Efficacy of cognitive rehabilitation in cognition and brain networks: A randomised clinical trial in patients with multiple sclerosis
This study evaluated the efficacy of the computerised Guttmann, NeuroPersonalTrainer® (GNPT) cognitive rehabilitation (CR) and characterised the induced changes in cerebral networks in patients with multiple sclerosis (MS). This multicentre, double-blind, randomised clinical trial compared upward in...
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Elsevier
2025-01-01
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| Series: | NeuroImage: Clinical |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213158225000452 |
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| author | E. Lopez-Soley E. Martinez-Heras F. Vivo A. Calvi S. Alba-Arbalat L. Romero-Pinel S. Martínez-Yélamos C. Ramo-Tello S. Presas-Rodríguez E. Munteis J.E. Martínez-Rodríguez J. Sastre-Garriga E. Anglada E.R. Meza-Murillo M.J. Arévalo R. Sánchez-Carrión R. Pelayo M. Bernabeu N. Sola-Valls M. Hervas M. Sepulveda A. Saiz Y. Blanco E. Solana S. Llufriu |
| author_facet | E. Lopez-Soley E. Martinez-Heras F. Vivo A. Calvi S. Alba-Arbalat L. Romero-Pinel S. Martínez-Yélamos C. Ramo-Tello S. Presas-Rodríguez E. Munteis J.E. Martínez-Rodríguez J. Sastre-Garriga E. Anglada E.R. Meza-Murillo M.J. Arévalo R. Sánchez-Carrión R. Pelayo M. Bernabeu N. Sola-Valls M. Hervas M. Sepulveda A. Saiz Y. Blanco E. Solana S. Llufriu |
| author_sort | E. Lopez-Soley |
| collection | DOAJ |
| description | This study evaluated the efficacy of the computerised Guttmann, NeuroPersonalTrainer® (GNPT) cognitive rehabilitation (CR) and characterised the induced changes in cerebral networks in patients with multiple sclerosis (MS). This multicentre, double-blind, randomised clinical trial compared upward intensity training (active treatment) to low-intensity static training (static treatment). Cognition was assessed using the Brief Repeatable battery before and after 12 weeks of training and at 10-months follow-up, and patients were classified as having a mild or severe cognitive impairment (CI). Brain MRI pre- and post-CR were analysed using an advanced tractography algorithm, based on multishell diffusion MRI, to obtain node-based graph metrics (local efficiency and strength) from microscopic fractional anisotropy. Seventy MS patients completed the study (age 48.9 ± 8.8, disease duration 16.8 ± 9.0 years); active treatment: 36, static treatment: 34. Verbal memory improved significantly post-CR in both groups (55 % active; 34 % static treatment), accompanied by increases in local efficiency and strength in multimodal regions. At follow-up, verbal memory declined in both groups but remained above the pre-CR assessment (−25 % and −17 %, respectively). Patients with severe-CI (n = 36) showed improvement only with active treatment, while those with mild-CI (n = 34) improved regardless of intensity treatment. Network changes were more pronounced in patients in active treatment and in those with severe-CI. Quality of life did not change at post-CR, and cognitive improvement was influenced by cognitive reserve (p = 0.011). In MS, GNPT temporarily improves verbal memory and increases network connectivity, reinforcing the CR as a valuable tool for enhancing cognitive skills and promoting neuronal plasticity. |
| format | Article |
| id | doaj-art-376db22ae647474093d953ca9056da21 |
| institution | OA Journals |
| issn | 2213-1582 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
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| series | NeuroImage: Clinical |
| spelling | doaj-art-376db22ae647474093d953ca9056da212025-08-20T02:02:24ZengElsevierNeuroImage: Clinical2213-15822025-01-014610377510.1016/j.nicl.2025.103775Efficacy of cognitive rehabilitation in cognition and brain networks: A randomised clinical trial in patients with multiple sclerosisE. Lopez-Soley0E. Martinez-Heras1F. Vivo2A. Calvi3S. Alba-Arbalat4L. Romero-Pinel5S. Martínez-Yélamos6C. Ramo-Tello7S. Presas-Rodríguez8E. Munteis9J.E. Martínez-Rodríguez10J. Sastre-Garriga11E. Anglada12E.R. Meza-Murillo13M.J. Arévalo14R. Sánchez-Carrión15R. Pelayo16M. Bernabeu17N. Sola-Valls18M. Hervas19M. Sepulveda20A. Saiz21Y. Blanco22E. Solana23S. Llufriu24Neuroimmunology and Multiple Sclerosis Unit. Hospital Clinic Barcelona, Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, SpainNeuroimmunology and Multiple Sclerosis Unit. Hospital Clinic Barcelona, Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, SpainNeuroimmunology and Multiple Sclerosis Unit. Hospital Clinic Barcelona, Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, SpainNeuroimmunology and Multiple Sclerosis Unit. Hospital Clinic Barcelona, Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, SpainNeuroimmunology and Multiple Sclerosis Unit. Hospital Clinic Barcelona, Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, SpainMultiple Sclerosis Unit, Department of Neurology, Hospital Universitari de Bellvitge. Neurology and Neurogenetics Group. Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), SpainMultiple Sclerosis Unit, Department of Neurology, Hospital Universitari de Bellvitge. Neurology and Neurogenetics Group. Neuroscience Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona (UB), L’Hospitalet de Llobregat, SpainMultiple Sclerosis Unit, Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, SpainMultiple Sclerosis Unit, Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, SpainNeurology Department, Hospital del Mar Medical Research Institute (IMIM), SpainNeurology Department, Hospital del Mar Medical Research Institute (IMIM), SpainCentre d’Esclerosi Múltiple de Catalunya (CEMcat), Hospital Universitari Vall d’Hebron, SpainCentre d’Esclerosi Múltiple de Catalunya (CEMcat), Hospital Universitari Vall d’Hebron, SpainCentre d’Esclerosi Múltiple de Catalunya (CEMcat), Hospital Universitari Vall d’Hebron, SpainCentre d’Esclerosi Múltiple de Catalunya (CEMcat), Hospital Universitari Vall d’Hebron, SpainInstitut Guttmann, Institut Universitari de Neurorehabilitació Affiliated to the Universitat Autònoma de Barcelona and Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, SpainInstitut Guttmann, Institut Universitari de Neurorehabilitació Affiliated to the Universitat Autònoma de Barcelona and Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, SpainInstitut Guttmann, Institut Universitari de Neurorehabilitació Affiliated to the Universitat Autònoma de Barcelona and Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, SpainNeurology Department, Hospital Universitari Sant Joan de Reus, Clinical and Epidemiological Neuroscience Group (NeuroÈpia), Institut d’Investigació Sanitària Pere Virgili (IISPV), SpainHospital de Sabadell Parc Taulí, SpainNeuroimmunology and Multiple Sclerosis Unit. Hospital Clinic Barcelona, Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, SpainNeuroimmunology and Multiple Sclerosis Unit. Hospital Clinic Barcelona, Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, SpainNeuroimmunology and Multiple Sclerosis Unit. Hospital Clinic Barcelona, Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, SpainNeuroimmunology and Multiple Sclerosis Unit. Hospital Clinic Barcelona, Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Spain; Corresponding authors.Neuroimmunology and Multiple Sclerosis Unit. Hospital Clinic Barcelona, Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS) and Universitat de Barcelona, Spain; Corresponding authors.This study evaluated the efficacy of the computerised Guttmann, NeuroPersonalTrainer® (GNPT) cognitive rehabilitation (CR) and characterised the induced changes in cerebral networks in patients with multiple sclerosis (MS). This multicentre, double-blind, randomised clinical trial compared upward intensity training (active treatment) to low-intensity static training (static treatment). Cognition was assessed using the Brief Repeatable battery before and after 12 weeks of training and at 10-months follow-up, and patients were classified as having a mild or severe cognitive impairment (CI). Brain MRI pre- and post-CR were analysed using an advanced tractography algorithm, based on multishell diffusion MRI, to obtain node-based graph metrics (local efficiency and strength) from microscopic fractional anisotropy. Seventy MS patients completed the study (age 48.9 ± 8.8, disease duration 16.8 ± 9.0 years); active treatment: 36, static treatment: 34. Verbal memory improved significantly post-CR in both groups (55 % active; 34 % static treatment), accompanied by increases in local efficiency and strength in multimodal regions. At follow-up, verbal memory declined in both groups but remained above the pre-CR assessment (−25 % and −17 %, respectively). Patients with severe-CI (n = 36) showed improvement only with active treatment, while those with mild-CI (n = 34) improved regardless of intensity treatment. Network changes were more pronounced in patients in active treatment and in those with severe-CI. Quality of life did not change at post-CR, and cognitive improvement was influenced by cognitive reserve (p = 0.011). In MS, GNPT temporarily improves verbal memory and increases network connectivity, reinforcing the CR as a valuable tool for enhancing cognitive skills and promoting neuronal plasticity.http://www.sciencedirect.com/science/article/pii/S2213158225000452Cognitive rehabilitationCognitionMRIStructural networksMultiple sclerosis |
| spellingShingle | E. Lopez-Soley E. Martinez-Heras F. Vivo A. Calvi S. Alba-Arbalat L. Romero-Pinel S. Martínez-Yélamos C. Ramo-Tello S. Presas-Rodríguez E. Munteis J.E. Martínez-Rodríguez J. Sastre-Garriga E. Anglada E.R. Meza-Murillo M.J. Arévalo R. Sánchez-Carrión R. Pelayo M. Bernabeu N. Sola-Valls M. Hervas M. Sepulveda A. Saiz Y. Blanco E. Solana S. Llufriu Efficacy of cognitive rehabilitation in cognition and brain networks: A randomised clinical trial in patients with multiple sclerosis NeuroImage: Clinical Cognitive rehabilitation Cognition MRI Structural networks Multiple sclerosis |
| title | Efficacy of cognitive rehabilitation in cognition and brain networks: A randomised clinical trial in patients with multiple sclerosis |
| title_full | Efficacy of cognitive rehabilitation in cognition and brain networks: A randomised clinical trial in patients with multiple sclerosis |
| title_fullStr | Efficacy of cognitive rehabilitation in cognition and brain networks: A randomised clinical trial in patients with multiple sclerosis |
| title_full_unstemmed | Efficacy of cognitive rehabilitation in cognition and brain networks: A randomised clinical trial in patients with multiple sclerosis |
| title_short | Efficacy of cognitive rehabilitation in cognition and brain networks: A randomised clinical trial in patients with multiple sclerosis |
| title_sort | efficacy of cognitive rehabilitation in cognition and brain networks a randomised clinical trial in patients with multiple sclerosis |
| topic | Cognitive rehabilitation Cognition MRI Structural networks Multiple sclerosis |
| url | http://www.sciencedirect.com/science/article/pii/S2213158225000452 |
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