Computer-aided retraining of memory and attention in people with multiple sclerosis: a randomized, double-blind controlled trial.
BACKGROUND
Cognitive compromise is one of the main contributing factors to activity and participation restrictions in people with multiple sclerosis (MS). Computer-aided programs are used for retraining memory and attention, but data on the efficacy of these interventions are scarce.


OBJECTIVE
To assess the efficacy of computer-aided retraining of memory and attention in people with MS impaired in these abilities.


METHODS
Randomized, double-blind, controlled trial.


METHODS
Outpatients (n=82) with subjective complaints of poor attention or memory, confirmed by a score <80th percentile in at least two tests of the Brief Repeatable Battery of Neuropsychological Tests (BRBNT).


METHODS
Participants were randomized to two computer-assisted retraining interventions: memory and attention (study arm), and visuo-constructional and visuo-motor coordination (control arm). Both groups received 16 training sessions over 8 weeks.


METHODS
Improvement of 20% or more in at least two BRBNT test scores at 8 weeks compared to baseline (primary end point). Changes in depression and health-related quality of life.


RESULTS
An improvement occurred in 45% of study patients vs. 43% of control patients (odds ratio 1.07, 95% confidence interval 0.44-2.64). The study treatment was better than the control treatment only on the word list generation test (p=0.016).


CONCLUSIONS
This trial does not support the efficacy of specific memory and attention retraining in MS.
Solari
Alessandra
A
Laboratory of Epidemiology, National Neurological Institute C. Besta, via Celoria 11, 20133 Milan, Italy. solari@istituto-besta.it
Motta
Achille
A
Mendozzi
Laura
L
Pucci
Eugenio
E
Forni
Marco
M
Mancardi
Gianluigi
G
Pozzilli
Carlo
C
D000328:Adult; D001288:Attention / Q000502:physiology; D003072:Cognition Disorders / Q000209:etiology / Q000534:rehabilitation*; D003194:Computer-Assisted Instruction / Q000379:methods / Q000706:statistics & numerical data*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology; D008569:Memory Disorders / Q000209:etiology / Q000534:rehabilitation*; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000534:rehabilitation*; D009483:Neuropsychological Tests; D011597:Psychomotor Performance / Q000502:physiology; D012985:Software Design; D016896:Treatment Outcome; D014705:Verbal Behavior / Q000502:physiology