Personalized rehab program may help MS patients manage cognitive issues
Feasibility study reported gains in planning daily activities, coping with fatigue
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A personalized neuropsychological rehabilitation program may help people with multiple sclerosis manage cognitive difficulties, according to a feasibility study.
- People with MS often experience cognitive difficulties, such as memory loss and trouble planning daily activities.
- A personalized neuropsychological rehabilitation program may help patients manage cognitive issues.
- Participants in a feasibility study reported better daily activity planning and enhanced use of cognitive strategies.
A brief, personalized neuropsychological rehabilitation program may help people with multiple sclerosis (MS) manage cognitive difficulties, according to a feasibility study.
Participants reported improvements in their ability to use cognitive strategies, plan daily activities, and cope with fatigue.
The study (ISRCTN11203922) showed that the program, called Neuropsychological Evaluation and Rehabilitation in Multiple Sclerosis (NEuRoMS), was associated with a moderate improvement in the psychological impact of MS after three months.
“These results highlight the potential value of brief, targeted interventions delivered early in the course of cognitive impairment [and align] with evidence that [people with MS] with mild-to-moderate impairment may benefit most from such interventions,” researchers wrote.
A larger definitive trial (ISRCTN10285713) is currently underway to determine whether NEuRoMS can improve cognitive and psychological outcomes for people with MS.
The study, “Neuropsychological evaluation and rehabilitation in multiple sclerosis (NEuRoMS): A mixed-methods, multi-centre feasibility randomised controlled trial,” was published in Multiple Sclerosis Journal — Experimental, Translational and Clinical.
Feasibility study aimed at informing definitive trial
People with MS may experience cognitive difficulties, including problems with memory, attention, planning, and processing speed, or how quickly the brain receives and responds to information. These changes can interfere with everyday activities, social relationships, and quality of life, but may go unnoticed, particularly when they are mild.
Neuropsychological rehabilitation aims to help people recognize and manage these changes by teaching practical strategies to compensate for cognitive difficulties. Previous research suggests that these approaches may be particularly useful for people with mild-to-moderate problems.
In this study, researchers conducted a study to assess the feasibility and acceptability of NEuRoMS, with the goal of informing a definitive trial. NEuRoMS is a personalized program designed specifically for people with MS and mild-to-moderate cognitive difficulties. It combines education, goal-setting, and practical cognitive strategies in sessions tailored to each person’s needs.
Our findings suggest that a definitive trial is feasible and that both the NEuRoMS intervention and trial procedures were acceptable, with [people with MS] and clinicians finding the intervention useful.
Participants received up to four hours of one-to-one support, delivered by supervised assistant psychologists, across up to six sessions over about two months. Sessions could be held online, in person, or by telephone, and participants also received a workbook and short videos explaining the program.
Of 125 individuals screened, 79 were enrolled. They had a mean age of 54.5 years, and most were women (69.6%). Most participants had relapsing-remitting MS (53.2%) and mild cognitive difficulties (81%), while 19% had moderate cognitive issues. Participants were assigned to receive NEuRoMS plus usual care or usual care alone (40 vs. 39 participants, respectively).
Overall, 92% of those assigned to NEuRoMS took part in at least one rehabilitation session. Participants generally described the program as useful, particularly valuing learning about cognitive difficulties and new ways to manage them.
“Our findings suggest that a definitive trial is feasible and that both the NEuRoMS intervention and trial procedures were acceptable, with [people with MS] and clinicians finding the intervention useful,” the researchers wrote.
Improvements reported in mood, fatigue management
Most participants also completed self-report questionnaires across MS impact on cognitive, psychosocial, functional, and work-related domains, usually online (over 95%). For instance, the planned primary outcome measure — MS Impact Scale psychological subscale, which assesses MS emotional, psychological, and social impact — was completed by about 90% of participants at three and six months, indicating that it is a feasible measure to use.
Although the study was primarily designed to determine whether the program and trial procedures were practical, researchers also sought early signs that NEuRoMS might be beneficial. At three months, participants receiving NEuRoMS showed a moderate improvement in the psychological impact of MS compared with those receiving usual care alone. They also reported changes in perceived cognitive difficulties and improvements in mood, self-confidence, and fatigue management.
In interviews, participants described using the strategies they learned to plan and manage everyday activities more effectively. Some said that becoming more aware of their cognitive difficulties helped them feel that these problems were manageable rather than something they simply had to live with.
These reported benefits appeared to continue for six months, with participants describing ongoing improvements in planning, daily activities, and use of cognitive strategies.
Overall, the researchers believe that “the NEuRoMS intervention was feasible and acceptable for [people with MS] with mild-to-moderate cognitive difficulties, with a signal of efficacy in perceived psychological impact,” the researchers wrote.
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