STUDY: Strong Evidence for Benefits of Cognitive Rehab to Improve Learning, Memory

[ActiveMSers]

An randomized controlled study to treat learning impairment in multiple sclerosis

The MEMREHAB trial

Nancy D. Chiaravalloti, PhD,
Nancy B. Moore, MA,
Olga M. Nikelshpur, PhD and
John DeLuca, PhD

Abstract

Objective: To examine the efficacy of the modified Story Memory Technique (mSMT), a 10-session behavioral intervention teaching context and imagery to facilitate learning, to improve learning and memory abilities in persons with multiple sclerosis (MS).

Methods: This double-blind, placebo-controlled, randomized clinical trial included 86 participants with clinically definite MS, 41 in the treatment group and 45 in the placebo control group. Participants completed a baseline neuropsychological assessment, including questionnaires assessing everyday memory, a repeat assessment immediately posttreatment, and a long-term follow-up assessment 6 months after treatment. After completion of the treatment phase, persons in the treatment group were assigned to a booster session or a non–booster session group to examine the efficacy of monthly booster sessions in facilitating the treatment effect over time.

Results: The treatment group showed a significantly improved learning slope relative to the placebo group posttreatment. Similar results were noted on objective measures of everyday memory, general contentment, and family report of apathy and executive dysfunction. Long-term follow-up data showed that posttreatment improvement in the treatment group continued to be noted on the list learning and self-report measures. The provision of booster sessions demonstrated little benefit.

Conclusion: The mSMT is effective for improving learning and memory in MS.

Classification of evidence: This study provides Class I evidence that the mSMT behavioral intervention improves both objective memory and everyday memory in patients with MS over 5 weeks, with treatment effects lasting over a 6-month period.

[ActiveMSers]

According to the National MS Society, the "treatment group met with a therapist and underwent a type of behavioral training, called Story Memory Technique, which involves the use of imagery and context-based memory training. The placebo group also interacted with a therapist but engaged in tasks that did not specifically target learning. Each group completed 10 training sessions (twice a week) over 5 weeks. Memory tests and questionnaires to assess anxiety, depression, and other parameters were completed by trial participants before, immediately following completion of training, and 6 months after completion."

They go on to conclude that "This controlled trial provides important new evidence that cognitive rehabilitation can improve learning and memory in people with MS, and should help promote the benefits of cognitive rehabilitation and improve its coverage by insurers. The results are also consistent with previous studies suggesting that cognitive rehabilitation improves not only the targeted function, but extends to improvement in other parameters such as fatigue, depression, and overall quality of life."

Work that brain, folks! It works!