Persistence of the effects of attention and executive functions intensive rehabilitation in relapsing remitting multiple sclerosis

BackgroundNeuropsychological rehabilitation efficacy in multiple sclerosis (MS) is a currently investigated issue. We reported, in a single blind controlled study, that an intensive short duration cognitive training of attention and executive functions significantly improves the treated functions and reduces depression in MS. The persistence of these effects over time are unknown.ObjectiveTo evaluate the persistence over time of neuropsychological improvement due to cognitive training nine months after rehabilitation onset.MethodsThis is a single blind randomized controlled study. 24 MS patients were randomly assigned to experimental group (n=13) and received PC assisted neuropsychological treatment for three months, or to control group (n=11), receiving no treatment. Patients were submitted to neuropsychological evaluation, depression and quality of life questionnaires at baseline, three months and nine months later.ResultsNine months follow up compared to baseline evaluation shows a statistically significant improvement (p<0.05) in attention, information processing and executive functions tests (PASAT 3″, COWA/S, WCSTpe), in depression and quality of life questionnaires in rehabilitated patients only. reliable change index (RCI) and modified RCI confirmed the clinical significance of this improvement in rehabilitated patients.ConclusionsThree months intensive neuropsychological rehabilitation of attention, information processing and executive functions induces a long lasting and clinically relevant neuropsychological improvement over time and a persistent depression and quality of life amelioration in patients with RR MS.

► MS affects cognition, mainly information processing, executive functions and attention.
► Cognitive rehabilitation has been addressed in studies, often with methodological limitations.
► Efficacy of an intensive attention/information processing and executive training in MS was shown.
► In this study we found, after nine months, the persistence of the improvement in cognitive measures.
► Also a reduction in depression and an improvement in quality of life was found in treated patients.