifique, 75013 Paris, France
| | - C Louapre
- Assistance publique hôpitaux de Paris, département de neurologie, hôpital Pitié-Salpêtrière, 75013 Paris, France; UMR S1127, Sorbonne université, université Pierre et Marie Curie Paris 06, institut de la Moelle Épinière, 75013 Paris, France; UMR S1127 and centre d'investigation clinique, institut national de santé et en recherche médicale, 1422, 75013 Paris, France; UMR 7225, centre national de la recherche scientifique, 75013 Paris, France
| | - R Assouad
- Assistance publique hôpitaux de Paris, département de neurologie, hôpital Pitié-Salpêtrière, 75013 Paris, France
| | - E Maillart
- Assistance publique hôpitaux de Paris, département de neurologie, hôpital Pitié-Salpêtrière, 75013 Paris, France
| | - C Lubetzki
- Assistance publique hôpitaux de Paris, département de neurologie, hôpital Pitié-Salpêtrière, 75013 Paris, France; UMR S1127, Sorbonne université, université Pierre et Marie Curie Paris 06, institut de la Moelle Épinière, 75013 Paris, France; UMR S1127 and centre d'investigation clinique, institut national de santé et en recherche médicale, 1422, 75013 Paris, France; UMR 7225, centre national de la recherche scientifique, 75013 Paris, France
| | - C Papeix
- Assistance publique hôpitaux de Paris, département de neurologie, hôpital Pitié-Salpêtrière, 75013 Paris, France; UMR S1127, Sorbonne université, université Pierre et Marie Curie Paris 06, institut de la Moelle Épinière, 75013 Paris, France; UMR S1127 and centre d'investigation clinique, institut national de santé et en recherche médicale, 1422, 75013 Paris, France; UMR 7225, centre national de la recherche scientifique, 75013 Paris, France
| |
Collapse
|
58
|
Virtual reality in multiple sclerosis rehabilitation: A review on cognitive and motor outcomes. J Clin Neurosci 2019; 65:106-111. [PMID: 30898488 DOI: 10.1016/j.jocn.2019.03.017] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 03/08/2019] [Accepted: 03/11/2019] [Indexed: 12/26/2022]
Abstract
Multiple sclerosis (MS) is a demyelinating neurodegenerative disease with lesions involving the central nervous system. Clinical symptoms consist of disturbances in motor activity (e.g., weakness, spasticity, and tremor), sensory functioning (e.g., pain), visual functions (e.g., diplopia and optic neuritis), besides different cognitive (attention deficit and executive dysfunction) and behavioral abnormalities. This review aims to evaluate the role of VR tools in cognitive and motor rehabilitation of MS patients. Studies performed between 2010 and 2017 and fulfilling the selected criteria were searched on PubMed, Scopus, Cochrane and Web of Sciences databases, by combining the terms "VR rehabilitation" and "MS". Our findings showed that, following the use of VR training, MS patients presented a significant improvement in motor (especially gait and balance) and cognitive function (with regard to executive and visual-spatial abilities, attention and memory skills). This review supports the idea that rehabilitation through new VR tools could positively affect MS patients' outcomes, by boosting motivation and participation with a better response to treatment.
Collapse
|
59
|
Amato MP, Prestipino E, Bellinvia A. Identifying risk factors for cognitive issues in multiple sclerosis. Expert Rev Neurother 2019; 19:333-347. [PMID: 30829076 DOI: 10.1080/14737175.2019.1590199] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Cognitive impairment (CI) in Multiple Sclerosis (MS) has progressively regained clinical and research interest and is currently recognized as a debilitating and burdensome problem for these patients. Studying risk and protecting factors that may influence the development and course of CI is currently an area of increasing interest, due to the potential for preventive strategies. Areas covered: In this narrative review the authors briefly addressed the physiopathologic basis, assessment and management of CI in MS and then focused on identifying modifiable and not modifiable risk factors for CI in MS, providing an overview of the current knowledge in the field and indicating avenues for future research. Expert opinion: Improving our understanding of potentially modifiable environmental and lifestyle risk factors or protective factors for CI is important in order to prompt preventive strategies and orient patient counselling and clinical management. To this aim, we need to enhance the current level of evidence linking lifestyle factors to cognition and evaluate some factors that were only preliminary addressed in research. Moreover, we need to explore the role of each factor into the subject cognitive outcome, next to the possible interactions between different environmental factors as well as between environmental and genetic factors.
Collapse
Affiliation(s)
- Maria Pia Amato
- a NEUROFARBA Department, Neuroscience section , University of Florence , Florence , Italy.,b IRCSS Fondazione Don Carlo Gnocchi , Florence , Italy
| | - Elio Prestipino
- a NEUROFARBA Department, Neuroscience section , University of Florence , Florence , Italy
| | - Angelo Bellinvia
- a NEUROFARBA Department, Neuroscience section , University of Florence , Florence , Italy
| |
Collapse
|
60
|
Sandroff BM, DeLuca J. Will behavioral treatments for cognitive impairment in multiple sclerosis become standards-of-care? Int J Psychophysiol 2019; 154:67-79. [PMID: 30825477 DOI: 10.1016/j.ijpsycho.2019.02.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 02/20/2019] [Accepted: 02/25/2019] [Indexed: 02/08/2023]
Abstract
Cognitive impairment is common and debilitating in persons with multiple sclerosis (MS), and further is poorly-managed by pharmacotherapy. Cognitive rehabilitation and exercise training have been identified as promising behavioral approaches for managing MS-related cognitive impairment based on systematic reviews and meta-analyses. However, each body of literature is associated with similar sets of methodological shortcomings, as has been identified by periodic systematic reviews and meta-analyses. Thus, there is little generalizability or transportability research supporting either behavioral approach for managing cognitive dysfunction in this population under real-world conditions (i.e., as a standard-of-care). To that end, this paper aims to catalyze the advancement of cognitive rehabilitation and exercise training research in MS, respectively, towards the successful implementation of generalizability/transportability trials. This first involves critical examinations of the respective cognitive rehabilitation and exercise training literatures in MS from a chronological perspective, with particular emphasis on how the fields have each evolved in response to systematic reviews and meta-analyses. Accordingly, the current paper then provides a roadmap for harmonizing research in those areas to systematically and efficiently inform the development of generalizability/transportability trials for behavioral approaches to manage MS-related cognitive dysfunction. This involves the recognition of overlapping facilitators and impediments for progress in each field, including considerations for the implementation of neuroimaging. Ultimately, the provision of such a framework aims to shorten the timeline for research to influence clinical practice and improve the lives of cognitively-impaired persons with MS.
