Neuroscience
Neuropsychological rehabilitation for multiple sclerosis
Cochrane Database Syst Rev. 2011;11:CD009131
Rosti-Otajärvi EM, Hämäläinen PI
Abstract
BACKGROUND: Cognitive deficits are a common manifestation in multiple sclerosis (MS) and have a wide effect on the patient's quality of life. Alleviation of the harmful effects caused by these deficits should be a major goal of MS research and practice.
OBJECTIVES: The aim of this review was to evaluate the effects of neuropsychological/cognitive rehabilitation in MS by conducting a systematic review.
SEARCH STRATEGY: A systematic literature search was carried out on reports drawn from Cochrane MS Group Specialised Register (To October 2010), Evidence-based medicine (EBM) reviews (To September 2010), MEDLINE (January 1950 to September 2010), EMBASE (1974 to September 2010), PsycINFO (January 1806 to September 2010), WEB OF SCIENCE (WOS) (January 1986 to September 2010), CINAHL (1982 to September 2010), and identified from the references in these reports.
SELECTION CRITERIA: Randomised Controlled Trials (RCTs) and quasi-randomised trials evaluating the effects of neuropsychological rehabilitation in MS compared to other interventions or no intervention at all and employing neuropsychological rehabilitation methods and outcome measures were included.
DATA COLLECTION AND ANALYSIS: Two review authors individually judged the relevance, risk of bias, and content of the included studies. Results were combined quantitatively with meta-analyses according to the intervention type: 1) Cognitive training and 2) Cognitive training combined with other neuropsychological rehabilitation methods. In addition, narrative presentation was used in reporting the results of those studies which were inappropriate to be included in the meta-analysis.
MAIN RESULTS: Fourteen studies (770 MS patients) fulfilled the inclusion criteria. On the basis of these studies, low level evidence was found that neuropsychological rehabilitation reduces cognitive symptoms in MS. Cognitive training was found to improve memory span (standardised mean difference 0.54 (95% confidence interval 0.2 to 0.88, P = 0.002)), working memory (standardised mean difference 0.33 (95% confidence interval 0.09 to 0.57, P = 0.006)), and immediate visual memory (standardised mean difference 0.32 (95% confidence interval 0.04 to 0.6, P = 0.02)). There was no evidence of an effect of cognitive training combined with other neuropsychological rehabilitation methods on cognitive or emotional functions. The overall quality as well as the comparability of the included studies were relatively low due to methodological limitations and heterogeneity of outcome measures. Although most of the pooled results in the meta-analyses yielded no significant findings, twelve of the fourteen studies showed some evidence of positive effects when the studies were individually analysed.
AUTHORS' CONCLUSIONS: The review indicates low level evidence for the positive effects of neuropsychological rehabilitation in MS. Interventions included in the review were heterogeneous. Consequently, clinical inferences can basically be drawn from single studies. Therefore, new trials may change the strength and direction of the evidence. To further strengthen the evidence, well-designed high quality studies are needed. In this systematic review, recommendations are given for improving the quality of future studies on the effects of neuropsychological rehabilitation in MS.
PMID: 22071863 [PubMed - in process]
- Neuropsychology Abstract Of The Day: Traumatic Brain Injury (tbi)
Bayley MT, Tate R, Douglas JM, Turkstra LS, Ponsford J, Stergiou-Kita M, Kua A, & Bragge P. (2014). INCOG Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury: Methods and Overview. Journal of Head Trauma Rehabilitation, 29(4), 290-306....
- Neuropsychology Abstract Of The Day: Prospective Memory
Remember to Buy Milk on the Way Home! A Meta-analytic Review of Prospective Memory in Mild Cognitive Impairment and Dementia. Journal of the International Neuropsychological Society. 2012 May 18;:1-11 Authors: van den Berg E, Kant N, Postma A Abstract...
- Neuropsychology Abstract Of The Day: Cognition In Depression
A meta-analysis of cognitive deficits in first-episode Major Depressive Disorder Journal of Affective Disorders. 2011 Nov 14; Lee RS, Hermens DF, Porter MA, Redoblado-Hodge MA Abstract BACKGROUND: Recurrent-episode Major Depressive Disorder (MDD) is associated...
- Neuropsychology Abstract Of The Day: Cognitive Rehab In Ugandan Childhood Malaria Survivors
Bangirana P, Giordani B, John CC, Page C, Opoka RO, & Boivin MJ (2009). Immediate Neuropsychological and Behavioral Benefits of Computerized Cognitive Rehabilitation in Ugandan Pediatric Cerebral Malaria Survivors. Journal of Development and Behavioral...
- Neuropsychology Abstract Of The Day: Stroke Rehab Outcome Assessment
Salter KL, Teasell RW, Foley NC, & Jutai JW. Outcome assessment in randomized controlled trials of stroke rehabilitation. American Journal of Physical Medicine and Rehabilitation. 2007 Dec ;86(12): 1007-1012. Department of Physical Medicine and Rehabilitation,...
