Treating learning impairments improves memory performance in multiple sclerosis: a randomized clinical trial

Abstract

This randomized clinical trial utilized established techniques to improve new learning and memory performance in multiple sclerosis (MS) participants with learning impairment. Participants were 29 individuals with clinically definite MS with documented learning deficits, randomly assigned to the experimental or control group. The experimental group underwent eight sessions of the Story Memory Technique (SMT), while the control group participated in eight sessions of memory exercises. Neuropsychological assessment was conducted at baseline, immediately following treatment and 5 weeks later to assess outcome. When stratifying participants by degree of learning deficits, a significant treatment effect was noted. MS participants with moderate-severe impairment in learning showed a significant improvement in learning abilities when compared to controls, (t(19) =3.32, P<0.01) evident in 88% of participants in the experimental group. Little improvement was noted in MS participants with mild learning impairments. Significant self-reported improvements in memory were noted in MS participants that underwent treatment, but not those that did not undergo treatment (t(26) =2.55, P<0.01). Results indicate that learning and memory deficits in MS can be effectively treated through a memory rehabilitation program utilizing context and imagery to improve new learning. Appropriate patient selection is important, with moderately-severely impaired individuals showing significantly greater benefit from treatment.

The Need for Screening, Assessment, and Treatment for Cognitive Dysfunction in Multiple Sclerosis

“…However, results of these experimental studies need to be translated into clinical trials and tested. Chiaravalloti et al 20 …”

Autobiographical memory in multiple sclerosis patients: Assessment and cognitive facilitation

“…Turning presently to cognitive rehabilitation in MS (see O'Brien, Chiaravalloti, Goverover, & DeLuca, 2008, for a review), anterograde memory has been targeted in a number of studies and several rehabilitation methods have been probed that aimed at improving learning abilities in MS patients (Allen, Goldstein, Heyman, & Rondinelli, 1998;Basso, Lowery, Ghormley, Combs, & Johnson, 2006;Chiaravalloti & DeLuca, 2002;Chiaravalloti, Demaree, Gaudino, & DeLuca, 2003;Chiaravalloti, DeLuca, Moore, & Ricker, 2005;Goveover, Hillary, Chiaravalloti, Arango-Lasprilla, & DeLuca, 2009;Hildebrant et al, 2007;Mendozzi et al, 1998;Solari et al, 2004). Among them, the use of mental visual imagery (MVI) techniques lead to positive outcomes in relapsingremitting MS patients with moderate to severe memory impairment (Chiaravalloti et al, 2005).…”

“…Among them, the use of mental visual imagery (MVI) techniques lead to positive outcomes in relapsingremitting MS patients with moderate to severe memory impairment (Chiaravalloti et al, 2005). However, an overview of anterograde memory rehabilitation in MS shows no general agreement either about the comparison of pre-and post-cognitive rehabilitation results or about the transfer of benefits in everyday life.…”

Group memory rehabilitation for people with multiple sclerosis: a feasibility randomized controlled trial

“…Memory rehabilitation has been provided for people with multiple sclerosis withpromisingresults. [4][5][6][7][8][9][10][11] Interventions have mainly involved individual training on computerized tasks, 5,[7][8][9][10][11] but some have delivered face to face group sessions. 6 Although the findings from individual studies mostly appear promising, reviews of memory rehabilitation in people with multiple sclerosis have indicated that the effectiveness of memory rehabilitation programmes is far from conclusive.…”