Collapse
Affiliation(s)
- Brian M Sandroff
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - John DeLuca
- Kessler Foundation, West Orange, NJ, USA; Department of Physical Medicine and Rehabilitation, Rutgers Medical School, Newark, NJ, USA
| |
Collapse
|
61
|
Amatya B, Khan F, Galea M. Rehabilitation for people with multiple sclerosis: an overview of Cochrane Reviews. Cochrane Database Syst Rev 2019; 1:CD012732. [PMID: 30637728 PMCID: PMC6353175 DOI: 10.1002/14651858.cd012732.pub2] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is a major cause of chronic, neurological disability, with a significant long-term disability burden, often requiring comprehensive rehabilitation. OBJECTIVES To systematically evaluate evidence from published Cochrane Reviews of clinical trials to summarise the evidence regarding the effectiveness and safety of rehabilitation interventions for people with MS (pwMS), to improve patient outcomes, and to highlight current gaps in knowledge. METHODS We searched the Cochrane Database of Systematic Reviews up to December 2017, to identify Cochrane Reviews that assessed the effectiveness of organised rehabilitation interventions for pwMS. Two reviewers independently assessed the quality of included reviews, using the Revised Assessment of Multiple Systematic Reviews (R-AMSTAR) tool, and the quality of the evidence for reported outcomes, using the GRADE framework. MAIN RESULTS Overall, we included 15 reviews published in the Cochrane Library, comprising 164 randomised controlled trials (RCTs) and four controlled clinical trials, with a total of 10,396 participants. The included reviews evaluated a wide range of rehabilitation interventions, including: physical activity and exercise therapy, hyperbaric oxygen therapy (HBOT), whole-body vibration, occupational therapy, cognitive and psychological interventions, nutritional and dietary supplements, vocational rehabilitation, information provision, telerehabilitation, and interventions for the management of spasticity. We assessed all reviews to be of high to moderate methodological quality, based on R-AMSTAR criteria.Moderate-quality evidence suggested that physical therapeutic modalities (exercise and physical activities) improved functional outcomes (mobility, muscular strength), reduced impairment (fatigue), and improved participation (quality of life). Moderate-quality evidence suggested that inpatient or outpatient multidisciplinary rehabilitation programmes led to longer-term gains at the levels of activity and participation, and interventions that provided information improved patient knowledge. Low-qualitty evidence suggested that neuropsychological interventions, symptom-management programmes (spasticity), whole body vibration, and telerehabilitation improved some patient outcomes. Evidence for other rehabilitation modalities was inconclusive, due to lack of robust studies. AUTHORS' CONCLUSIONS The evidence suggests that regular specialist evaluation and follow-up to assess the needs of patients with all types of MS for appropriate rehabilitation interventions may be of benefit, although the certainty of evidence varies across the different types of interventions evaluated by the reviews. Structured, multidisciplinary rehabilitation programmes and physical therapy (exercise or physical activities) can improve functional outcomes (mobility, muscle strength, aerobic capacity), and quality of life. Overall, the evidence for many rehabilitation interventions should be interpreted cautiously, as the majority of included reviews did not include data from current studies. More studies, with appropriate design, which report the type and intensity of modalities and their cost-effectiveness are needed to address the current gaps in knowledge.
Collapse
Affiliation(s)
- Bhasker Amatya
- Royal Melbourne Hospital, Royal Park CampusDepartment of Rehabilitation MedicinePoplar RoadParkvilleMelbourneVictoriaAustralia3052
| | - Fary Khan
- Royal Melbourne Hospital, Royal Park CampusDepartment of Rehabilitation MedicinePoplar RoadParkvilleMelbourneVictoriaAustralia3052
| | - Mary Galea
- Royal Melbourne Hospital, Royal Park CampusDepartment of Rehabilitation MedicinePoplar RoadParkvilleMelbourneVictoriaAustralia3052
| | | |
Collapse
|
62
|
Primary progressive multiple sclerosis in Iran: A consensus recommendation for diagnosis and management. Mult Scler Relat Disord 2018; 26:112-120. [DOI: 10.1016/j.msard.2018.09.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/12/2018] [Accepted: 09/11/2018] [Indexed: 12/14/2022]
|
63
|
Gromisch ES, Fiszdon JM, Kurtz MM. The effects of cognitive-focused interventions on cognition and psychological well-being in persons with multiple sclerosis: A meta-analysis. Neuropsychol Rehabil 2018; 30:767-786. [PMID: 29973121 DOI: 10.1080/09602011.2018.1491408] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Elizabeth S. Gromisch
- Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, Hartford, CT, USA
- Psychology Service, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Joanna M. Fiszdon
- Psychology Service, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Matthew M. Kurtz
- Department of Psychology and Program in Neuroscience and Behavior, Wesleyan University, Middletown, CT, USA
| |
Collapse
|
64
|
Ferreira-Correia A, Barberis T, Msimanga L. Barriers to the implementation of a computer-based rehabilitation programme in two public psychiatric settings. S Afr J Psychiatr 2018. [DOI: 10.4102/sajpsychiatry.v24i0.1163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
65
|
Ferreira-Correia A, Barberis T, Msimanga L. Barriers to the implementation of a computer-based rehabilitation programme in two public psychiatric settings. S Afr J Psychiatr 2018; 24:1163. [PMID: 30263222 PMCID: PMC6138119 DOI: 10.4102/sajpsychiatry.v24.i0.1163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 05/04/2018] [Indexed: 11/30/2022] Open
Abstract
Background Working memory (WM) deficits have a negative impact on treatment adherence and quality of life. Efficient and effective interventions are needed in order to improve the cognitive functioning of those affected, especially in low-resource communities. Computer-based rehabilitation programmes (CBRP) are low-cost therapeutic approaches for WM deficits. Perceptions and experiences of target users may influence whether CBRP constitute an effective therapeutic option for adults with cognitive impairment in under-resourced environments. Aim The goal of the study was to explore the experiences of a group of volunteers with WM deficits (associated with diagnoses of HIV and schizophrenia), in terms of the perceived barriers they encountered during their participation in a CBRP. Methods A qualitative, descriptive research design was implemented. Short interviews and field notes were used in order to investigate the experiences of nine participants in relation to the CBRP. The sample included four participants living with HIV and five with schizophrenia, all with WM deficits. Results Using a thematic analysis, eight barriers were identified: unawareness of the cognitive deficit, anticipation of negative results, stigma, difficulties accessing a computer and/or Internet connection, ill health, negative emotional experiences, daily routine challenges and non-conducive or sabotaging environments. A representational model of these barriers is proposed. Conclusion The implementation of a cognitive rehabilitation strategy should not only take into consideration issues of access to particular strategies and materials but should also be preceded by an exploration of how individual and contextual barriers are experienced by the potential users, as these contribute to the risk of dropout.
Collapse
Affiliation(s)
| | - Tyler Barberis
- Department of Psychology, University of the Witwatersrand, South Africa
| | - Lerato Msimanga
- Department of Psychology, University of the Witwatersrand, South Africa
| |
Collapse
|
66
|
Mani A, Chohedri E, Ravanfar P, Mowla A, Nikseresht A. Efficacy of group cognitive rehabilitation therapy in multiple sclerosis. Acta Neurol Scand 2018; 137:589-597. [PMID: 29411360 DOI: 10.1111/ane.12904] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Cognitive impairment occurs in 40%-65% of patients with multiple sclerosis (MS). Several techniques for cognitive rehabilitation (CR) in these patients have been evaluated; however, the results have been controversial. In this study, we investigated the efficacy of group compensatory CR in patients with MS-related cognitive impairment. MATERIALS AND METHODS Thirty-four female patients with diagnosed relapsing-remitting MS and evidence of impaired cognitive function were included and randomized to intervention (n = 17) and control (n = 17) groups. CR intervention consisted of eight 2-hour sessions of comprehensive group CR over a 4-week period that focused on improvement of memory, attention, and executive function. As placebo, the control group received the same number of non-therapeutic group sessions. Assessment of cognitive function was performed before intervention (pretest), at the end of intervention (post-test), and 3 months later (follow-up). RESULTS The study population included 34 patients with a mean age of 35.5 years. Statistical comparison of memory assessments at 3-month follow-up showed significantly higher scores in the CR group than in the control group (93.33 vs 86.40 for Addenbrooke's Cognitive Examination test and 16.58 vs 12.00 for visual memory, 19.32 vs 14.05 for verbal memory, and 51.28 vs 44.41 for general scores on the Memory Functioning Questionnaire test, respectively). Wisconsin card sorting test score comparison showed significantly lower total time consumption in the CR group than in the control group (308.1 vs 340.8 seconds, respectively). Behavior rating inventory of executive function-adult scores in all four subtests were significantly higher in the CR group than in the control group (40.25 vs 55.4 for behavioral regulation index, 51.16 vs 68.6 for metacognition index, and 97.41 vs 124.00 for global executive composite, respectively). Attention was the only domain in which we did not observe any significant variation between groups in terms of post-test and follow-up scores. CONCLUSION This study supports the efficacy of group CR in the improvement of cognitive function in patients with MS.
