Study Provides Strong Evidence for Benefits of Cognitive Rehabilitation to Improve Learning and Memory in People with MS

Nov 25, 2013

Researchers at the Kessler Foundation in New Jersey report results of a clinical trial showing that a specific type of memory training improves learning in people with MS for at least 6 months after the training has ended, and also benefits other aspects of quality of life. This controlled trial, funded by the National Institutes of Health, provides important results that should help promote the benefits of cognitive rehabilitation and improve its coverage by insurers. Nancy Chiaravalloti, PhD, John DeLuca, PhD, and colleagues recently reported their results early online in the journal Neurology.

Background: More than half of people with MS experience cognitive changes, particularly problems with learning and memory. These problems can affect a person’s quality of life by interfering with work, social interactions, and other situations. Because of different methods used to study cognitive rehabilitation, there has been controversy as to whether interventions are effective in improving memory problems in people with MS. Dr. Chiaravalloti and colleagues conducted a clinical trial of people with MS to see if a specific type of behavioral training can improve memory.

The study: The researchers performed a double-blind, randomized controlled trial in which participants and therapists were unaware of the assignment to a particular group. They enrolled 86 people with various subtypes of MS. Forty-five participants were assigned to a “treatment” group, and 41 were assigned to a “placebo” group.

The treatment group met with a therapist and underwent a type of behavioral training, called Story Memory Technique, which involves the use of imagery and context-based memory training. The placebo group also interacted with a therapist but engaged in tasks that did not specifically target learning. Each group completed 10 training sessions (twice a week) over 5 weeks. Memory tests and questionnaires to assess anxiety, depression, and other parameters were completed by trial participants before, immediately following completion of training, and 6 months after completion. In a second part of the study, participants in the treatment group received additional once-monthly “booster” sessions involving applying the Story Memory Technique to real-life situations, while the placebo group had monthly sessions that did not involve this training technique.

Results revealed that more participants in the treatment group than the placebo group showed improved learning and memory, improved general contentment, improved planning and organizing ability, and reduced apathy. These effects of the behavioral training were sustained for at least 6 months. The “booster” training appeared to provide no additional benefit.

Comment: This controlled trial provides important new evidence that cognitive rehabilitation can improve learning and memory in people with MS, and should help promote the benefits of cognitive rehabilitation and improve its coverage by insurers. The results are also consistent with previous studies suggesting that cognitive rehabilitation improves not only the targeted function, but extends to improvement in other parameters such as fatigue, depression, and overall quality of life. Further studies will enhance our understanding of who will benefit most, and the best types and length of training needed to optimize success.
 

source: National MS Society

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