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Cognitive improvement and functional connectivity changes after integrative group-based cognitive rehabilitation in multiple sclerosis
Author(s): ,
O Rilo
Affiliations:
University of Deusto
,
J Peña
Affiliations:
University of Deusto
,
O Natalia
Affiliations:
University of Deusto
,
A Rodriguez Antigüedad
Affiliations:
Basurto University Hospital, Bilbao
,
M Mendibe Bilbao
Affiliations:
Cruces University Hospital, Barakaldo
,
A Cabrera
Affiliations:
Galdakao Hospital, Galdakao, Spain
,
A Gómez Gastiasoro
Affiliations:
University of Deusto
,
J DeLuca
Affiliations:
Kessler Foundation, West Orange;Rutgers, New Jersey Medical School, Newark, NJ, United States
,
N Chiaravalloti
Affiliations:
Kessler Foundation, West Orange;Rutgers, New Jersey Medical School, Newark, NJ, United States
N Ibarretxe Bilbao
Affiliations:
University of Deusto
ECTRIMS Online Library. Rilo O. Sep 15, 2016; 146999; 144
Oiane Rilo
Oiane Rilo
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Abstract: 144

Type: Oral

Abstract Category: RIMS - Neuropsychology and fatigue management

Objective: Cognitive impairment is a common consequence of multiple sclerosis (MS). Nowadays, there is some evidence for the efficacy of individual cognitive rehabilitation, but very few studies have attempted to address the wide range of cognitive domains affected by the disorder in a group format. In addition, the effect of cognitive rehabilitation on brain functional connectivity (FC) still remains unclear in MS. Therefore, the current study aimed to examine changes in cognitive performance and brain FC after the implementation of an integrative group-based cognitive rehabilitation programme (REHACOP) in MS.

Methods: Forty MS participants were randomly assigned to the experimental (n=20) or waiting list control (n=20) group. The experimental group received cognitive rehabilitation for three months (three one-hour sessions per week) focused on attention (sustained, selective, alternating and divided), learning and memory (verbal and visual memory, as well as working memory), executive functioning (objectives planning and attainment, verbal reasoning, categorisation and conceptualisation), language (verbal fluency, syntax, grammar, vocabulary and comprehension) and social cognition (social reasoning, theory of mind and moral dilemmas). Participants underwent an extensive neuropsychological assessment at baseline and follow-up, which included measures of attention, working, processing speed, verbal memory, verbal fluency and executive functioning. All participants underwent a 3D T1-weighted imaging and resting-state functional magnetic resonance imaging study on a Philips Achieva 3T. Repeated measures MANCOVA was used to determine cognitive and FC changes after cognitive rehabilitation, using SPSS and CONN-Functional Connectivity toolbox, respectively.

Results: Cognitive Group x Time interactions showed that participants completing the REHACOP programme exhibited significant improvements on working memory, processing speed, verbal memory and executive functioning when compared to the control group (p< 0.05). In the same way, preliminary resting-state analyses showed significant changes in brain FC between brain areas involved in the default mode network after cognitive rehabilitation (p< 0.05, FDR-corrected).

Conclusion: These results show that the REHACOP integrative group-based cognitive rehabilitation programme not only improves cognitive functioning, but also produces changes in brain FC in MS participants.

Disclosure: N.O. and J.P. are co-authors and copyright holders of the REHACOP cognitive rehabilitation program, published by Parima Digital, S.L. (Bilbao, Spain). O.R., A.R.A., M.M.B., A.C., A.G.G., N.C. and N.I.B. have no conflicts of interest to report. JDL has received grant funding from Biogen IDEC in unrelated MS work, serves on an advisory board to Biogen IDEC, has served on the speakers bureau for EMD Serono.

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