Efficacy of cognitive rehabilitation in cognition and brain networks: A randomised clinical trial in patients with multiple sclerosis

This study evaluated the efficacy of the computerised Guttmann, NeuroPersonalTrainer® (GNPT) cognitive rehabilitation (CR) and characterised the induced changes in cerebral networks in patients with multiple sclerosis (MS). This multicentre, double-blind, randomised clinical trial compared upward intensity training (active treatment) to low-intensity static training (static treatment). Cognition was assessed using the Brief Repeatable battery before and after 12 weeks of training and at 10-months follow-up, and patients were classified as having a mild or severe cognitive impairment (CI). Brain MRI pre- and post-CR were analysed using an advanced tractography algorithm, based on multishell diffusion MRI, to obtain node-based graph metrics (local efficiency and strength) from microscopic fractional anisotropy. Seventy MS patients completed the study (age 48.9 ± 8.8, disease duration 16.8 ± 9.0 years); active treatment: 36, static treatment: 34. Verbal memory improved significantly post-CR in both groups (55 % active; 34 % static treatment), accompanied by increases in local efficiency and strength in multimodal regions. At follow-up, verbal memory declined in both groups but remained above the pre-CR assessment (-25 % and -17 %, respectively). Patients with severe-CI (n = 36) showed improvement only with active treatment, while those with mild-CI (n = 34) improved regardless of intensity treatment. Network changes were more pronounced in patients in active treatment and in those with severe-CI. Quality of life did not change at post-CR, and cognitive improvement was influenced by cognitive reserve (p = 0.011). In MS, GNPT temporarily improves verbal memory and increases network connectivity, reinforcing the CR as a valuable tool for enhancing cognitive skills and promoting neuronal plasticity.

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Publication Details

Journal
NeuroImage Clinical
Published
2025-01-01
DOI
https://doi.org/10.1016/j.nicl.2025.103775
Citations
1
Primary Topic
Multiple Sclerosis Research Studies
Type
article
Field-Weighted Citation Impact
1.47

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article

Efficacy of cognitive rehabilitation in cognition and brain networks: A randomised clinical trial in patients with multiple sclerosis

Salut Albà-Arbalat, Elisenda Anglada, Sara Llufriú, Lucía Romero et al.
1 citations
NeuroImage Clinical
Multiple Sclerosis Research Studies
1.47
article

Efficacy of cognitive rehabilitation in cognition and brain networks: A randomised clinical trial in patients with multiple sclerosis

Salut Albà-Arbalat, Elisenda Anglada, Sara Llufriú, Lucía Romero, Jaume Sastre‐Garriga, Eloy Martínez‐Heras, Elisabeth Solana, Núria Solà‐Valls, Montserrat Bernabeu Guitart, Silvia Presas‐Rodríguez, José Rodríguez, María Sepúlveda, Elvira Munteis, Rocío Sánchez-Carrión, Sergio Martínez‐Yélamos, Alberto Calvi, Cristina Ramo‐Tello, Albert Saiz, Mariona Hervás, Elisabet López-Soley, Francesc Vivó, E. R. Meza Murillo, Yolanda Blanco, María Jesús Arévalo, R. Pelayo
article en
1 citations

Abstract

This study evaluated the efficacy of the computerised Guttmann, NeuroPersonalTrainer® (GNPT) cognitive rehabilitation (CR) and characterised the induced changes in cerebral networks in patients with multiple sclerosis (MS). This multicentre, double-blind, randomised clinical trial compared upward intensity training (active treatment) to low-intensity static training (static treatment). Cognition was assessed using the Brief Repeatable battery before and after 12 weeks of training and at 10-months follow-up, and patients were classified as having a mild or severe cognitive impairment (CI). Brain MRI pre- and post-CR were analysed using an advanced tractography algorithm, based on multishell diffusion MRI, to obtain node-based graph metrics (local efficiency and strength) from microscopic fractional anisotropy. Seventy MS patients completed the study (age 48.9 ± 8.8, disease duration 16.8 ± 9.0 years); active treatment: 36, static treatment: 34. Verbal memory improved significantly post-CR in both groups (55 % active; 34 % static treatment), accompanied by increases in local efficiency and strength in multimodal regions. At follow-up, verbal memory declined in both groups but remained above the pre-CR assessment (-25 % and -17 %, respectively). Patients with severe-CI (n = 36) showed improvement only with active treatment, while those with mild-CI (n = 34) improved regardless of intensity treatment. Network changes were more pronounced in patients in active treatment and in those with severe-CI. Quality of life did not change at post-CR, and cognitive improvement was influenced by cognitive reserve (p = 0.011). In MS, GNPT temporarily improves verbal memory and increases network connectivity, reinforcing the CR as a valuable tool for enhancing cognitive skills and promoting neuronal plasticity.

NeuroImage ClinicalVol. 46
Institut d'Investigació Biomédica de Bellvitge (ES), Institut de Recerca Biomèdica Catalunya Sud (ES), Hospital de Sabadell (ES), Vall d'Hebron Hospital Universitari (ES), Hospital Del Mar (ES), Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (ES), Hospital Universitari Germans Trias i Pujol (ES), Hospital del Mar Research Institute (ES), Fundació Clínic per a la Recerca Biomèdica (ES), Consorci Institut D'Investigacions Biomediques August Pi I Sunyer (ES), Universitat de Barcelona (ES)
Amgen, Bristol-Myers Squibb, Eli Lilly and Company, Sanofi, Biogen, Teva Pharmaceutical Industries, Celgene, European Committee for Treatment and Research in Multiple Sclerosis, Centres de Recerca de Catalunya, Horizon Therapeutics, Guarantors of Brain, European Commission, Generalitat de Catalunya, Universitat de Barcelona, Red Española de Esclerosis Múltiple, Horizon 2020 Framework Programme, Agència de Gestió d'Ajuts Universitaris i de Recerca, Instituto de Salud Carlos III, European Regional Development Fund, Spanish National Plan for Scientific and Technical Research and Innovation
Openalex Percentile: Top 21%
Multiple Sclerosis Research Studies
1.47
DOIOpen Access PDFOpenAlex
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