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. 2002 Jan;72(1):93–98. doi: 10.1136/jnnp.72.1.93

Evaluation of cognitive assessment and cognitive intervention for people with multiple sclerosis

N Lincoln 1, A Dent 1, J Harding 1, N Weyman 1, C Nicholl 1, L Blumhardt 1, E Playford 1
PMCID: PMC1737698  PMID: 11784832

Abstract

Objectives: Cognitive problems in multiple sclerosis are common but any possible benefits of treatment remain uncertain. The aim of the study was to evaluate the benefits of providing a psychology service, including cognitive assessment and intervention, to patients with multiple sclerosis.

Method: The study was a single blind randomised controlled trial. A total of 240 patients with clinically definite, laboratory supported, or clinically probable multiple sclerosis were recruited from an multiple sclerosis management clinic and assessed on a brief screening battery. They were randomised into three groups. The control group received no further intervention. The assessment group received a detailed cognitive assessment, the result of which was fed back to staff involved in the patients' care. The treatment group received the same detailed cognitive assessment and a treatment programme designed to help reduce the impact of their cognitive problems. Patients were followed up 4 and 8 months later on the general health questionnaire (GHQ-28), extended activities of daily living scale, SF-36, everyday memory questionnaire, dysexecutive syndrome questionnaire, and memory aids questionnaire.

Results: The three groups were compared on the outcome measures at 4 and 8 months after recruitment. There were few significant differences between the groups and those that occurred favoured the control group. Overall, the results showed no effect of the interventions on mood, quality of life, subjective cognitive impairment or independence.

Conclusions: The study failed to detect any significant effects of cognitive assessment or cognitive intervention in this cohort of people with multiple sclerosis.

