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注意和执行功能强化康复对复发缓解型多发性硬化症的影响的持续性

Persistence of the effects of attention and executive functions intensive rehabilitation in relapsing remitting multiple sclerosis.

作者信息

Mattioli F, Stampatori C, Scarpazza C, Parrinello G, Capra R

机构信息

Neuropsychology Unit, Spedali Civili of Brescia, V. Nikolajewka, 13, 25123 Brescia, Italy.

Neuropsychology Unit, Spedali Civili of Brescia, V. Nikolajewka, 13, 25123 Brescia, Italy.

出版信息

Mult Scler Relat Disord. 2012 Oct;1(4):168-73. doi: 10.1016/j.msard.2012.06.004. Epub 2012 Jul 21.

Abstract

BACKGROUND

Neuropsychological rehabilitation efficacy in multiple sclerosis (MS) is a currently investigated issue. We reported, in a single blind controlled study, that an intensive short duration cognitive training of attention and executive functions significantly improves the treated functions and reduces depression in MS. The persistence of these effects over time are unknown.

OBJECTIVE

To evaluate the persistence over time of neuropsychological improvement due to cognitive training nine months after rehabilitation onset.

METHODS

This is a single blind randomized controlled study. 24 MS patients were randomly assigned to experimental group (n=13) and received PC assisted neuropsychological treatment for three months, or to control group (n=11), receiving no treatment. Patients were submitted to neuropsychological evaluation, depression and quality of life questionnaires at baseline, three months and nine months later.

RESULTS

Nine months follow up compared to baseline evaluation shows a statistically significant improvement (p<0.05) in attention, information processing and executive functions tests (PASAT 3″, COWA/S, WCSTpe), in depression and quality of life questionnaires in rehabilitated patients only. reliable change index (RCI) and modified RCI confirmed the clinical significance of this improvement in rehabilitated patients.

CONCLUSIONS

Three months intensive neuropsychological rehabilitation of attention, information processing and executive functions induces a long lasting and clinically relevant neuropsychological improvement over time and a persistent depression and quality of life amelioration in patients with RR MS.

摘要

背景

多发性硬化症(MS)的神经心理康复疗效是目前正在研究的问题。我们在一项单盲对照研究中报告,对注意力和执行功能进行强化短期认知训练可显著改善MS患者的相关功能并减轻抑郁症状。这些效果随时间的持续性尚不清楚。

目的

评估康复开始九个月后认知训练带来的神经心理改善随时间的持续性。

方法

这是一项单盲随机对照研究。24例MS患者被随机分为实验组(n = 13),接受为期三个月的计算机辅助神经心理治疗,或对照组(n = 11),不接受治疗。患者在基线、三个月和九个月时接受神经心理评估、抑郁和生活质量问卷调查。

结果

与基线评估相比,九个月的随访显示,仅康复患者在注意力、信息处理和执行功能测试(PASAT 3″、COWA/S、WCSTpe)、抑郁和生活质量问卷调查方面有统计学显著改善(p < 0.05)。可靠变化指数(RCI)和改良RCI证实了康复患者这种改善的临床意义。

结论

对RR型MS患者进行为期三个月的注意力、信息处理和执行功能强化神经心理康复训练,可随着时间推移带来持久且具有临床意义的神经心理改善,并持续改善抑郁和生活质量。

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