Affiliations: Klinikum Bremen-Ost, Department of Neurology,
Züricher Str. 40, 28325 Bremen, Germany | University of Oldenburg, Institute for Psychology,
26111 Oldenburg, Germany | MeVis, Center for Medical Diagnostic Systems and
Visualization, Universitätsallee 29, 28359 Bremen, Germany | Klinikum Bremen-Ost, Department of Radiology,
Züricher Str. 40, 28325 Bremen, Germany
Note: [] Corresponding author: Helmut Hildebrandt, Ph.D., Department of
Neurology, Klinikum Bremen-Ost, Züricher Str. 40, 28325 Bremen, Germany.
Tel.: +49 421 4081200; Fax: +49 421 4082599; E-mail:
[email protected]
Abstract: Purpose: Cognitive disorders are common in MS patients without any
generally recommended treatment. Recent brain imaging studies show considerable
neuroplasticity for cognitive tasks in MS patients, but also brain atrophy
already early in the disease progression. We explored the benefits of a
home-based cognitive training program for memory and working memory functions
in relapsing-remitting MS patients controlling for whole brain and central
brain atrophy as covariates. Methods: Using a single-blinded controlled
study design, 42 patients were randomised into a treatment group and a control
group. Home based computer training focusing on memory and working memory was
started at least 4 weeks after the discontinuation of methylprednisolone
treatment and lasted for 6 weeks. Two weeks later the patients were
re-investigated for their clinical and cognitive performance. We assessed also
quality of life (QoL), depression and fatigue using self-rating scales.
Results: Training had no effect on the neurological status and on QoL or
fatigue. However, the treatment group showed better verbal learning, long-delay
verbal memory performance, and working memory performance. The impact of
treatment on long-delay verbal memory performance was independent from the
extent of brain atrophy, whereas for the other findings brain atrophy played a
significant role. Conclusions: An intensive home-based cognitive training
program is suitable to improve the cognitive performance of MS patients. The
impact of brain atrophy on rehabilitation outcome may differ for cognitive
functions.
Keywords: Multiple sclerosis, cognitive training, memory, working memory, brain atrophy
