Cognitive rehabilitation in multiple sclerosis.

2018 ◽  
pp. 265-292 ◽  
Author(s):  
Nancy D. Chiaravalloti ◽  
John DeLuca
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Rehabilitation

Cognitive rehabilitation in children and adolescents with multiple sclerosis

2010 ◽  
Vol 31 (S2) ◽  
pp. 275-278 ◽  
Author(s):  
Emilio Portaccio ◽  
Benedetta Goretti ◽  
Valentina Zipoli ◽  
Bahia Hakiki ◽  
Marta Giannini ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Children And Adolescents ◽  
Cognitive Rehabilitation

scholarly journals The Rationale for Monitoring Cognitive Function in Multiple Sclerosis: Practical Issues for Clinicians

2018 ◽  
Vol 12 (1) ◽  
pp. 31-40 ◽  
Author(s):  
Christos Bakirtzis ◽  
Panagiotis Ioannidis ◽  
Lambros Messinis ◽  
Grigorios Nasios ◽  
Elina Konstantinopoulou ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Practice ◽  
Cognitive Function ◽  
Cognitive Rehabilitation ◽  
Assessment Tools ◽  
Systematic Evaluation ◽  
Presenting Symptoms ◽  
Increased Risk ◽  
Medication Side ◽  
Multiple Sclerosis Patients

About half of patients with multiple sclerosis exhibit cognitive impairment which negatively affects their quality of life. The assessment of cognitive function in routine clinical practice is still undervalued, although various tools have been proposed for this reason. In this article, we describe the potential benefits of implementing cognitive assessment tools in routine follow -ups of MS patients. Early detection of changes in cognitive performance may provide evidence of disease activity, could unmask depression or medication side-effects and provide suitable candidates for cognitive rehabilitation. Since apathy and cognitive deficiencies are common presenting symptoms in Progressive Multifocal Leukoencephalopathy, we discuss the utility of frequent monitoring of mental status in multiple sclerosis patients at increased risk. In addition, we propose a relevant algorithm aiming to incorporate a systematic evaluation of cognitive function in every day clinical practice in multiple sclerosis.

scholarly journals A randomized controlled trial of a cognitive rehabilitation intervention for persons with multiple sclerosis

2012 ◽  
Vol 26 (10) ◽  
pp. 882-893 ◽  
Author(s):  
Alexa K Stuifbergen ◽  
Heather Becker ◽  
Frank Perez ◽  
Janet Morison ◽  
Vicki Kullberg ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Randomized Controlled Trial ◽  
Cognitive Rehabilitation ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Rehabilitation Intervention

scholarly journals Short Report: Adherence to Neuropsychological Recommendations in Patients with Multiple Sclerosis

2019 ◽  
Vol 21 (2) ◽  
pp. 70-75
Author(s):  
Marnina Stimmel ◽  
Shaina Shagalow ◽  
Elizabeth K. Seng ◽  
Jeffrey G. Portnoy ◽  
Roseann Archetti ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Rehabilitation ◽  
Neuropsychological Testing ◽  
Treatment Recommendations ◽  
Phone Call ◽  
Short Report ◽  
Test Results ◽  
Adherence To Treatment ◽  
Other Information ◽  
Record Review

Abstract Background: Adherence to nonmedication recommendations is typically low, as seen in various health populations. Because literature on adherence to treatment recommendations made after neuropsychological testing in multiple sclerosis (MS) is lacking, this study evaluated adherence and reasons for nonadherence. Relationships between adherence to recommendations and various other factors in patients with MS were also evaluated. Methods: Of 66 adult patients seen for neuropsychological testing at an MS center, 55 were eligible for this study. Forty-five patients (mean age, 43.4 years; 75.6% women) were reached by phone, and all agreed to an interview involving questions regarding adherence to treatment recommendations. Other information was obtained through retrospective medical record review. Results: Overall self-reported adherence to recommendations made from neuropsychological testing was 38%. Adherence rates varied by recommendation type: psychopharmacological management had the highest rate (80%), and referrals for cognitive rehabilitation had the lowest (6.5%). Reasons for nonadherence included needing more information and wanting to speak with one's physician regarding the recommendations. Adherence was associated with patients' ability to spontaneously recall at least some of their recommendations and with receiving both a written report and a phone call with test results. Conclusions: Adherence to recommendations made after neuropsychological testing for patients with MS is low. Points of intervention may be to give directed feedback for each recommendation and to provide both a written report and a phone call with results and recommendations. Asking patients to repeat back the recommendations may be a simple and efficient way to increase understanding and improve adherence.

scholarly journals Group cognitive rehabilitation to reduce the psychological impact of multiple sclerosis on quality of life: the CRAMMS RCT