Collapse
Affiliation(s)
- A. Mani
- Research Center for Psychiatry and Behavioral Sciences; Shiraz University of Medical Sciences; Shiraz Iran
| | - E. Chohedri
- Research Center for Psychiatry and Behavioral Sciences; Shiraz University of Medical Sciences; Shiraz Iran
| | - P. Ravanfar
- Research Center for Psychiatry and Behavioral Sciences; Shiraz University of Medical Sciences; Shiraz Iran
| | - A. Mowla
- Substance Abuse and Mental Health Research Center; Shiraz University of Medical Sciences; Shiraz Iran
| | - A. Nikseresht
- Clinical Neurology Research Center; Shiraz University of Medical Sciences; Shiraz Iran
| |
Collapse
|
67
|
Grzegorski T, Losy J. Cognitive impairment in multiple sclerosis - a review of current knowledge and recent research. Rev Neurosci 2018; 28:845-860. [PMID: 28787275 DOI: 10.1515/revneuro-2017-0011] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 05/19/2017] [Indexed: 11/15/2022]
Abstract
Multiple sclerosis (MS) is a chronic, progressive disease of the central nervous system that is characterised by inflammatory damage to the myelin sheath. Though often neglected, cognitive impairment is a common feature of MS that affects 43-70% of patients. It has a sophisticated neuroanatomic and pathophysiologic background and disturbs such vital cognitive domains as speed of information processing, memory, attention, executive functions and visual perceptual functions. In recent years there has been growing interest in neuroimaging findings with regard to cognitive impairment in MS. The possible options of managing cognitive dysfunction in MS are pharmacologic interventions, cognitive rehabilitation and exercise training; however, not enough evidence has been presented in this field. The aim of our article is to provide current knowledge on cognitive impairment in MS based on the most recent scientific results and conclusions with regard to affected cognitive domains, neuropsychological assessment, underlying mechanisms of this disturbance, neuroimaging findings and therapeutic options.
Collapse
|
68
|
Goverover Y, Chiaravalloti ND, O'Brien AR, DeLuca J. Evidenced-Based Cognitive Rehabilitation for Persons With Multiple Sclerosis: An Updated Review of the Literature From 2007 to 2016. Arch Phys Med Rehabil 2018; 99:390-407. [DOI: 10.1016/j.apmr.2017.07.021] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 07/11/2017] [Accepted: 07/19/2017] [Indexed: 01/24/2023]
|
69
|
Beste C, Mückschel M, Paucke M, Ziemssen T. Dual-Tasking in Multiple Sclerosis - Implications for a Cognitive Screening Instrument. Front Hum Neurosci 2018; 12:24. [PMID: 29445335 PMCID: PMC5797790 DOI: 10.3389/fnhum.2018.00024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 01/16/2018] [Indexed: 01/22/2023] Open
Abstract
The monitoring of cognitive functions is central to the assessment and consecutive management of multiple sclerosis (MS). Though, especially cognitive processes that are central to everyday behavior like dual-tasking are often neglected. We examined dual-task performance using a psychological-refractory period (PRP) task in N = 21 patients and healthy controls and conducted standard neuropsychological tests. In dual-tasking, MS patients committed more erroneous responses when dual-tasking was difficult. In easier conditions, performance of MS patients did not differ to controls. Interestingly, the response times were generally not affected by the difficulty of the dual task, showing that the deficits observed do not reflect simple motor deficits or deficits in information processing speed but point out deficits in executive control functions and response selection in particular. Effect sizes were considerably large with d∼0.80 in mild affected patients and the achieved power was above 99%. There are cognitive control and dual tasking deficits in MS that are not attributable to simple motor speed deficits. Scaling of the difficulty of dual-tasking makes the test applied suitable for a wide variety of MS-patients and may complement neuropsychological assessments in clinical care and research setting.
Collapse
Affiliation(s)
- Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Moritz Mückschel
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.,Multiple Sclerosis Center, Center of Clinical Neuroscience, Department of Neurology, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Madlen Paucke
- Multiple Sclerosis Center, Center of Clinical Neuroscience, Department of Neurology, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Tjalf Ziemssen
- Multiple Sclerosis Center, Center of Clinical Neuroscience, Department of Neurology, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| |
Collapse
|
70
|
Repetitive Transcranial Magnetic Stimulation, Cognition, and Multiple Sclerosis: An Overview. Behav Neurol 2018; 2018:8584653. [PMID: 29568339 PMCID: PMC5822759 DOI: 10.1155/2018/8584653] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Accepted: 12/07/2017] [Indexed: 11/30/2022] Open
Abstract
Multiple sclerosis (MS) affects cognition in the majority of patients. A major aspect of the disease is brain volume loss (BVL), present in all phases and types (relapsing and progressive) of the disease and linked to both motor and cognitive disabilities. Due to the lack of effective pharmacological treatments for cognition, cognitive rehabilitation and other nonpharmacological interventions such as repetitive transcranial magnetic stimulation (rTMS) have recently emerged and their potential role in functional connectivity is studied. With recently developed advanced neuroimaging and neurophysiological techniques, changes related to alterations of the brain's functional connectivity can be detected. In this overview, we focus on the brain's functional reorganization in MS, theoretical and practical aspects of rTMS utilization in humans, and its potential therapeutic role in treating cognitively impaired MS patients.
Collapse
|
71
|
Sumowski JF, Benedict R, Enzinger C, Filippi M, Geurts JJ, Hamalainen P, Hulst H, Inglese M, Leavitt VM, Rocca MA, Rosti-Otajarvi EM, Rao S. Cognition in multiple sclerosis: State of the field and priorities for the future. Neurology 2018; 90:278-288. [PMID: 29343470 PMCID: PMC5818015 DOI: 10.1212/wnl.0000000000004977] [Citation(s) in RCA: 337] [Impact Index Per Article: 56.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 10/10/2017] [Indexed: 12/15/2022] Open
Abstract
Cognitive decline is recognized as a prevalent and debilitating symptom of multiple sclerosis (MS), especially deficits in episodic memory and processing speed. The field aims to (1) incorporate cognitive assessment into standard clinical care and clinical trials, (2) utilize state-of-the-art neuroimaging to more thoroughly understand neural bases of cognitive deficits, and (3) develop effective, evidence-based, clinically feasible interventions to prevent or treat cognitive dysfunction, which are lacking. There are obstacles to these goals. Our group of MS researchers and clinicians with varied expertise took stock of the current state of the field, and we identify several important practical and theoretical challenges, including key knowledge gaps and methodologic limitations related to (1) understanding and measurement of cognitive deficits, (2) neuroimaging of neural bases and correlates of deficits, and (3) development of effective treatments. This is not a comprehensive review of the extensive literature, but instead a statement of guidelines and priorities for the field. For instance, we provide recommendations for improving the scientific basis and methodologic rigor for cognitive rehabilitation research. Toward this end, we call for multidisciplinary collaborations toward development of biologically based theoretical models of cognition capable of empirical validation and evidence-based refinement, providing the scientific context for effective treatment discovery.
Collapse
Affiliation(s)
- James F Sumowski
- From the Department of Neurology & Corinne Goldsmith Dickinson Center for Multiple Sclerosis (J.F.S., M.I.), Icahn School of Medicine at Mount Sinai, New York; Department of Neurology (R.B.), School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York (SUNY); Department of Neurology (C.E.), Medical University of Graz, Austria; Department of Neurology & Neuroimaging Research Unit, Division of Neuroscience (M.F., M.A.R.), San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Department of Anatomy and Neurosciences (J.J.G., H.H.), VU University Medical Center, Amsterdam Neuroscience, VUmc MS Center Amsterdam, the Netherlands; Masku Neurological Rehabilitation Centre (P.H.), Masku, Finland; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child Health (M.I.), University of Genoa, Italy; Department of Neurology & Columbia University Multiple Sclerosis Clinical Care and Research Center (V.M.L.), Columbia University Medical Center, New York, NY; Department of Neurology and Rehabilitation (E.M.R.-O.), Tampere University Hospital, Finland; and Schey Center for Cognitive Neuroimaging, Neurological Institute (S.R.), Cleveland Clinic, OH.
