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Evidence review finds that computer-based cognitive training can significantly improve memory in patients with multiple sclerosis (MS)

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Com­put­er-Based Cog­ni­tive Train­ing Improves Mem­o­ry Domains in Mul­ti­ple Scle­ro­sis (Neu­rol­o­gy Advi­sor):

Com­put­er-based cog­ni­tive train­ing may assist in improv­ing mem­o­ry in patients with mul­ti­ple scle­ro­sis (MS), accord­ing to a sys­tem­at­ic review pub­lished in Mul­ti­ple Scle­ro­sis and Relat­ed Dis­or­ders.

A total of 9 stud­ies report­ing the use of com­put­er-based cog­ni­tive train­ing in patients with MS were includ­ed in this sys­tem­at­ic review. For inclu­sion, each study was required to have report­ed both pre- and post-cog­ni­tive train­ing neu­ropsy­cho­log­i­cal assess­ment scores. In addi­tion, each study was required to include an inter­ven­tion arm and a place­bo or no-inter­ven­tion arm…The inves­ti­ga­tors not­ed that the cog­ni­tive train­ing effects may dif­fer in the vary­ing sub­types of MS, yet sub­types were not dif­fer­en­ti­at­ed in the includ­ed stud­ies. Also, stud­ies includ­ed com­put­er train­ing pro­grams that dif­fered in type, course length, and total train­ing dura­tion.”

The Study

Effi­ca­cy of com­put­er-based cog­ni­tive train­ing in neu­ropsy­cho­log­i­cal per­for­mance of patients with mul­ti­ple scle­ro­sis: A sys­tem­at­ic review and meta-analy­sis (Mul­ti­ple Scle­ro­sis and Relat­ed Dis­or­ders). From the abstract:

  • IMPORTANCE: Mul­ti­ple scle­ro­sis (MS) is a chron­ic inflam­ma­to­ry dis­ease of the cen­tral ner­vous sys­tem char­ac­ter­ized by relaps­es and a pro­gres­sive course that may lead to accu­mu­la­tion of phys­i­cal and cog­ni­tive dis­abil­i­ty. Cog­ni­tive train­ing inter­ven­tions seem to improve the cog­ni­tive per­for­mance of MS patients. The aim of the present meta-analy­sis is to quan­ti­ta­tive­ly inves­ti­gate the effect of com­put­er-based cog­ni­tive reha­bil­i­ta­tion on the neu­ropsy­cho­log­i­cal per­for­mance of patients with MS.
  • METHODS: We per­formed a sys­tem­at­ic review of the PubMed data­base to iden­ti­fy avail­able stud­ies that per­formed com­put­er-based cog­ni­tive train­ing in MS patients. Stud­ies should have report­ed pre- and post-cog­ni­tive train­ing neu­ropsy­cho­log­i­cal tests scores and includ­ed both inter­ven­tion and place­bo/no-inter­ven­tion MS groups. We 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 cog­ni­tive train­ing 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 present 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.

The Study in Context

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