Computer-based cognitive training in MS

A new study by Dardiotis et al (2018) in the journal Multiple Sclerosis and Related Disorders revealed a significant effect for computer based cognitive training wih respect to the performance of the memory domain of patients with Multiple sclerosis (MS).

MS is a chronic inflammatory disease of the central nervous system characterized by relapses and a progressive course that can lead to physical and cognitive disability. 

The authors conclude that cognitive training interventions seem to improve the cognitive performance of MS patients. A total of 9 studies reporting the use of computer-based cognitive training in patients with MS were included in this systematic review.

METHODS: The authors performed a systematic review to identify available studies that performed computer-based cognitive training in MS patients. Studies included reported pre- and post-cognitive training neuropsychological tests scores and included both intervention and placebo/no-intervention MS groups.

They analyzed the effect of computer-based cognitive rehabilitation on individual neuropsychological tests, on specific functional domains, and on overall cognition performance. The effect-size of cognitivetraining pre- and post-treatment compared to placebo/ no-intervention was estimated using the standardized mean difference (SMD). The 95% confidence intervals (CI) were estimated using a Z test by comparing the final values. Baseline between-group differences in selected outcomes were estimated with ANOVA.

RESULTS:   In total, 9 studies fulfilled the criteria for inclusion and were inserted in the quantitative analysis. Computer-based cognitive training was found to improve the performance in the memory domain of MS patients compared to control interventions (SMD, 0.22; 95% CI 0.01-0.43; p = 0.04). Moreover, in the subgroup analysis, cognitive training demonstrated significant effects in Selective Reminding Test (SRT) delay memory (SMD, 0.58; 95% CI 0.29-0.87; p < 0.001).

CONCLUSIONS: The reported meta-analysis revealed a significant effect for computer-based cognitive training on the performance of the memory domain of patients with MS. This finding may have significant implications in the current treatment practice when cognitive decline is detected in MS patients.

Reference

Dardiotis E, Nousia A, Siokas V, et al. Efficacy of computer-based cognitive training in neuropsychological performance of patients with multiple sclerosis: A systematic review and meta-analysis. Mult Scler Relat Disord. 2017;20:58-66.