Neuroscience
Neuropsychology Abstract of the Day: Neuropsychological Rehabilitation for Multiple Sclerosis
Neuropsychological rehabilitation for multiple sclerosis
Cochrane Database Syst Rev. 2011;11:CD009131
Rosti-Otajärvi EM, Hämäläinen PI
Abstract
BACKGROUND: Cognitive deficits are a common manifestation in multiple sclerosis (MS) and have a wide effect on the patient's quality of life. Alleviation of the harmful effects caused by these deficits should be a major goal of MS research and practice.
OBJECTIVES: The aim of this review was to evaluate the effects of neuropsychological/cognitive rehabilitation in MS by conducting a systematic review.
SEARCH STRATEGY: A systematic literature search was carried out on reports drawn from Cochrane MS Group Specialised Register (To October 2010), Evidence-based medicine (EBM) reviews (To September 2010), MEDLINE (January 1950 to September 2010), EMBASE (1974 to September 2010), PsycINFO (January 1806 to September 2010), WEB OF SCIENCE (WOS) (January 1986 to September 2010), CINAHL (1982 to September 2010), and identified from the references in these reports.
SELECTION CRITERIA: Randomised Controlled Trials (RCTs) and quasi-randomised trials evaluating the effects of neuropsychological rehabilitation in MS compared to other interventions or no intervention at all and employing neuropsychological rehabilitation methods and outcome measures were included.
DATA COLLECTION AND ANALYSIS: Two review authors individually judged the relevance, risk of bias, and content of the included studies. Results were combined quantitatively with meta-analyses according to the intervention type: 1) Cognitive training and 2) Cognitive training combined with other neuropsychological rehabilitation methods. In addition, narrative presentation was used in reporting the results of those studies which were inappropriate to be included in the meta-analysis.
MAIN RESULTS: Fourteen studies (770 MS patients) fulfilled the inclusion criteria. On the basis of these studies, low level evidence was found that neuropsychological rehabilitation reduces cognitive symptoms in MS. Cognitive training was found to improve memory span (standardised mean difference 0.54 (95% confidence interval 0.2 to 0.88, P = 0.002)), working memory (standardised mean difference 0.33 (95% confidence interval 0.09 to 0.57, P = 0.006)), and immediate visual memory (standardised mean difference 0.32 (95% confidence interval 0.04 to 0.6, P = 0.02)). There was no evidence of an effect of cognitive training combined with other neuropsychological rehabilitation methods on cognitive or emotional functions. The overall quality as well as the comparability of the included studies were relatively low due to methodological limitations and heterogeneity of outcome measures. Although most of the pooled results in the meta-analyses yielded no significant findings, twelve of the fourteen studies showed some evidence of positive effects when the studies were individually analysed.
AUTHORS' CONCLUSIONS: The review indicates low level evidence for the positive effects of neuropsychological rehabilitation in MS. Interventions included in the review were heterogeneous. Consequently, clinical inferences can basically be drawn from single studies. Therefore, new trials may change the strength and direction of the evidence. To further strengthen the evidence, well-designed high quality studies are needed. In this systematic review, recommendations are given for improving the quality of future studies on the effects of neuropsychological rehabilitation in MS.
PMID: 22071863 [PubMed - in process]
- Neuropsychology Abstract Of The Day: Traumatic Brain Injury (tbi)
Bayley MT, Tate R, Douglas JM, Turkstra LS, Ponsford J, Stergiou-Kita M, Kua A, & Bragge P. (2014). INCOG Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury: Methods and Overview. Journal of Head Trauma Rehabilitation, 29(4), 290-306....
- Neuropsychology Abstract Of The Day: Prospective Memory
Remember to Buy Milk on the Way Home! A Meta-analytic Review of Prospective Memory in Mild Cognitive Impairment and Dementia. Journal of the International Neuropsychological Society. 2012 May 18;:1-11 Authors: van den Berg E, Kant N, Postma A Abstract...
- Neuropsychology Abstract Of The Day: Cognition In Depression
A meta-analysis of cognitive deficits in first-episode Major Depressive Disorder Journal of Affective Disorders. 2011 Nov 14; Lee RS, Hermens DF, Porter MA, Redoblado-Hodge MA Abstract BACKGROUND: Recurrent-episode Major Depressive Disorder (MDD) is associated...
- Neuropsychology Abstract Of The Day: Cognitive Rehab In Ugandan Childhood Malaria Survivors
Bangirana P, Giordani B, John CC, Page C, Opoka RO, & Boivin MJ (2009). Immediate Neuropsychological and Behavioral Benefits of Computerized Cognitive Rehabilitation in Ugandan Pediatric Cerebral Malaria Survivors. Journal of Development and Behavioral...
- Neuropsychology Abstract Of The Day: Stroke Rehab Outcome Assessment
Salter KL, Teasell RW, Foley NC, & Jutai JW. Outcome assessment in randomized controlled trials of stroke rehabilitation. American Journal of Physical Medicine and Rehabilitation. 2007 Dec ;86(12): 1007-1012. Department of Physical Medicine and Rehabilitation,...