Memory rehabilitation can be beneficial for patients with multiple sclerosis

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Multiple sclerosis (MS) patients who receive memory rehabilitation have better memory function and quality of life compared to those who do not receive memory rehabilitation and can last up to 1 year, according to a study published in the journal Cochrane database for systematic reviews.

Memory problems are common in people with MS and can affect their ability to go about their daily activities and affect their quality of life. Interest in memory rehabilitation in this patient population has grown with numerous randomized clinical trials (RCTs). This type of rehabilitation implements specific techniques and strategies that can help a person remember, store, or recall memories, but it is not known whether it will be effective in reducing forgetfulness or improving the performance of daily activities said the researchers.

To confirm the effectiveness of memory rehabilitation, researchers conducted a review to determine whether patients with MS who received memory rehabilitation had better immediate, medium, or longer-term outcomes compared to patients with no treatment or active controls on memory function , other cognitive skills and functional skills for activities of daily living, mood and quality of life.


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By September 6, 2020, they searched several databases for RCTs that included patients with relapsing-remitting, secondary progressive, or primary progressive MS in which a memory rehabilitation treatment group was compared with a control group.

The primary endpoints were measurements of the extent of memory problems in everyday life. The results were categorized into 3 separate time points: immediate (≤ 1 month), medium-term (1-6 months) and long-term (> 6 months).

The analysis comprised 44 studies with 2,714 patients who received memory training that included restorative techniques (e.g. computer-based programs) and compensatory approaches (e.g. memory aids such as diaries or calendars).

The researchers found small to moderate differences in favor of the rehabilitation group for subjective memory reports in the immediate, medium, and longer term follow-up exams – standardized mean difference (SMD) 0.32; 95% CI, 0.05-0.58; 568 participants, medium-quality evidence; SMD 0.23; 95% CI, 0.11-0.35; 1045 participants, high quality evidence; and SMD 0.16; 95% CI, 0.02-0.30; 775 participants, each with high quality evidence. The intervention group showed greater improvement than the control group at each follow-up.

The analysis also showed slight to moderate differences in favor of the rehabilitation group for quality of life measures in immediate, medium, and long-term follow-up – SMD 0.42; 95% CI, 0.15-0.68; 371 participants, high quality evidence; SMD 0.30; 95% CI, 0.02-0.58; 683 participants, high quality evidence; and SMD 0.17; 95% CI, 0.02-0.32; 687 participants, each with high quality evidence. The intervention group performed better than the control group at each follow-up.

There was a moderate difference between the groups in the mood measurements of depression in the immediate follow-up (SMD 0.34; 95% CI, 0.15–0.53; 853 participants, evidence of medium quality) in favor of the intervention group. Little to no differences were found between the groups in terms of visual memory, working memory or activities in daily living. Memory rehabilitation never had any effect on anxiety.

The researchers found that for 8 studies they only received data on whether the studies used intention-to-treat or per-protocol analysis and therefore could not complete a sensitivity analysis of these 2 groups. Eliminating studies with a high risk of bias also often resulted in a decrease in heterogeneity during the analysis.

“This review examined the evidence from RCTs and quasi-RCTs and found evidence suggesting that memory rehabilitation effectively improves memory performance on subjective and objective (verbal, visual and working memory) assessments at immediate and intermediate follow-up and quality of life immediately to live medium and longer term and reduce depression (but only immediately after the intervention), ”the researchers concluded.

Disclosure: Some of the study authors stated links with biotech, pharmaceutical, and / or device companies. For a full list of author disclosures, see the original reference.

reference

Taylor LA, Mhizha-Murira JR, Smith L, et al. Memory rehabilitation for people with multiple sclerosis. Cochrane Database Syst Rev. Published online October 18, 2021. doi: 10.1002 / 14651858.CD008754.pub4


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