title: Are cognitive interventions for multiple sclerosis effective and feasible?
abstract: OBJECTIVE
  Fifty percent of patients with Multiple Sclerosis (MS) are estimated to have cognitive impairments leading to considerable decline in productivity and quality of life. Cognitive intervention has been considered to complement pharmacological treatments. However, a lack of agreement concerning the efficacy of cognitive interventions in MS still exists. A systematic review and meta-analysis was conducted to assess the effects of cognitive interventions in MS.
  
  
  METHODS
  To overcome limitations of previous meta-analyses, several databases were searched only for Randomized Clinical Trials (RCTs) with low risk of bias.
  
  
  RESULTS
  Five studies (total of 139 participants) met our eligibility criteria. Although good completion and adherence rates were evident, we found no evidence of intervention effects on cognition or mood in post-intervention or follow-up assessments.
  
  
  CONCLUSIONS
  This is the first meta-analysis assessing the effects of cognitive intervention in MS including only RCTs with comparable conditions. Research regarding efficacy, cost-effectiveness and feasibility is still in its infancy. Caution is advised when interpreting these results due to the small number of RCTs meeting the inclusion criteria. Considering the costs of disease, good completion and adherence rates of this approach, further research is warranted. Recommendations concerning improved research practices in the field are presented as well.
authors.affiliation: Neuropsychophysiology Laboratory, CIPsi, School of Psychology, University of Minho, Braga, Portugal.
authors.forename: Rosana
authors.initials: R
authors.lastname: Magalhães
authors.affiliation: Neuropsychophysiology Laboratory, CIPsi, School of Psychology, University of Minho, Braga, Portugal.
authors.forename: Jorge
authors.initials: J
authors.lastname: Alves
authors.affiliation: Department of Family Medicine, Health Sciences Centre, University of Calgary, Calgary, AB, Canada.
authors.forename: Roger E
authors.initials: RE
authors.lastname: Thomas
authors.affiliation: Neuropsychology and Neuroscience Laboratory (NNL), Kessler Foundation, West Orange, NJ, USA Department of Physical Medicine & Rehabilitation, Rutgers the State University of New Jersey, NJ, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Chiaravalloti
authors.affiliation: Neuropsychophysiology Laboratory, CIPsi, School of Psychology, University of Minho, Braga, Portugal Department of Counseling and Applied Educational Psychology, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA Spaulding Center of Neuromodulation, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Óscar F
authors.initials: ÓF
authors.lastname: Gonçalves
authors.affiliation: Neuropsychophysiology Laboratory, CIPsi, School of Psychology, University of Minho, Braga, Portugal Department of Cognitive Sciences, University of California, Irvine, CA, USA.
authors.forename: Agavni
authors.initials: A
authors.lastname: Petrosyan
authors.affiliation: Neuropsychophysiology Laboratory, CIPsi, School of Psychology, University of Minho, Braga, Portugal.
authors.forename: Adriana
authors.initials: A
authors.lastname: Sampaio
mesh_terms: D003072:Cognition Disorders / Q000209:etiology* / Q000534:rehabilitation*; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D005240:Feasibility Studies; D006801:Humans; D009103:Multiple Sclerosis / Q000150:complications*; D016032:Randomized Controlled Trials as Topic
keywords: Rehabilitation; feasibility; meta-analysis; multiple sclerosis; systematic review