title: The Effects of Cognitive Rehabilitation on Relapsing Remitting Multiple Sclerosis Patients.
abstract: BACKGROUND
  The aims of this study were to determine the severity of cognitive impairment with Brief Repeatable Battery Neuropsychology (BRB-N) and to show the benefits of cognitive rehabilitation programs to develop coping strategies for the retardation of cognitive losses in relapsing remitting multiple sclerosis (RRMS) patients.
  
  
  METHODS
  The cognitive screening with BRB-N was performed in RRMS patients who had applied to the MS outpatient clinic of Bakırköy Psychiatric and Neurological Diseases Hospital, had an Expanded Disability Status Scale (EDSS) score between 1.0 and 5.5, and had no other cognitive disease or used drugs that effected the cognitive status. Thirty two patients with cognitive impairment underwent consecutive computer-assisted cognitive rehabilitation program once a week for 8 weeks conducted by psychologists. The effects of the program were evaluated with the tests repeated every 4 weeks.
  
  
  RESULTS
  The mean age of the patients was 36.09±7.19 years. Their initial and control test scores were found to be paced auditory serial addition test (PASAT) 29.21±17.97; 42.43±15.43, Selective Reminding Test-Total Learning (SRT-TL) 8.03±2.36; 10.09±1.77, Selective Reminding Test-Long-term Memory (SRT-DR) 6.72±2.74; 9±2.29, Spatial Recall Test-Total Learning (SPART-TL) 4.72±2.02; 4.22±1.74, Spatial Recall Test-Long-term Memory (SPART-DR) 5.94±2.54; 5.16±2.23, Symbol Digit Modalities Test (SDMT) 40.44±17.04; 46.47±17.94, Word Fluency Test (WLG) 32.88±9.87; 40.44±9.95 respectively. There was no significant statistical difference between Multiple Sclerosis Neuropsychological Screening Questionnaire (MSNQ) and SPART values of preface, 1stcontrol and 2ndcontrol (p>0.05). There was significant statistical difference between PASAT, WLG, SDMT, SRT-TL, SRT-DR values of Preface, 1stcontrol, and 2ndcontrol (p=0.0001).
  
  
  CONCLUSIONS
  It was determined that on distinctive improvement on sustaining attention, working memory and information processing speed, and verbal fluency and verbal learning with cognitive rehabilitation, no changes were observed on visuospatial learning. This approach is hopeful and further comprehensive studies are needed.
authors.affiliation: Clinic of Neurology, Şanlıurfa Balıklıgöl State Hospital, Şanlıurfa, Turkey.
authors.forename: İlknur
authors.initials: İ
authors.lastname: Güçlü Altun
authors.affiliation: İstanbul University Forensic Medicine Institute, İstanbul, Turkey.
authors.forename: Dursun
authors.initials: D
authors.lastname: Kirbaş
authors.affiliation: Şanlıurfa Public Health Management, Şanlıurfa, Turkey.
authors.forename: Deniz Utku
authors.initials: DU
authors.lastname: Altun
authors.affiliation: 3 Clinic of Neurology, Bakırköy Prof. Dr. Mazhar Osman Psychiatric Training and Research Hospital, İstanbul, Turkey.
authors.forename: Aysun
authors.initials: A
authors.lastname: Soysal
authors.affiliation: 3 Clinic of Neurology, Bakırköy Prof. Dr. Mazhar Osman Psychiatric Training and Research Hospital, İstanbul, Turkey.
authors.forename: Pakize Nevin
authors.initials: PN
authors.lastname: Sütlaş
authors.affiliation: 3 Clinic of Neurology, Bakırköy Prof. Dr. Mazhar Osman Psychiatric Training and Research Hospital, İstanbul, Turkey.
authors.forename: Demet
authors.initials: D
authors.lastname: Yandim Kuşçu
authors.affiliation: 3 Clinic of Neurology, Bakırköy Prof. Dr. Mazhar Osman Psychiatric Training and Research Hospital, İstanbul, Turkey.
authors.forename: Neslihan
authors.initials: N
authors.lastname: Behrem Gayir
authors.affiliation: 2 Clinic of Neurology, Bakırköy Prof. Dr. Mazhar Osman Psychiatric Training and Research Hospital, İstanbul, Turkey.
authors.forename: Ekim
authors.initials: E
authors.lastname: Arslan
authors.affiliation: Clinic of Neurology, İstanbul Bilim University, İstanbul, Turkey.
authors.forename: Barış
authors.initials: B
authors.lastname: Topçular
keywords: Multiple sclerosis; cognitive impairment; cognitive rehabilitation