In a randomized-controlled trial, cognitive rehabilitation therapy (CRT) and mindfulness-based cognitive therapy (MBCT) had short-term positive effects on cognitive complaints in MS patients. In the long term, CRT helped to improve personalized cognitive goals and MBCT processing speed.
Cognitive complaints and objective impairments are frequent and disabling in MS patients and profoundly affect daily living. There is increasing evidence for a compensatory and restorative effect of CRT, but its effect on cognitive problems in everyday life is unknown. Similarly, some positive effects of mindfulness on cognition have been, e.g. MBCT.
The randomized-controlled REMIND-MS study investigated the effectiveness of both CRT and MBCT on patient-reported cognitive complaints in MS . Effects on personalized cognitive goals and objective cognitive function were also evaluated. Participants were 110 MS patients with cognitive complaints, of whom 63 (57%) were objectively cognitively impaired. They completed questionnaires, performed cognitive tests, personalized goals setting, and underwent magnetoencephalography (MEG scan) at baseline, post-treatment, and after 6-month follow-up.
The 110 participants were randomized to CRT (n=37), MBCT (n=36), or enhanced treatment as usual (ETAU; n=37); 100 participants completed the study. Both CRT and MBCT positively affected patient-reported cognitive complaints compared with ETAU after 9 weeks (P<0.05), but not 6 months later. At 9 weeks of follow-up, CRT resulted in a decrease in general cognitive complaints and executive-function cognitive complaints. The latter effect was also found in the MBCT group.
At 6-months of follow-up, participants in the CRT group better achieved personalized cognitive goals (P=0.028). MBCT had a positive effect on processing speed (P=0.027). Participants with fewer cognitive complaints at baseline benefited more from CRT as suggested by the Cognitive Failures Questionnaire (P=0.012–0.040), while participants with better processing speed at baseline benefited more from MBCT (P=0.016).
Dr. Ilse Nauta (Vrije Universiteit Amsterdam, Netherlands) concluded that regardless of whether patients were relatively less or relatively more affected by cognitive problems, they all benefited from the interventions, depending on whether you focus on short-term or longer-term results . Both interventions seem promising in the treatment of MS-related cognitive problems.
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