The Effects of Cognitive Rehabilitation on Relapsing Remitting Multiple Sclerosis Patients

İlknur Güçlü Altun; Dursun Kirbaş; Deniz Utku Altun; Aysun Soysal; Pakize Nevin Sütlaş; Demet Yandim Kuşçu; Neslihan Behrem Gayir; Ekim Arslan; Barış Topçular

doi:10.5152/npa.2015.7425

The Effects of Cognitive Rehabilitation on Relapsing Remitting Multiple Sclerosis Patients

Noro Psikiyatr Ars. 2015 Jun;52(2):174-179. doi: 10.5152/npa.2015.7425. Epub 2015 Jun 1.

Authors

İlknur Güçlü Altun¹, Dursun Kirbaş², Deniz Utku Altun³, Aysun Soysal⁴, Pakize Nevin Sütlaş⁴, Demet Yandim Kuşçu⁴, Neslihan Behrem Gayir⁴, Ekim Arslan⁵, Barış Topçular⁶

Affiliations

¹ Clinic of Neurology, Şanlıurfa Balıklıgöl State Hospital, Şanlıurfa, Turkey.
² İstanbul University Forensic Medicine Institute, İstanbul, Turkey.
³ Şanlıurfa Public Health Management, Şanlıurfa, Turkey.
⁴ 3 Clinic of Neurology, Bakırköy Prof. Dr. Mazhar Osman Psychiatric Training and Research Hospital, İstanbul, Turkey.
⁵ 2 Clinic of Neurology, Bakırköy Prof. Dr. Mazhar Osman Psychiatric Training and Research Hospital, İstanbul, Turkey.
⁶ Clinic of Neurology, İstanbul Bilim University, İstanbul, Turkey.

Abstract

Introduction: The aims of this study were to determine the severity of cognitive impairment with Brief Repeatable Battery Neuropsychology (BRB-N) and to show the benefits of cognitive rehabilitation programs to develop coping strategies for the retardation of cognitive losses in relapsing remitting multiple sclerosis (RRMS) patients.

Methods: The cognitive screening with BRB-N was performed in RRMS patients who had applied to the MS outpatient clinic of Bakırköy Psychiatric and Neurological Diseases Hospital, had an Expanded Disability Status Scale (EDSS) score between 1.0 and 5.5, and had no other cognitive disease or used drugs that effected the cognitive status. Thirty two patients with cognitive impairment underwent consecutive computer-assisted cognitive rehabilitation program once a week for 8 weeks conducted by psychologists. The effects of the program were evaluated with the tests repeated every 4 weeks.

Results: The mean age of the patients was 36.09±7.19 years. Their initial and control test scores were found to be paced auditory serial addition test (PASAT) 29.21±17.97; 42.43±15.43, Selective Reminding Test-Total Learning (SRT-TL) 8.03±2.36; 10.09±1.77, Selective Reminding Test-Long-term Memory (SRT-DR) 6.72±2.74; 9±2.29, Spatial Recall Test-Total Learning (SPART-TL) 4.72±2.02; 4.22±1.74, Spatial Recall Test-Long-term Memory (SPART-DR) 5.94±2.54; 5.16±2.23, Symbol Digit Modalities Test (SDMT) 40.44±17.04; 46.47±17.94, Word Fluency Test (WLG) 32.88±9.87; 40.44±9.95 respectively. There was no significant statistical difference between Multiple Sclerosis Neuropsychological Screening Questionnaire (MSNQ) and SPART values of preface, 1^st control and 2^nd control (p>0.05). There was significant statistical difference between PASAT, WLG, SDMT, SRT-TL, SRT-DR values of Preface, 1^st control, and 2^nd control (p=0.0001).

Conclusion: It was determined that on distinctive improvement on sustaining attention, working memory and information processing speed, and verbal fluency and verbal learning with cognitive rehabilitation, no changes were observed on visuospatial learning. This approach is hopeful and further comprehensive studies are needed.

Keywords: Multiple sclerosis; cognitive impairment; cognitive rehabilitation.