A novel network-based cognitive rehabilitation approach in patients with relapsing-remitting multiple sclerosis and mild cognitive impairment
Author(s): ,
M. Mitolo
IRCCS San Camillo Hospital, Venice, Italy; University of Sheffield, Sheffield, United Kingdom
A. Venneri
IRCCS San Camillo Hospital, Venice, Italy; University of Sheffield, Sheffield, United Kingdom
B. Sharrack
University of Sheffield, Sheffield, United Kingdom
ECTRIMS Online Library. Mitolo M. Oct 9, 2015; 116670; 1096
Micaela Mitolo
Micaela Mitolo
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Abstract: 180

Type: Oral

Abstract Category: Neuropsychology

Background: Although a growing body of evidence has highlighted the role of cognitive rehabilitation in the management of cognitive dysfunction in patients with Multiple Sclerosis (MS), there is still no clear evidence for a validated therapeutic approach.

Objectives: We investigated the effectiveness of an intensive network-based cognitive rehabilitation program, specifically designed to promote the involvement and the synchronous co-activation of multiple areas of the brain, targeting multiple cognitive domains.

Methods: Twenty-nine patients with Relapsing-Remitting MS and an Expanded Disability Status Scale score of ≤5.5 were included in this study. All patients underwent a complete neuropsychological assessment and brain MRI including Resting-State fMRI at baseline and 6 weeks later. Patients in the experimental group (n = 15) received intensive network-based cognitive rehabilitation for 20 sessions

(1 hour per day, 5 days a week, for 4 weeks). Patients in the control group (n = 14) received no cognitive treatment.

Results: At baseline there were no significant differences in age, sex, education, disability, brain MRI atrophy assessment or in the scores achieved on the cognitive tests between the treated and untreated groups of patients. At reassessment, the experimental group showed significant improvements in tasks assessing executive function (including PASAT, p=0.000) compared with the control group. A transfer effects was also found in a logical memory task (p=0.001) indicating a generalization of the effects to untrained abilities. A reorganization of functional connectivity on fMRI was only detected in the experimental group who increased connectivity in the cuneus, lingual gyrus and in fronto-parietal regions and decreased connectivity in the inferior and middle occipital gyrus and in temporal areas (e.g. fusiform gyrus).

Conclusions: These preliminary findings suggest that a network-based cognitive rehabilitation program, that stimulates multiple cognitive domains targeting distant areas simultaneously, might represent a valid therapeutic approach in MS.

Disclosure: Micaela Mitolo: nothing to disclose

Annalena Venneri: nothing to disclose

Basil Sharrack: nothing to disclose
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