| | - Ralph Benedict
- From the Department of Neurology & Corinne Goldsmith Dickinson Center for Multiple Sclerosis (J.F.S., M.I.), Icahn School of Medicine at Mount Sinai, New York; Department of Neurology (R.B.), School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York (SUNY); Department of Neurology (C.E.), Medical University of Graz, Austria; Department of Neurology & Neuroimaging Research Unit, Division of Neuroscience (M.F., M.A.R.), San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Department of Anatomy and Neurosciences (J.J.G., H.H.), VU University Medical Center, Amsterdam Neuroscience, VUmc MS Center Amsterdam, the Netherlands; Masku Neurological Rehabilitation Centre (P.H.), Masku, Finland; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child Health (M.I.), University of Genoa, Italy; Department of Neurology & Columbia University Multiple Sclerosis Clinical Care and Research Center (V.M.L.), Columbia University Medical Center, New York, NY; Department of Neurology and Rehabilitation (E.M.R.-O.), Tampere University Hospital, Finland; and Schey Center for Cognitive Neuroimaging, Neurological Institute (S.R.), Cleveland Clinic, OH
| | - Christian Enzinger
- From the Department of Neurology & Corinne Goldsmith Dickinson Center for Multiple Sclerosis (J.F.S., M.I.), Icahn School of Medicine at Mount Sinai, New York; Department of Neurology (R.B.), School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York (SUNY); Department of Neurology (C.E.), Medical University of Graz, Austria; Department of Neurology & Neuroimaging Research Unit, Division of Neuroscience (M.F., M.A.R.), San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Department of Anatomy and Neurosciences (J.J.G., H.H.), VU University Medical Center, Amsterdam Neuroscience, VUmc MS Center Amsterdam, the Netherlands; Masku Neurological Rehabilitation Centre (P.H.), Masku, Finland; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child Health (M.I.), University of Genoa, Italy; Department of Neurology & Columbia University Multiple Sclerosis Clinical Care and Research Center (V.M.L.), Columbia University Medical Center, New York, NY; Department of Neurology and Rehabilitation (E.M.R.-O.), Tampere University Hospital, Finland; and Schey Center for Cognitive Neuroimaging, Neurological Institute (S.R.), Cleveland Clinic, OH
| | - Massimo Filippi
- From the Department of Neurology & Corinne Goldsmith Dickinson Center for Multiple Sclerosis (J.F.S., M.I.), Icahn School of Medicine at Mount Sinai, New York; Department of Neurology (R.B.), School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York (SUNY); Department of Neurology (C.E.), Medical University of Graz, Austria; Department of Neurology & Neuroimaging Research Unit, Division of Neuroscience (M.F., M.A.R.), San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Department of Anatomy and Neurosciences (J.J.G., H.H.), VU University Medical Center, Amsterdam Neuroscience, VUmc MS Center Amsterdam, the Netherlands; Masku Neurological Rehabilitation Centre (P.H.), Masku, Finland; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child Health (M.I.), University of Genoa, Italy; Department of Neurology & Columbia University Multiple Sclerosis Clinical Care and Research Center (V.M.L.), Columbia University Medical Center, New York, NY; Department of Neurology and Rehabilitation (E.M.R.-O.), Tampere University Hospital, Finland; and Schey Center for Cognitive Neuroimaging, Neurological Institute (S.R.), Cleveland Clinic, OH
| | - Jeroen J Geurts
- From the Department of Neurology & Corinne Goldsmith Dickinson Center for Multiple Sclerosis (J.F.S., M.I.), Icahn School of Medicine at Mount Sinai, New York; Department of Neurology (R.B.), School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York (SUNY); Department of Neurology (C.E.), Medical University of Graz, Austria; Department of Neurology & Neuroimaging Research Unit, Division of Neuroscience (M.F., M.A.R.), San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Department of Anatomy and Neurosciences (J.J.G., H.H.), VU University Medical Center, Amsterdam Neuroscience, VUmc MS Center Amsterdam, the Netherlands; Masku Neurological Rehabilitation Centre (P.H.), Masku, Finland; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child Health (M.I.), University of Genoa, Italy; Department of Neurology & Columbia University Multiple Sclerosis Clinical Care and Research Center (V.M.L.), Columbia University Medical Center, New York, NY; Department of Neurology and Rehabilitation (E.M.R.-O.), Tampere University Hospital, Finland; and Schey Center for Cognitive Neuroimaging, Neurological Institute (S.R.), Cleveland Clinic, OH
| | - Paivi Hamalainen
- From the Department of Neurology & Corinne Goldsmith Dickinson Center for Multiple Sclerosis (J.F.S., M.I.), Icahn School of Medicine at Mount Sinai, New York; Department of Neurology (R.B.), School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York (SUNY); Department of Neurology (C.E.), Medical University of Graz, Austria; Department of Neurology & Neuroimaging Research Unit, Division of Neuroscience (M.F., M.A.R.), San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Department of Anatomy and Neurosciences (J.J.G., H.H.), VU University Medical Center, Amsterdam Neuroscience, VUmc MS Center Amsterdam, the Netherlands; Masku Neurological Rehabilitation Centre (P.H.), Masku, Finland; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child Health (M.I.), University of Genoa, Italy; Department of Neurology & Columbia University Multiple Sclerosis Clinical Care and Research Center (V.M.L.), Columbia University Medical Center, New York, NY; Department of Neurology and Rehabilitation (E.M.R.-O.), Tampere University Hospital, Finland; and Schey Center for Cognitive Neuroimaging, Neurological Institute (S.R.), Cleveland Clinic, OH
| | - Hanneke Hulst
- From the Department of Neurology & Corinne Goldsmith Dickinson Center for Multiple Sclerosis (J.F.S., M.I.), Icahn School of Medicine at Mount Sinai, New York; Department of Neurology (R.B.), School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York (SUNY); Department of Neurology (C.E.), Medical University of Graz, Austria; Department of Neurology & Neuroimaging Research Unit, Division of Neuroscience (M.F., M.A.R.), San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Department of Anatomy and Neurosciences (J.J.G., H.H.), VU University Medical Center, Amsterdam Neuroscience, VUmc MS Center Amsterdam, the Netherlands; Masku Neurological Rehabilitation Centre (P.H.), Masku, Finland; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child Health (M.I.), University of Genoa, Italy; Department of Neurology & Columbia University Multiple Sclerosis Clinical Care and Research Center (V.M.L.), Columbia University Medical Center, New York, NY; Department of Neurology and Rehabilitation (E.M.R.-O.), Tampere University Hospital, Finland; and Schey Center for Cognitive Neuroimaging, Neurological Institute (S.R.), Cleveland Clinic, OH
| | - Matilde Inglese
- From the Department of Neurology & Corinne Goldsmith Dickinson Center for Multiple Sclerosis (J.F.S., M.I.), Icahn School of Medicine at Mount Sinai, New York; Department of Neurology (R.B.), School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York (SUNY); Department of Neurology (C.E.), Medical University of Graz, Austria; Department of Neurology & Neuroimaging Research Unit, Division of Neuroscience (M.F., M.A.R.), San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Department of Anatomy and Neurosciences (J.J.G., H.H.), VU University Medical Center, Amsterdam Neuroscience, VUmc MS Center Amsterdam, the Netherlands; Masku Neurological Rehabilitation Centre (P.H.), Masku, Finland; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child Health (M.I.), University of Genoa, Italy; Department of Neurology & Columbia University Multiple Sclerosis Clinical Care and Research Center (V.M.L.), Columbia University Medical Center, New York, NY; Department of Neurology and Rehabilitation (E.M.R.-O.), Tampere University Hospital, Finland; and Schey Center for Cognitive Neuroimaging, Neurological Institute (S.R.), Cleveland Clinic, OH
| | - Victoria M Leavitt
