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Old 11-05-2019, 05:49 PM
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Default Can cognitive rehabilitation help in MS? New study says: unlikely

The best way to treat cognitive issues in MS? Prevent them from happening in the first place by taking a DMT and exercising. -D

Cognitive Rehabilitation for Attention and Memory in people with Multiple Sclerosis: a randomised controlled trial (CRAMMS)

Authors:
Nadina Lincoln
Lucy Bradshaw
Chris Constantinescu
Florence Day
Avril Drummond
Deborah Fitzsimmons
Shaun Harris
Alan Montgomery
Roshan das Nair

Abstract

Objective
The aim was to assess the clinical and cost-effectiveness of cognitive rehabilitation for attention and memory problems in people with multiple sclerosis.

Design
Multi-centre, pragmatic, randomised controlled trial.

Setting
Community.

Participants
People with multiple sclerosis aged 18 to 69 years, who reported cognitive problems in daily life and had evidence of cognitive problems on standardised assessment.

Interventions
A group cognitive rehabilitation programme delivered in 10 weekly sessions in comparison with usual care.

Main measures
The primary outcome was the Multiple Sclerosis Impact Scale Psychological subscale at 12 months after randomisation. Secondary outcomes included measures of everyday memory problems, mood, fatigue, cognitive abilities and employment at 6 and 12 months after randomisation.

Results
245 participants were allocated to cognitive rehabilitation and 204 to usual care. Mean Multiple Sclerosis Impact Scale Psychological subscale at 12 months was 22.2 [SD=6.1] for cognitive rehabilitation and 23.4 [SD=6.0] for usual care group; adjusted difference -0.6, 95% CI -1.5 to 0.3, p=0.20. No differences were observed in cognitive abilities, fatigue or employment. There were small differences in favour of cognitive rehabilitation for the Multiple Sclerosis Impact Scale Psychological subscale at 6 months and everyday memory and mood at 6 and 12 months. There was no evidence of an effect on costs (-808 95% CI -2248 to 632) or on quality adjusted life year gain (0.00 95% CI -0.01 to 0.02).

Conclusions
This cognitive rehabilitation programme had no long-term benefits on the impact of multiple sclerosis on quality of life, but there was some evidence of an effect on everyday memory problems and mood.
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