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Comparing the Effectiveness of Computer-Based, Manual-based, and Combined Cognitive Rehabilitation on Cognitive Functions in Relapsing-Remitting Multiple Sclerosis Patients.

ABSTRACT: Introduction:This study aimed to compare the effectiveness of computer-based, manual-based, and combined cognitive rehabilitation to improve cognitive functions among patients with Relapsing-Remitting Multiple Sclerosis (RRMS). Methods:This was a quasi-experimental study with a pre-test-post-test, and a 2-month follow-up, as well as a control group design. Sixty female patients with RRMS were selected by convenience sampling technique. Then they were randomly assigned into three experimental groups (computer-based, manual-based, and combined cognitive rehabilitation, each group including 12 patients), a placebo group (12 patients), and a control group (12 patients). The interventions were conducted in 21 sessions for the experimental groups for 5 months. The placebo group received physical rehabilitation intervention, and the control group received no intervention. The study participants were assessed by Psychiatric-Neurological Profile, Mini-Mental State Examination, Kurtzke Expanded Disability Status Scale, Stroop Color and Word Test, Wisconsin Card Sorting Test, and Paced Auditory Serial Addition Test. The obtained data were analyzed by repeated-measures multivariate analysis of variance in SPSS. Results:The effect of group factor was not significant (?2=0.129), but the effect of time (?2=0.884) and interaction effect of time and group (?2=0.295) were statistically significant (P<0.05). There was no significant difference between the effects of all three rehabilitation interventions (P>0.05). In the post-test totally and in Follow-up partially, all comparisons among three experimental groups with control and placebo groups were statistically significant (P<0.05). Conclusion:Cognitive rehabilitation was effective in improving cognitive functions in patients with RRMS. Thus, these interventions are recommended for application, along with other treatment protocols to treat RRMS in clinical settings.

SUBMITTER: Rahmani M

PROVIDER: S-EPMC7253816 | biostudies-literature | 2020 Jan-Feb

REPOSITORIES: biostudies-literature

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Comparing the Effectiveness of Computer-Based, Manual-based, and Combined Cognitive Rehabilitation on Cognitive Functions in Relapsing-Remitting Multiple Sclerosis Patients.

Rahmani Mehri M Rahimian Boogar Isaac I Talepasand Siavash S Nokani Mostafa M

Basic and clinical neuroscience 20200101 1

<h4>Introduction</h4>This study aimed to compare the effectiveness of computer-based, manual-based, and combined cognitive rehabilitation to improve cognitive functions among patients with Relapsing-Remitting Multiple Sclerosis (RRMS).<h4>Methods</h4>This was a quasi-experimental study with a pre-test-post-test, and a 2-month follow-up, as well as a control group design. Sixty female patients with RRMS were selected by convenience sampling technique. Then they were randomly assigned into three e ...[more]

PMID: 32483480

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Project description:Cognitive impairments are commonly observed in patients with multiple sclerosis and are associated with lower levels of quality of life. No consensus has been reached on how to tackle effectively cognitive decline in this clinical population non-pharmacologically. This exploratory case-control study aims to investigate the effectiveness of a hypothesis-based cognitive training designed to target multiple domains by promoting the synchronous co-activation of different brain areas and thereby improve cognition and induce changes in functional connectivity in patients with relapsing-remitting multiple sclerosis. Forty-five patients (36 females and 9 males, mean age 44.62 ± 8.80 years) with clinically stable relapsing-remitting multiple sclerosis were assigned to either a standard cognitive training or to control groups (sham training and non-active control). The standard training included twenty sessions of computerized exercises involving various cognitive functions supported by distinct brain networks. The sham training was a modified version of the standard training that comprised the same exercises and number of sessions but with increased processing speed load. The non-active control group received no cognitive training. All patients underwent comprehensive neuropsychological and magnetic resonance imaging assessments at baseline and after 5 weeks. Cognitive and resting-state magnetic resonance imaging data were analyzed using repeated measures models. At reassessment, the standard training group showed significant cognitive improvements compared to both control groups in memory tasks not specifically targeted by the training: the Buschke Selective Reminding Test and the Semantic Fluency test. The standard training group showed reductions in functional connectivity of the salience network, in the anterior cingulate cortex, associated with improvements on the Buschke Selective Reminding Test. No changes were observed in the sham training group. These findings suggest that multi-domain training that stimulates multiple brain areas synchronously may improve cognition in people with relapsing-remitting multiple sclerosis if sufficient time to process training material is allowed. The associated reduction in functional connectivity of the salience network suggests that training-induced neuroplastic functional reorganization may be the mechanism supporting performance gains. This study was approved by the Regional Ethics Committee of Yorkshire and Humber (approval No. 12/YH/0474) on November 20, 2013.

Dataset Information

Comparing the Effectiveness of Computer-Based, Manual-based, and Combined Cognitive Rehabilitation on Cognitive Functions in Relapsing-Remitting Multiple Sclerosis Patients.

Publications

Comparing the Effectiveness of Computer-Based, Manual-based, and Combined Cognitive Rehabilitation on Cognitive Functions in Relapsing-Remitting Multiple Sclerosis Patients.

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