- From the Department of Neurology & Corinne Goldsmith Dickinson Center for Multiple Sclerosis (J.F.S., M.I.), Icahn School of Medicine at Mount Sinai, New York; Department of Neurology (R.B.), School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York (SUNY); Department of Neurology (C.E.), Medical University of Graz, Austria; Department of Neurology & Neuroimaging Research Unit, Division of Neuroscience (M.F., M.A.R.), San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Department of Anatomy and Neurosciences (J.J.G., H.H.), VU University Medical Center, Amsterdam Neuroscience, VUmc MS Center Amsterdam, the Netherlands; Masku Neurological Rehabilitation Centre (P.H.), Masku, Finland; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child Health (M.I.), University of Genoa, Italy; Department of Neurology & Columbia University Multiple Sclerosis Clinical Care and Research Center (V.M.L.), Columbia University Medical Center, New York, NY; Department of Neurology and Rehabilitation (E.M.R.-O.), Tampere University Hospital, Finland; and Schey Center for Cognitive Neuroimaging, Neurological Institute (S.R.), Cleveland Clinic, OH
| | - Maria A Rocca
- From the Department of Neurology & Corinne Goldsmith Dickinson Center for Multiple Sclerosis (J.F.S., M.I.), Icahn School of Medicine at Mount Sinai, New York; Department of Neurology (R.B.), School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York (SUNY); Department of Neurology (C.E.), Medical University of Graz, Austria; Department of Neurology & Neuroimaging Research Unit, Division of Neuroscience (M.F., M.A.R.), San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Department of Anatomy and Neurosciences (J.J.G., H.H.), VU University Medical Center, Amsterdam Neuroscience, VUmc MS Center Amsterdam, the Netherlands; Masku Neurological Rehabilitation Centre (P.H.), Masku, Finland; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child Health (M.I.), University of Genoa, Italy; Department of Neurology & Columbia University Multiple Sclerosis Clinical Care and Research Center (V.M.L.), Columbia University Medical Center, New York, NY; Department of Neurology and Rehabilitation (E.M.R.-O.), Tampere University Hospital, Finland; and Schey Center for Cognitive Neuroimaging, Neurological Institute (S.R.), Cleveland Clinic, OH
| | - Eija M Rosti-Otajarvi
- From the Department of Neurology & Corinne Goldsmith Dickinson Center for Multiple Sclerosis (J.F.S., M.I.), Icahn School of Medicine at Mount Sinai, New York; Department of Neurology (R.B.), School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York (SUNY); Department of Neurology (C.E.), Medical University of Graz, Austria; Department of Neurology & Neuroimaging Research Unit, Division of Neuroscience (M.F., M.A.R.), San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Department of Anatomy and Neurosciences (J.J.G., H.H.), VU University Medical Center, Amsterdam Neuroscience, VUmc MS Center Amsterdam, the Netherlands; Masku Neurological Rehabilitation Centre (P.H.), Masku, Finland; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child Health (M.I.), University of Genoa, Italy; Department of Neurology & Columbia University Multiple Sclerosis Clinical Care and Research Center (V.M.L.), Columbia University Medical Center, New York, NY; Department of Neurology and Rehabilitation (E.M.R.-O.), Tampere University Hospital, Finland; and Schey Center for Cognitive Neuroimaging, Neurological Institute (S.R.), Cleveland Clinic, OH
| | - Stephen Rao
- From the Department of Neurology & Corinne Goldsmith Dickinson Center for Multiple Sclerosis (J.F.S., M.I.), Icahn School of Medicine at Mount Sinai, New York; Department of Neurology (R.B.), School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York (SUNY); Department of Neurology (C.E.), Medical University of Graz, Austria; Department of Neurology & Neuroimaging Research Unit, Division of Neuroscience (M.F., M.A.R.), San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Department of Anatomy and Neurosciences (J.J.G., H.H.), VU University Medical Center, Amsterdam Neuroscience, VUmc MS Center Amsterdam, the Netherlands; Masku Neurological Rehabilitation Centre (P.H.), Masku, Finland; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Mother-Child Health (M.I.), University of Genoa, Italy; Department of Neurology & Columbia University Multiple Sclerosis Clinical Care and Research Center (V.M.L.), Columbia University Medical Center, New York, NY; Department of Neurology and Rehabilitation (E.M.R.-O.), Tampere University Hospital, Finland; and Schey Center for Cognitive Neuroimaging, Neurological Institute (S.R.), Cleveland Clinic, OH
| |
Collapse
|
72
|
Covey TJ, Shucard JL, Benedict RH, Weinstock-Guttman B, Shucard DW. Improved cognitive performance and event-related potential changes following working memory training in patients with multiple sclerosis. Mult Scler J Exp Transl Clin 2018; 4:2055217317747626. [PMID: 29348927 PMCID: PMC5768274 DOI: 10.1177/2055217317747626] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 11/09/2017] [Indexed: 12/04/2022] Open
Abstract
Background Few studies of cognitive rehabilitation in multiple sclerosis (MS) have targeted working memory specifically. Objective We examined the effects of n-back working memory training on cognitive performance and brain function in patients with MS. Methods Patients with MS (n = 12) and healthy controls (HC; n = 12) underwent 20 sessions of n-back working memory training. Before and after training (pre- and posttest) cognitive event-related potential (ERP) measures were obtained during a 3-back task. In addition, a battery of cognitive tests was administered. Results Following n-back training, both MS patients and HCs showed significant improvement on tests of working memory, processing speed, complex attention, and reasoning ability. MS and HCs also exhibited an enhancement of N2 ERP component amplitude, and earlier N2 and P3 latencies, following n-back training. Conclusions Targeted training of working memory with the n-back task may improve cognitive function in MS. Enhancement of N2 ERP component amplitude and shorter N2 and P3 latency following training in patients with MS is consistent with plasticity of neural processes that are involved in working memory.
Collapse
Affiliation(s)
- Thomas J Covey
- Division of Cognitive and Behavioral Neurosciences, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, USA.,Neuroscience Program, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, USA
| | - Janet L Shucard
- Division of Cognitive and Behavioral Neurosciences, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, USA.,Neuroscience Program, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, USA
| | - Ralph Hb Benedict
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, USA.,Neuroscience Program, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, USA
| | - Bianca Weinstock-Guttman
- Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, USA
| | - David W Shucard
- Division of Cognitive and Behavioral Neurosciences, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, USA.,Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, USA.,Neuroscience Program, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, USA
| |
Collapse
|
73
|
Efficacy of a Computer-Assisted Cognitive Rehabilitation Intervention in Relapsing-Remitting Multiple Sclerosis Patients: A Multicenter Randomized Controlled Trial. Behav Neurol 2017; 2017:5919841. [PMID: 29463950 PMCID: PMC5804109 DOI: 10.1155/2017/5919841] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 09/25/2017] [Accepted: 10/04/2017] [Indexed: 11/17/2022] Open
Abstract
Cognitive impairment is frequently encountered in multiple sclerosis (MS) affecting between 40-65% of individuals, irrespective of disease duration and severity of physical disability. In the present multicenter randomized controlled trial, fifty-eight clinically stable RRMS patients with mild to moderate cognitive impairment and relatively low disability status were randomized to receive either computer-assisted (RehaCom) functional cognitive training with an emphasis on episodic memory, information processing speed/attention, and executive functions for 10 weeks (IG; n = 32) or standard clinical care (CG; n = 26). Outcome measures included a flexible comprehensive neuropsychological battery of tests sensitive to MS patient deficits and feedback regarding personal benefit gained from the intervention on four verbal questions. Only the IG group showed significant improvements in verbal and visuospatial episodic memory, processing speed/attention, and executive functioning from pre - to postassessment. Moreover, the improvement obtained on attention was retained over 6 months providing evidence on the long-term benefits of this intervention. Group by time interactions revealed significant improvements in composite cognitive domain scores in the IG relative to the demographically and clinically matched CG for verbal episodic memory, processing speed, verbal fluency, and attention. Treated patients rated the intervention positively and were more confident about their cognitive abilities following treatment.
