Cognitive Rehab ‘Effective, Low-risk’ in Treating Difficulties Due to MS

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by Marisa Wexler, MS |

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Cognitive rehabilitation is an effective therapy for cognitive problems brought on by multiple sclerosis (MS), a review study highlights.

“Clinicians should consider this low-cost, low-risk, yet effective treatment approach for their patients,” its researchers wrote.

The study, “Neurological update: cognitive rehabilitation in multiple sclerosis,” was published in the Journal of Neurology.

For as many as two out of every three people with MS, cognitive impairment is a symptom of the disease. How this impairment manifests varies from person to person, but often involves problems with learning and memory, as well as difficulty or delays in processing new information.

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While cognitive impairment can have a sizable impact on a person’s daily life — making it harder to maintain relationships, hold a job, and handle errands and other tasks — treatments for this MS symptom are limited. Most medications approved to treat MS are not especially effective at addressing cognitive dysfunction.

Cognitive rehabilitation is a non-pharmacological approach to managing such difficulties. It has two broad strategies, restorative and compensatory. Both involve doing activities or other work to ease cognitive symptoms.

In restorative cognitive rehabilitation, sometimes called cognitive remediation, the goal is to reinforce, strengthen, and restore cognitive skills that may be impaired. This type of rehabilitation commonly involves repetitive exercises that are done using a computer.

By contrast, compensatory cognitive rehabilitation does not aim to help patients gain back lost cognitive skills. Instead, it focuses on creating strategies to help people handle their impairments, finding ways to make difficult things more manageable.

A trio of researchers at the Kessler Foundation and New Jersey Medical School at Rutgers University conducted a review of published scientific studies on the effects of both kinds of cognitive rehabilitation in people with MS. In total, the team assessed 81 studies, most of which were published in the last decade.

Analyzing these data collectively, the researchers found “evidence that cognitive rehabilitation programs (either restorative or compensatory) are efficacious in treating MS-related cognitive dysfunction,” they wrote.

“Cognitive rehabilitation should be part of a comprehensive treatment plan for people with MS who experience cognitive deficits. Given the lack of approved pharmacological treatments, behavioral approaches are the best treatment options that clinicians can currently offer,” John DeLuca, PhD, a study co-author with the Kessler Foundation, said in a press release.

“Patients generally report enjoying treatment, which would be conducive to compliance [taking therapies as directed],” DeLuca added. “Furthermore, computer-based treatments can be easily delivered at home, making this low-cost effective intervention more convenient and accessible to individuals in need.”

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