Cognitive rehab and mindfulness reduce cognitive complaints in MS

In a randomised-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 personalised cognitive goals and MBCT improved 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 observed.

The randomised-controlled REMIND-MS study looked at the effectiveness of both CRT and MBCT on patient-reported cognitive complaints in MS [1]. Effects on personalised cognitive goals and objective cognitive functioning 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, personalised goals setting, and underwent a magnetoencephalography (MEG) scan at baseline, post-treatment, and after 6-months of follow-up.

The 110 participants were randomised 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 was associated with a decrease in general cognitive complaints and executive-function cognitive complaints. The latter effect was also found in the MBCT group.

After 6 months of follow-up, participants in the CRT group better achieved personalised 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, the 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 one focuses on short-term or longer-term results. Both interventions seem promising in the treatment of MS-related cognitive problems.

1. Nauta IM, et al. Cognitive rehabilitation and mindfulness reduce cognitive complaints in multiple sclerosis (REMIND-MS): a randomized controlled trial. Abstract O163, ECTRIMS 2022, 26–28 October, Amsterdam, the Netherlands.

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Posted on 20 December 202227 March 2024