Collapse
|
74
|
Nauta IM, Speckens AEM, Kessels RPC, Geurts JJG, de Groot V, Uitdehaag BMJ, Fasotti L, de Jong BA. Cognitive rehabilitation and mindfulness in multiple sclerosis (REMIND-MS): a study protocol for a randomised controlled trial. BMC Neurol 2017; 17:201. [PMID: 29162058 PMCID: PMC5698960 DOI: 10.1186/s12883-017-0979-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 11/12/2017] [Indexed: 11/29/2022] Open
Abstract
Background Cognitive problems frequently occur in patients with multiple sclerosis (MS) and profoundly affect their quality of life. So far, the best cognitive treatment options for MS patients are a matter of debate. Therefore, this study aims to investigate the effectiveness of two promising non-pharmacological treatments: cognitive rehabilitation therapy (CRT) and mindfulness-based cognitive therapy (MBCT). Furthermore, this study aims to gain additional knowledge about the aetiology of cognitive problems among MS patients, since this may help to develop and guide effective cognitive treatments. Methods/design In a dual-centre, single-blind randomised controlled trial (RCT), 120 MS patients will be randomised into one of three parallel groups: CRT, MBCT or enhanced treatment as usual (ETAU). Both CRT and MBCT consist of a structured 9-week program. ETAU consists of one appointment with an MS specialist nurse. Measurements will be performed at baseline, post-intervention and 6 months after the interventions. The primary outcome measure is the level of subjective cognitive complaints. Secondary outcome measures are objective cognitive function, functional brain network measures (using magnetoencephalography), psychological symptoms, well-being, quality of life and daily life functioning. Discussion To our knowledge, this will be the first RCT that investigates the effect of MBCT on cognitive function among MS patients. In addition, studying the effect of CRT on cognitive function may provide direction to the contradictory evidence that is currently available. This study will also provide information on changes in functional brain networks in relation to cognitive function. To conclude, this study may help to understand and treat cognitive problems among MS patients. Trial registration This trial was prospectively registered at the Dutch Trial Registration (number NTR6459, registered on 31 May 2017).
Collapse
Affiliation(s)
- Ilse M Nauta
- Department of Neurology, Amsterdam Neuroscience, MS Center Amsterdam, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, the Netherlands.
| | - Anne E M Speckens
- Department of Psychiatry, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, PO Box 9101, 6500 HB, Nijmegen, the Netherlands.,Department of Medical Psychology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - Jeroen J G Geurts
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, MS Center Amsterdam, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, the Netherlands
| | - Vincent de Groot
- Department of Rehabilitation Medicine, MS Center Amsterdam, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, the Netherlands
| | - Bernard M J Uitdehaag
- Department of Neurology, Amsterdam Neuroscience, MS Center Amsterdam, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, the Netherlands
| | - Luciano Fasotti
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, PO Box 9101, 6500 HB, Nijmegen, the Netherlands.,Klimmendaal Rehabilitation Center, PO Box 9044, 6800 CG, Arnhem, the Netherlands
| | - Brigit A de Jong
- Department of Neurology, Amsterdam Neuroscience, MS Center Amsterdam, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, the Netherlands
| |
Collapse
|
75
|
Tacchino A, Brichetto G, Zaratin P, Battaglia MA, Ponzio M. Multiple sclerosis and rehabilitation: an overview of the different rehabilitation settings. Neurol Sci 2017; 38:2131-2138. [DOI: 10.1007/s10072-017-3110-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 09/05/2017] [Indexed: 12/28/2022]
|
76
|
Mhizha-Murira JR, Drummond A, Klein OA, dasNair R. Reporting interventions in trials evaluating cognitive rehabilitation in people with multiple sclerosis: a systematic review. Clin Rehabil 2017; 32:243-254. [PMID: 28828902 DOI: 10.1177/0269215517722583] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the quantity and quality of description of cognitive rehabilitation for cognitive deficits in people with multiple sclerosis, using a variety of published checklists, and suggest ways of improving the reporting of these interventions. DATA SOURCES A total of 10 electronic databases were searched, including MEDLINE, EMBASE, CINAHL and PsycINFO, from inception to May 2017. Grey literature databases, trial registers, reference lists and author citations were also searched. REVIEW METHODS Papers were included if participants were people with multiple sclerosis aged 18 years and over and if the effectiveness of cognitive rehabilitation in improving functional ability for memory, attention or executive dysfunction, with or without a control group, was being evaluated. RESULTS A total of 54 studies were included in this review. The reporting of a number of key aspects of cognitive rehabilitation was poor. This was particularly in relation to content of interventions (reported completely in 26 of the 54 studies), intervention procedures (reported completely in 16 of the 54 studies), delivery mode (reported completely in 24 of the 54 studies) and intervention mechanism of action (reported completely in 21 of the 54 studies). CONCLUSION The quality of reporting of cognitive rehabilitation for memory, attention and executive function for multiple sclerosis, across a range of study designs, is poor. Existing reporting checklists do not adequately cover aspects relevant to cognitive rehabilitation, such as the approaches used to address cognitive deficits. Future checklists could consider these aspects we have identified in this review.
Collapse
Affiliation(s)
| | - Avril Drummond
- 1 School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Olga A Klein
- 1 School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Roshan dasNair
- 2 Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| |
Collapse
|
77
|
Rouleau I, Dagenais E, Tremblay A, Demers M, Roger É, Jobin C, Duquette P. Prospective memory impairment in multiple sclerosis: a review. Clin Neuropsychol 2017; 32:922-936. [PMID: 28774220 DOI: 10.1080/13854046.2017.1361473] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Multiple sclerosis (MS) is a progressive disease of the central nervous system affecting information processing speed, episodic memory, attention, and executive functions. MS patients also often report prospective memory (PM) failures that directly impact their functional autonomy, including professional and social life. The purpose of this paper was to review the literature concerning the assessment and remediation of PM deficits in MS. METHOD The literature pertaining to PM impairment in MS was carefully reviewed using PubMed, PsyINFO, and Google Scholar, as well as cross-references from the articles published on this topic. Since PM rehabilitation in MS patients is still in its infancy, this review mainly focuses on studies that have directly assessed PM through various measures including questionnaires, standardized clinical tests, and experimental procedures. CONCLUSION This literature review confirms the presence of PM deficits in MS patients, even in the early stages of the disease. A further need for controlled studies on PM assessment and PM interventions in patients with MS is stressed.
Collapse
Affiliation(s)
- Isabelle Rouleau
- a Department of Psychology , Université du Québec à Montréal , Montreal , Canada.,b Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM) , Montreal , Canada
| | - Emmanuelle Dagenais
- a Department of Psychology , Université du Québec à Montréal , Montreal , Canada
| | - Alexandra Tremblay
- a Department of Psychology , Université du Québec à Montréal , Montreal , Canada
| | - Mélanie Demers
- a Department of Psychology , Université du Québec à Montréal , Montreal , Canada
| | - Élaine Roger
- b Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM) , Montreal , Canada
| | - Céline Jobin
- c Neurology Service , Hôpital du Sacré-Coeur de Montréal , Montreal , Canada
| | - Pierre Duquette
- b Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM) , Montreal , Canada
| |
Collapse
|
78
|
Sarabandi M. A Comparison of Implicit and Explicit Motor Sequence Learning in Patients with Relapsing-Remitting Multiple Sclerosis. Sports (Basel) 2017; 5:E34. [PMID: 29910394 PMCID: PMC5968985 DOI: 10.3390/sports5020034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 05/17/2017] [Accepted: 05/23/2017] [Indexed: 12/16/2022] Open
Abstract
This study tends to assess implicit and explicit types of motor learning in patients with Multiple Sclerosis (MS) and normal peers by means of a serial reaction time. Sample size was 15 for each group and Samples included 30 patients with MS and 30 normal peers and were assigned to implicit and explicit learning groups. A repeated measures ANOVA was used for measuring reaction time and response error, and a paired samples t-test was used to compare regular and irregular sequence data in each group. Comparison of these two types of learning in speed (response time) and accuracy (number of errors) showed the number of errors (P = 0.012) and response time (P = 0.012) in the implicit motor learning group of MS patients and the number of errors (P = 0.096) and response time (P = 0.954) in the explicit motor learning group of MS patients. Moreover, comparison showed the number of errors (P = 0.008) and response time (P = 0.05) in the implicit group of normal peers and the number of errors (P = 0.011) and response time (P = 0.442) in the explicit group of normal peers. The results showed that explaining and describing the task is less effective at training the motor sequence of MS patients and that these patients benefit more from implicit learning.