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Selected References

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  1. Amato M. P., Ponziani G., Amaducci L. Cognitive impairment in multiple sclerosis: a longitudinal study. Electroencephalogr Clin Neurophysiol Suppl. 1999;50:465–468. [PubMed] [Google Scholar]
  2. Beardsall L., Brayne C. Estimation of verbal intelligence in an elderly community: a prediction analysis using a shortened NART. Br J Clin Psychol. 1990 Feb;29(Pt 1):83–90. doi: 10.1111/j.2044-8260.1990.tb00851.x. [DOI] [PubMed] [Google Scholar]
  3. Beatty W. W., Monson N. Problem solving by patients with multiple sclerosis: comparison of performance on the Wisconsin and California Card Sorting Tests. J Int Neuropsychol Soc. 1996 Mar;2(2):134–140. doi: 10.1017/s1355617700000989. [DOI] [PubMed] [Google Scholar]
  4. Brassington J. C., Marsh N. V. Neuropsychological aspects of multiple sclerosis. Neuropsychol Rev. 1998 Jun;8(2):43–77. doi: 10.1023/a:1025621700003. [DOI] [PubMed] [Google Scholar]
  5. Freeman J. A., Langdon D. W., Hobart J. C., Thompson A. J. Inpatient rehabilitation in multiple sclerosis: do the benefits carry over into the community? Neurology. 1999 Jan 1;52(1):50–56. doi: 10.1212/wnl.52.1.50. [DOI] [PubMed] [Google Scholar]
  6. Gilchrist A. C., Creed F. H. Depression, cognitive impairment and social stress in multiple sclerosis. J Psychosom Res. 1994 Apr;38(3):193–201. doi: 10.1016/0022-3999(94)90115-5. [DOI] [PubMed] [Google Scholar]
  7. Grossman M., Robinson K. M., Onishi K., Thompson H., Cohen J., D'Esposito M. Sentence comprehension in multiple sclerosis. Acta Neurol Scand. 1995 Oct;92(4):324–331. doi: 10.1111/j.1600-0404.1995.tb00137.x. [DOI] [PubMed] [Google Scholar]
  8. Hauser S. L., Dawson D. M., Lehrich J. R., Beal M. F., Kevy S. V., Propper R. D., Mills J. A., Weiner H. L. Intensive immunosuppression in progressive multiple sclerosis. A randomized, three-arm study of high-dose intravenous cyclophosphamide, plasma exchange, and ACTH. N Engl J Med. 1983 Jan 27;308(4):173–180. doi: 10.1056/NEJM198301273080401. [DOI] [PubMed] [Google Scholar]
  9. Heaton R. K., Nelson L. M., Thompson D. S., Burks J. S., Franklin G. M. Neuropsychological findings in relapsing-remitting and chronic-progressive multiple sclerosis. J Consult Clin Psychol. 1985 Feb;53(1):103–110. doi: 10.1037//0022-006x.53.1.103. [DOI] [PubMed] [Google Scholar]
  10. Hudak P. L., Wright J. G. The characteristics of patient satisfaction measures. Spine (Phila Pa 1976) 2000 Dec 15;25(24):3167–3177. doi: 10.1097/00007632-200012150-00012. [DOI] [PubMed] [Google Scholar]
  11. Jønsson A., Korfitzen E. M., Heltberg A., Ravnborg M. H., Byskov-Ottosen E. Effects of neuropsychological treatment in patients with multiple sclerosis. Acta Neurol Scand. 1993 Dec;88(6):394–400. doi: 10.1111/j.1600-0404.1993.tb05366.x. [DOI] [PubMed] [Google Scholar]
  12. Litvan I., Grafman J., Vendrell P., Martinez J. M. Slowed information processing in multiple sclerosis. Arch Neurol. 1988 Mar;45(3):281–285. doi: 10.1001/archneur.1988.00520270059021. [DOI] [PubMed] [Google Scholar]
  13. McIntosh-Michaelis S. A., Roberts M. H., Wilkinson S. M., Diamond I. D., McLellan D. L., Martin J. P., Spackman A. J. The prevalence of cognitive impairment in a community survey of multiple sclerosis. Br J Clin Psychol. 1991 Nov;30(Pt 4):333–348. doi: 10.1111/j.2044-8260.1991.tb00954.x. [DOI] [PubMed] [Google Scholar]
  14. Nelson H. E. A modified card sorting test sensitive to frontal lobe defects. Cortex. 1976 Dec;12(4):313–324. doi: 10.1016/s0010-9452(76)80035-4. [DOI] [PubMed] [Google Scholar]
  15. Poser C. M., Paty D. W., Scheinberg L., McDonald W. I., Davis F. A., Ebers G. C., Johnson K. P., Sibley W. A., Silberberg D. H., Tourtellotte W. W. New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol. 1983 Mar;13(3):227–231. doi: 10.1002/ana.410130302. [DOI] [PubMed] [Google Scholar]
  16. Prosiegel M., Michael C. Neuropsychology and multiple sclerosis: diagnostic and rehabilitative approaches. J Neurol Sci. 1993 Apr;115 (Suppl):S51–S54. doi: 10.1016/0022-510x(93)90209-h. [DOI] [PubMed] [Google Scholar]
  17. Rao S. M., Leo G. J., Bernardin L., Unverzagt F. Cognitive dysfunction in multiple sclerosis. I. Frequency, patterns, and prediction. Neurology. 1991 May;41(5):685–691. doi: 10.1212/wnl.41.5.685. [DOI] [PubMed] [Google Scholar]
  18. Rao S. M., Leo G. J., Ellington L., Nauertz T., Bernardin L., Unverzagt F. Cognitive dysfunction in multiple sclerosis. II. Impact on employment and social functioning. Neurology. 1991 May;41(5):692–696. doi: 10.1212/wnl.41.5.692. [DOI] [PubMed] [Google Scholar]
  19. Rao S. M. Neuropsychology of multiple sclerosis: a critical review. J Clin Exp Neuropsychol. 1986 Oct;8(5):503–542. doi: 10.1080/01688638608405173. [DOI] [PubMed] [Google Scholar]
  20. Rao S. M., St Aubin-Faubert P., Leo G. J. Information processing speed in patients with multiple sclerosis. J Clin Exp Neuropsychol. 1989 Aug;11(4):471–477. doi: 10.1080/01688638908400907. [DOI] [PubMed] [Google Scholar]
  21. Sharrack B., Hughes R. A. The Guy's Neurological Disability Scale (GNDS): a new disability measure for multiple sclerosis. Mult Scler. 1999 Aug;5(4):223–233. doi: 10.1177/135245859900500406. [DOI] [PubMed] [Google Scholar]
  22. Thompson S. B. Providing a neuropsychology service for people with multiple sclerosis in an interdisciplinary rehabilitation unit. Disabil Rehabil. 1996 Jul;18(7):348–353. doi: 10.3109/09638289609165893. [DOI] [PubMed] [Google Scholar]
  23. Vickrey B. G., Hays R. D., Harooni R., Myers L. W., Ellison G. W. A health-related quality of life measure for multiple sclerosis. Qual Life Res. 1995 Jun;4(3):187–206. doi: 10.1007/BF02260859. [DOI] [PubMed] [Google Scholar]

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