2020 ◽  
Vol 24 (4) ◽  
pp. 1-182 ◽  
Author(s):  
Nadina B Lincoln ◽  
Lucy E Bradshaw ◽  
Cris S Constantinescu ◽  
Florence Day ◽  
Avril ER Drummond ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Confidence Interval ◽  
Usual Care ◽  
Cognitive Rehabilitation ◽  
Rehabilitation Programme ◽  
Everyday Memory ◽  
Impact Scale ◽  
The Everyday ◽  
Everyday Memory Questionnaire ◽  
Memory Questionnaire

Background People with multiple sclerosis have problems with memory and attention. The effectiveness of cognitive rehabilitation has not been established. Objectives The objectives were to assess the clinical effectiveness and cost-effectiveness of a cognitive rehabilitation programme for people with multiple sclerosis. Design This was a multicentre, randomised controlled trial in which participants were randomised in a ratio of 6 : 5 to receive cognitive rehabilitation plus usual care or usual care alone. Participants were assessed at 6 and 12 months after randomisation. Setting The trial was set in hospital neurology clinics and community services. Participants Participants were people with multiple sclerosis who had cognitive problems, were aged 18–69 years, could travel to attend group sessions and gave informed consent. Intervention The intervention was a group cognitive rehabilitation programme delivered weekly by an assistant psychologist to between four and six participants for 10 weeks. Main outcome measures The primary outcome was the Multiple Sclerosis Impact Scale – Psychological subscale at 12 months. Secondary outcomes included results from the Everyday Memory Questionnaire, the 30-Item General Health Questionnaire, the EuroQol-5 Dimensions, five-level version and a service use questionnaire from participants, and the Everyday Memory Questionnaire – relative version and the Modified Carer Strain Index from a relative or friend of the participant. Results Of the 449 participants randomised, 245 were allocated to cognitive rehabilitation (intervention group) and 204 were allocated to usual care (control group). Of these, 214 in the intervention group and 173 in the control group were included in the primary analysis. There was no clinically important difference in the Multiple Sclerosis Impact Scale – Psychological subscale score between the two groups at the 12-month follow-up (adjusted difference in means –0.6, 95% confidence interval –1.5 to 0.3; p = 0.20). There were no important differences between the groups in relation to cognitive abilities, fatigue, employment, or carer strain at follow-up. However, there were differences, although small, between the groups in the Multiple Sclerosis Impact Scale – Psychological subscale score at 6 months (adjusted difference in means –0.9, 95% confidence interval –1.7 to –0.1; p = 0.03) and in everyday memory on the Everyday Memory Questionnaire as reported by participants at 6 (adjusted difference in means –5.3, 95% confidence interval –8.7 to –1.9) and 12 months (adjusted difference in means –4.4, 95% confidence interval –7.8 to –0.9) and by relatives at 6 (adjusted difference in means –5.4, 95% confidence interval –9.1 to –1.7) and 12 months (adjusted difference in means –5.5, 95% confidence interval –9.6 to –1.5) in favour of the cognitive rehabilitation group. There were also differences in mood on the 30-Item General Health Questionnaire at 6 (adjusted difference in means –3.4, 95% confidence interval –5.9 to –0.8) and 12 months (adjusted difference in means –3.4, 95% confidence interval –6.2 to –0.6) in favour of the cognitive rehabilitation group. A qualitative analysis indicated perceived benefits of the intervention. There was no evidence of a difference in costs (adjusted difference in means –£574.93, 95% confidence interval –£1878.93 to £729.07) or quality-adjusted life-year gain (adjusted difference in means 0.00, 95% confidence interval –0.02 to 0.02). No safety concerns were raised and no deaths were reported. Limitations The trial included a sample of participants who had relatively severe cognitive problems in daily life. The trial was not powered to perform subgroup analyses. Participants could not be blinded to treatment allocation. Conclusions This cognitive rehabilitation programme had no long-term benefits on quality of life for people with multiple sclerosis. Future work Future research should evaluate the selection of those who may benefit from cognitive rehabilitation. Trial registration Current Controlled Trials ISRCTN09697576. Funding This project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 4. See the National Institute for Health Research Journals Library website for further project information.

scholarly journals Repetitive Transcranial Magnetic Stimulation, Cognition, and Multiple Sclerosis: An Overview

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Grigorios Nasios ◽  
Lambros Messinis ◽  
Efthimios Dardiotis ◽  
Panagiotis Papathanasopoulos
Keyword(s):  
Multiple Sclerosis ◽  
Transcranial Magnetic Stimulation ◽  
Functional Connectivity ◽  
Cognitive Rehabilitation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Cognitively Impaired ◽  
Functional Reorganization ◽  
Brain Volume Loss ◽  
Potential Therapeutic Role

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.

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