Collapse
Affiliation(s)
- Maliheh Sarabandi
- Department of Physical Training, Faculty of Human Sciences, University of Zabol, Zabol 009854, Iran.
| |
Collapse
|
79
|
Hulst HE, Langdon DW. Functional training is a senseless strategy in MS cognitive rehabilitation: Strategy training is the only useful approach - NO. Mult Scler 2017; 23:930-932. [PMID: 28332909 PMCID: PMC5455978 DOI: 10.1177/1352458517692422] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Hanneke E Hulst
- VU University Medical Center, Department of Anatomy and Neurosciences, MS Center Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands.,Royal Holloway, University of London, Surrey, UK
| | | |
Collapse
|
80
|
Rehabilitation in Multiple Sclerosis: A Systematic Review of Systematic Reviews. Arch Phys Med Rehabil 2017; 98:353-367. [DOI: 10.1016/j.apmr.2016.04.016] [Citation(s) in RCA: 113] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 04/22/2016] [Indexed: 01/08/2023]
|
81
|
Pedullà L, Brichetto G, Tacchino A, Vassallo C, Zaratin P, Battaglia MA, Bonzano L, Bove M. Adaptive vs. non-adaptive cognitive training by means of a personalized App: a randomized trial in people with multiple sclerosis. J Neuroeng Rehabil 2016; 13:88. [PMID: 27716336 PMCID: PMC5050994 DOI: 10.1186/s12984-016-0193-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 09/17/2016] [Indexed: 11/26/2022] Open
Abstract
Background Cognitive impairment is common in multiple sclerosis (MS), but the definition of the best cognitive rehabilitation tools and features is still an open issue among researchers. The aims of the present study were to evaluate the effectiveness of COGNI-TRAcK (a customized application software delivering personalized working memory-based exercises) on cognitively impaired people with MS and to investigate the effects of an adaptive vs. a non-adaptive cognitive training administered by means of COGNI-TRAcK. Methods Twenty eight patients (20 women, age 47.5 ± 9.3 years, Expanded Disability Status Scale score 3.8 ± 1.9) were randomized in two homogeneous groups, both performing a 8-week home-based cognitive rehabilitation treatment by means of COGNI-TRAcK. The study group (ADAPT-gr) underwent an adaptive training given by the automatic adjustment of tasks difficulty to the subjects’ performance, whilst the control group (CONST-gr) was trained at constant difficulty levels. Before and after the treatment, patients’ cognitive status was assessed using a gold standard neuropsychological evaluation. Moreover, the mostly affected cognitive domains in MS (i.e., attention, concentration and information processing speed) were also assessed 6 months after the end of the treatment. Results The analysis of variance showed a significant Group*Time interaction in six out of ten tests of the cognitive evaluation. Post-hoc analysis revealed a significant improvement between the performances before and after the intervention only in the ADAPT-gr in tests evaluating verbal memory acquisition (p <0.05) and delayed recall (p = 0.001), verbal fluency (p = 0.01), sustained attention, concentration and information processing speed (p < 0.01). This last effect was maintained also after 6 months (p < 0.05). Conclusions We concluded that COGNI-TRAcK represents a suitable tool to administer a personalized training to cognitively impaired subjects and that an adaptive working load is a crucial feature determining the effectiveness of cognitive treatment, allowing transfer effects to several cognitive domains and long-term maintenance of results.
Collapse
Affiliation(s)
- Ludovico Pedullà
- Department of Experimental Medicine, Section of Human Physiology, University of Genoa, Genoa, Italy.,Italian Multiple Sclerosis Foundation, Scientific Research Area, Genoa, Italy
| | - Giampaolo Brichetto
- Italian Multiple Sclerosis Foundation, Scientific Research Area, Genoa, Italy.
| | - Andrea Tacchino
- Italian Multiple Sclerosis Foundation, Scientific Research Area, Genoa, Italy
| | - Claudio Vassallo
- Italian Multiple Sclerosis Foundation, Scientific Research Area, Genoa, Italy
| | - Paola Zaratin
- Italian Multiple Sclerosis Foundation, Scientific Research Area, Genoa, Italy
| | | | - Laura Bonzano
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Marco Bove
- Department of Experimental Medicine, Section of Human Physiology, University of Genoa, Genoa, Italy.
| |
Collapse
|
82
|
Hämäläinen P, Rosti-Otajärvi E. Cognitive impairment in MS: rehabilitation approaches. Acta Neurol Scand 2016; 134 Suppl 200:8-13. [PMID: 27580900 DOI: 10.1111/ane.12650] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2016] [Indexed: 11/29/2022]
Abstract
Cognitive deficits have been reported in 45%-70% of patients with multiple sclerosis (MS). Like other symptoms of MS, cognitive deficits are highly variable. Slowed information processing and memory and learning dysfunction are regarded as the most frequent cognitive deficits in MS. Both white and gray matter damages have been suggested to contribute to cognitive impairments in MS. There is no direct relationship between cognitive deficits and physical disability, disease duration or course of the disease. In addition to cognitive impairments, neuropsychiatric symptoms are observed in MS, the most common being alterations in mood state. Neurobehavioral deficits have multidimensional effects on the activities of daily living and quality of life. Consequently, attention should be paid to early diagnosis and treatment. Based on studies on cognitive retraining and more multimodal neuropsychological rehabilitation, both approaches show promise in the treatment of cognitive impairments and their harmful effects. This review introduces the frequency and characteristics of cognitive impairments, as well as main findings on the effects of neuropsychological rehabilitation in MS.
Collapse
Affiliation(s)
- P. Hämäläinen
- Masku Neurological Rehabilitation Centre; Masku Finland
| | - E. Rosti-Otajärvi
- Department of Neurology and Rehabilitation; Tampere University Hospital; Tampere Finland
| |
Collapse
|
83
|
Bora E, Özakbaş S, Velakoulis D, Walterfang M. Social Cognition in Multiple Sclerosis: a Meta-Analysis. Neuropsychol Rev 2016; 26:160-72. [DOI: 10.1007/s11065-016-9320-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Accepted: 05/12/2016] [Indexed: 12/16/2022]
|
84
|
Brown CL, Colbeck M, Fogarty D, Funk S. Learning to live with multiple sclerosis cognitive impairment and how it influences readiness for group cognitive intervention. Disabil Health J 2016; 9:638-45. [PMID: 27297229 DOI: 10.1016/j.dhjo.2016.04.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 03/26/2016] [Accepted: 04/26/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND Up to 65% of people with multiple sclerosis (MS) have cognitive impairment that negatively affects quality of life, social functioning, and work. Evidence is building to suggest cognitive rehabilitation is a helpful intervention strategy, and that a group approach can be effective for individuals with MS. Further exploration of how to maximize the potential of group cognitive interventions is warranted. OBJECTIVE To describe how the psychological process of learning to live with MS-related cognitive changes influences participation in a group cognitive intervention. METHODS A qualitative design with interpretive description approach was used to ask consumers with MS the important features of a group cognitive intervention. Ten females with self-reported physician-diagnosed MS participated in two focus groups. Focus groups were audio recorded and transcribed. Inductive analysis resulted in content and process categories and themes. RESULTS The focus groups echoed the processes and relationships that occur in a group intervention program. The main three themes represented stages in a process of learning to live with cognitive changes. The three themes were: 1) coming to know yourself with cognitive changes, 2) learning to cope with cognitive changes and 3) living a changed life. Relationships exist between these stages and the extent to which an individual will benefit from a group cognitive intervention program. CONCLUSIONS Knowledge of group process and the psychological processes involved in behavioral change are essential skills for facilitating a cognitive intervention group for people with MS.
