Efficacy of a short cognitive training program in patients with multiple sclerosis

BACKGROUND: Cognitive impairment is a common feature in multiple sclerosis (MS) and may have a substantial impact on quality of life. Evidence about the effectiveness of neuropsychological rehabilitation is still limited, but current data suggest that computer-assisted cognitive training improves cognitive performance. OBJECTIVE: The objective of this study was to evaluate the efficacy of combined computer-assisted training supported by home-based neuropsychological training to improve attention, processing speed, memory and executive functions during 3 consecutive months. METHODS: In this randomized controlled study blinded for the evaluators, 62 MS patients with clinically stable disease and mild-to-moderate levels of cognitive impairment were randomized to receive a computer-assisted neuropsychological training program (n=30) or no intervention (control group [CG]; n=32). The cognitive assessment included the Brief Repeatable Battery of Neuropsychological Test. Other secondary measures included subjective cognitive impairment, anxiety and depression, fatigue and quality of life measures. RESULTS: The treatment group (TG) showed significant improvements in measures of verbal memory, working memory and phonetic fluency after intervention, and repeated measures analysis of covariance revealed a positive effect in most of the functions. The control group (CG) did not show changes. The TG showed a significant reduction in anxiety symptoms and significant improvement in quality of life. There were no improvements in fatigue levels and depressive symptoms. CONCLUSION: Cognitive intervention with a computer-assisted training supported by home training between face-to-face sessions is a useful tool to treat patients with MS and improve functions such as verbal memory, working memory and phonetic fluency.