Manocchio Nicola, Moriano Chiara, D'Amato Anna, Bossa Michela, Foti Calogero, Nocentini Ugo
Physical and Rehabilitation Medicine, Clinical Sciences and Translational Medicine Department, Tor Vergata University, 00133 Rome, Italy.
PhD Course in Tissue Engineering and Remodeling Biotechnologies for Body Function, Tor Vergata University, 00133 Rome, Italy.
NeuroSci. 2025 Jul 15;6(3):64. doi: 10.3390/neurosci6030064.
Cognitive impairment is a prevalent and disabling feature of multiple sclerosis (MS), significantly impacting patients' quality of life (QoL) and psychological well-being. Despite its clinical relevance, there are currently no approved pharmacological treatments for cognitive deficits in MS, highlighting the need for effective non-pharmacological interventions. This narrative review explores evidence from studies evaluating the efficacy of cognitive re-education (CR) approaches (including traditional, group-based, computer-assisted, virtual reality, and innovative methods such as music therapy) on cognitive and QoL outcomes in people with MS. The findings demonstrate that while CR consistently influences cognitive domains such as memory, attention, and executive function, its effects on QoL are more variable and often depend on intervention type, duration, and individual patient characteristics. Notably, integrative approaches like virtual reality and music therapy show promising results in enhancing both cognitive performance and psychosocial well-being. Several studies report that cognitive gains are accompanied by improvements in mental health and functional QoL, particularly when interventions are tailored to individual needs and delivered within multidisciplinary frameworks. However, some interventions yield only limited or transient QoL benefits, underlining the importance of personalized, goal-oriented strategies that address both cognitive and psychosocial dimensions. Further research is needed to optimize intervention strategies and clarify the mechanisms linking cognitive and QoL outcomes.
认知障碍是多发性硬化症（MS）的一种普遍且致残的特征，对患者的生活质量（QoL）和心理健康有重大影响。尽管其具有临床相关性，但目前尚无批准用于治疗MS认知缺陷的药物治疗方法，这凸显了有效非药物干预措施的必要性。这篇叙述性综述探讨了评估认知再教育（CR）方法（包括传统方法、基于小组的方法、计算机辅助方法、虚拟现实方法以及音乐疗法等创新方法）对MS患者认知和QoL结果疗效的研究证据。研究结果表明，虽然CR始终会影响记忆、注意力和执行功能等认知领域，但其对QoL的影响更具变异性，且通常取决于干预类型、持续时间和个体患者特征。值得注意的是，虚拟现实和音乐疗法等综合方法在提高认知表现和心理社会幸福感方面显示出有前景的结果。多项研究报告称，认知改善伴随着心理健康和功能性QoL的改善，特别是当干预措施根据个体需求进行调整并在多学科框架内实施时。然而，一些干预措施仅产生有限或短暂的QoL益处，这凸显了个性化、目标导向策略的重要性，这些策略应兼顾认知和心理社会层面。需要进一步研究以优化干预策略并阐明连接认知和QoL结果的机制。