Collapse
Affiliation(s)
- Cara L Brown
- Department of Occupational Therapy, College of Rehabilitation Sciences, University of Manitoba, R106 - 771 McDermot Avenue, Winnipeg, MB, Canada R3T 2N2.
| | - Melissa Colbeck
- Department of Occupational Therapy, College of Rehabilitation Sciences, University of Manitoba, R106 - 771 McDermot Avenue, Winnipeg, MB, Canada R3T 2N2
| | - Danielle Fogarty
- Department of Occupational Therapy, College of Rehabilitation Sciences, University of Manitoba, R106 - 771 McDermot Avenue, Winnipeg, MB, Canada R3T 2N2
| | - Sara Funk
- Department of Occupational Therapy, College of Rehabilitation Sciences, University of Manitoba, R106 - 771 McDermot Avenue, Winnipeg, MB, Canada R3T 2N2
| |
Collapse
|
85
|
Lincoln NB, das Nair R, Bradshaw L, Constantinescu CS, Drummond AER, Erven A, Evans AL, Fitzsimmons D, Montgomery AA, Morgan M. Cognitive Rehabilitation for Attention and Memory in people with Multiple Sclerosis: study protocol for a randomised controlled trial (CRAMMS). Trials 2015; 16:556. [PMID: 26643818 PMCID: PMC4672565 DOI: 10.1186/s13063-015-1016-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 10/19/2015] [Indexed: 11/10/2022] Open
Abstract
Background People with multiple sclerosis have problems with memory and attention. Cognitive rehabilitation is a structured set of therapeutic activities designed to retrain an individual’s memory and other cognitive functions. Cognitive rehabilitation may be provided to teach people strategies to cope with these problems, in order to reduce the impact on everyday life. The effectiveness of cognitive rehabilitation for people with multiple sclerosis has not been established. Methods This is a multi-centre, randomised controlled trial investigating the clinical and cost-effectiveness of a group-based cognitive rehabilitation programme for attention and memory problems for people with multiple sclerosis. Four hundred people with multiple sclerosis will be randomised from at least four centres. Participants will be eligible if they have memory problems, are 18 to 69 years of age, are able to travel to attend group sessions and give informed consent. Participants will be randomised in a ratio of 6:5 to the group rehabilitation intervention plus usual care or usual care alone. Intervention groups will receive 10 weekly sessions of a manualised cognitive rehabilitation programme. The intervention will include both restitution strategies to retrain impaired attention and memory functions and compensation strategies to enable participants to cope with their cognitive problems. All participants will receive a follow-up questionnaire and an assessment by a research assistant at 6 and 12 months after randomisation. The primary outcome is the Multiple Sclerosis Impact Scale (MSIS) Psychological subscale at 12 months. Secondary outcomes include the Everyday Memory Questionnaire, General Health Questionnaire-30, EQ-5D and a service use questionnaire from participants, and the Everyday Memory Questionnaire-relative version and Carer Strain Index from a relative or friend. The primary analysis will be based on intention to treat. A mixed-model regression analysis of the MSIS Psychological subscale at 12 months will be used to estimate the effect of the group cognitive rehabilitation programme. Discussion The study will provide evidence regarding the clinical and cost-effectiveness of a group-based cognitive rehabilitation programme for attention and memory problems in people with multiple sclerosis. Trial registration ISRCTN09697576. Registered 14 August 2014.
Collapse
Affiliation(s)
- Nadina B Lincoln
- Division of Rehabilitation and Ageing, School of Medicine B127a Medical School Queens Medical Centre, Nottingham, NG7 2UH, UK.
| | - Roshan das Nair
- Division of Rehabilitation and Ageing, School of Medicine B127a Medical School Queens Medical Centre, Nottingham, NG7 2UH, UK. .,Department of Clinical Psychology & Neuropsychology, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK.
| | - Lucy Bradshaw
- Nottingham Clinical Trials Unit, C floor South Block, Queens Medical Centre, Nottingham, NG7 2UH, UK.
| | - Cris S Constantinescu
- Department of Clinical Neurology, South Block, Queens Medical Centre, University of Nottingham, Nottingham, NG7 2UH, UK.
| | - Avril E R Drummond
- School of Health Sciences, A Floor, South Block, Queens Medical Centre, University of Nottingham, Nottingham, NG7 2HA, UK.
| | - Alexandra Erven
- Nottingham Clinical Trials Unit, C floor South Block, Queens Medical Centre, Nottingham, NG7 2UH, UK.
| | - Amy L Evans
- Nottingham Clinical Trials Unit, C floor South Block, Queens Medical Centre, Nottingham, NG7 2UH, UK.
| | - Deborah Fitzsimmons
- Swansea Centre for Health Economics, College of Human and Health Sciences, Singleton Campus, Swansea University, Swansea, SA2 8PP, UK.
| | - Alan A Montgomery
- Nottingham Clinical Trials Unit, C floor South Block, Queens Medical Centre, Nottingham, NG7 2UH, UK.
| | | |
Collapse
|
86
|
Shah P. Symptomatic management in multiple sclerosis. Ann Indian Acad Neurol 2015; 18:S35-42. [PMID: 26538847 PMCID: PMC4604696 DOI: 10.4103/0972-2327.164827] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Revised: 06/26/2015] [Accepted: 06/15/2015] [Indexed: 02/02/2023] Open
Abstract
Multiple sclerosis (MS) is the commonest cause of disability in young adults. While there is increasing choice and better treatments available for delaying disease progression, there are still, very few, effective symptomatic treatments. For many patients such as those with primary progressive MS (PPMS) and those that inevitably become secondary progressive, symptom management is the only treatment available. MS related symptoms are complex, interrelated, and can be interdependent. It requires good understanding of the condition, a holistic multidisciplinary approach, and above all, patient education and empowerment.
Collapse
Affiliation(s)
- Pushkar Shah
- Department of Neurology, Institute of Neurosciences, South Glasgow University Hospital NHS Trust, Glasgow, G51 4TF, United Kingdom
| |
Collapse
|
87
|
Wu TH, Hu LY, Lu T, Chen PM, Chen HJ, Shen CC, Wen CH. Risk of psychiatric disorders following trigeminal neuralgia: a nationwide population-based retrospective cohort study. J Headache Pain 2015; 16:64. [PMID: 26174508 PMCID: PMC4501948 DOI: 10.1186/s10194-015-0548-y] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 06/29/2015] [Indexed: 11/23/2022] Open
Abstract
Background TN is one of the most common causes of facial pain. A higher prevalence of psychiatric co-morbidities, especially depressive disorder, has been proven in patients with TN; however, a clear temporal-causal relationship between TN and specific psychiatric disorders has not been well established. We performed a nationwide population-based retrospective cohort study to explore the relationship between TN and the subsequent development of psychiatric disorders, including schizophrenia, bipolar disorder, depressive disorder, anxiety disorder, and sleep disorder. Methods We identified subjects who were newly diagnosed with TN between January 1, 2000 and December 31, 2010 in the Taiwan National Health Insurance Research Database. A comparison cohort was constructed for patients without TN who were matched according to age and sex. All TN and control patients were observed until diagnosed with psychiatric disorders, death, withdrawal from the National Health Institute system, or until December 31, 2010. Results The TN cohort consisted of 3273 patients, and the comparison cohort consisted of 13,092 matched control patients without TN. The adjusted hazard ratio (aHR) of depressive disorder, anxiety disorder and sleep disorder in subjects with TN was higher than that of the controls during the follow-up [aHR: 2.85 (95 % confidence interval: 2.11–3.85), aHR: 2.98 (95 % confidence interval: 2.12–4.18) and aHR: 2.17 (95 % confidence interval: 1.48–3.19), respectively]. Conclusions TN might increase the risk of subsequent newly diagnosed depressive disorder, anxiety disorder, and sleep disorder, but not schizophrenia or bipolar disorder. Additional prospective studies are required to confirm these findings.
Collapse
Affiliation(s)
- Tung-Han Wu
- Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Chiayi Branch, Chiayi, Taiwan,
| | | | | | | | | | | | | |
Collapse
|