Hämäläinen Päivi, Rosti-Otajärvi Eija
Masku Neurological Rehabilitation Centre, PO Box 15, 21251 Masku, Finland.
Neurodegener Dis Manag. 2014;4(2):147-54. doi: 10.2217/nmt.14.8.
Cognitive deficits are common symptoms in multiple sclerosis (MS), and evident even in the early stages of the disease. Cognitive functions most frequently affected are information processing, memory and learning, and attention. Deficits may have a multidimensional impact on quality of life by weakening the ability to work, impairing social functioning and increasing the strain of the caregiver. To date, no effective pharmacological treatment for cognitive decline has been established, although there is some evidence suggesting that disease-modifying therapies may help to preserve cognitive function. Neuropsychological rehabilitation aims at alleviation of the negative effects of cognitive impairments and has been found to be effective in patients with stroke and traumatic brain injury. This paper discusses the evidence on neuropsychological rehabilitation in MS based on a recent systematic literature review and suggests a model for alleviating the effects of cognitive impairments in MS. The preliminary research evidence on the effects of neuropsychological rehabilitation in MS is positive: rehabilitation may have favorable effects on patients' cognitive performance and coping with cognitive impairments. In clinical practice, the diagnostics and treatment of cognitive impairments should be improved. Neuropsychological rehabilitation should be an important part of a rehabilitation regimen in MS.
认知缺陷是多发性硬化症（MS）的常见症状，甚至在疾病早期就很明显。最常受影响的认知功能是信息处理、记忆与学习以及注意力。这些缺陷可能会通过削弱工作能力、损害社交功能以及增加照顾者的负担，对生活质量产生多方面的影响。尽管有一些证据表明疾病修正疗法可能有助于维持认知功能，但迄今为止，尚未确立针对认知衰退的有效药物治疗方法。神经心理康复旨在减轻认知障碍的负面影响，并且已被发现在中风和创伤性脑损伤患者中有效。本文基于最近的系统文献综述，讨论了MS中神经心理康复的证据，并提出了一个减轻MS认知障碍影响的模型。关于MS中神经心理康复效果的初步研究证据是积极的：康复可能对患者的认知表现以及应对认知障碍产生有利影响。在临床实践中，应改进认知障碍的诊断和治疗。神经心理康复应成为MS康复方案的重要组成部分。
