Mattioli Flavia, Stampatori Chiara, Bellomi Fabio, Danni Maura, Compagnucci Laura, Uccelli Antonio, Pardini Matteo, Santuccio Giuseppe, Fregonese Giuditta, Pattini Marianna, Allegri Beatrice, Clerici Raffaella, Lattuada Annalisa, Montomoli Cristina, Corso Barbara, Capra Ruggero
Neuropsychology Unit, Spedali Civili di Brescia , Brescia , Italy.
Clinica Neurologica, University of Ancona , Ancona , Italy.
Front Neurol. 2015 Jan 13;5:278. doi: 10.3389/fneur.2014.00278. eCollection 2014.
Specific cognitive rehabilitation in multiple sclerosis (MS) resulted to be effective compared to no treatment. So far the possible role of an aspecific psychological intervention on cognition has not been investigated.
The aim of the SMICT RCT was to compare the efficacy of a specific cognitive training with an aspecific psychological intervention in relapsing-remitting MS patients.
From a sample of 150 patients, with the same disability and immunomodulatory therapy, submitted to neuropsychological examination, 45 impaired in at least one test were included and 41 randomized to have either a specific cognitive training for the impaired function (22) or to an aspecific psychological intervention (19) for 4 months, starting after baseline examination. Neuropsychological tests and functional scales were administered at baseline and 1 year later.
After 1 year, the mean number of pathological tests was significantly lower in the specific treatment group, compared to the aspecific group. Memory and attention/speeded information processing functions were mostly improved. Depression and quality of life were not different between groups at follow up.
Our study demonstrates that an intensive and domain specific cognitive approach results to be more effective than aspecific psychological intervention in patients with MS.
与未接受治疗相比,多发性硬化症(MS)的特定认知康复已被证明是有效的。迄今为止,非特定心理干预对认知的潜在作用尚未得到研究。
SMICT随机对照试验的目的是比较特定认知训练与非特定心理干预对复发缓解型MS患者的疗效。
从150名具有相同残疾程度且接受免疫调节治疗的患者样本中,这些患者均接受了神经心理学检查,其中45名至少在一项测试中表现受损,将他们纳入研究,41名被随机分配,其中22名接受针对受损功能的特定认知训练,19名接受非特定心理干预,为期4个月,从基线检查后开始。在基线和1年后进行神经心理学测试和功能量表评估。
1年后,与非特定治疗组相比,特定治疗组的病理测试平均数量显著更低。记忆和注意力/快速信息处理功能大多得到改善。随访时两组之间的抑郁和生活质量没有差异。
我们的研究表明,在MS患者中,强化且针对特定领域的认知方法比非特定心理干预更有效。