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| Home > Articles > Published articles > Efficacy of cognitive rehabilitation in cognition and brain networks : |
(Hospital Clínic i Provincial de Barcelona) (Hospital Clínic i Provincial de Barcelona) (Hospital Clínic i Provincial de Barcelona) (Hospital Clínic i Provincial de Barcelona) (Hospital Universitari de Bellvitge) (Hospital Universitari de Bellvitge) (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol) (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol) (Institut Hospital del Mar d'Investigacions Mèdiques) (Hospital Universitari Vall d'Hebron) (Hospital Universitari Vall d'Hebron) (Hospital Universitari Vall d'Hebron) (Hospital Universitari Vall d'Hebron) (Institut Germans Trias i Pujol. Institut Guttmann) (Institut Germans Trias i Pujol. Institut Guttmann) (Hospital Clínic i Provincial de Barcelona) (Hospital Clínic i Provincial de Barcelona) (Hospital Clínic i Provincial de Barcelona) (Hospital Clínic i Provincial de Barcelona)| Date: | 2025 |
| Abstract: | 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. |
| Grants: | Instituto de Salud Carlos III PI21/00944 Agència de Gestió d'Ajuts Universitaris i de Recerca 2021/SGR-00002 Instituto de Salud Carlos III PI19/00950 Instituto de Salud Carlos III PI22/00750 Instituto de Salud Carlos III PI19/01634 Ministerio de Economía y Competitividad FI16/00251 Instituto de Salud Carlos III PI18/01030 Instituto de Salud Carlos III PI21/01189 Ministerio de Economía y Competitividad RD16/0015/0002 Ministerio de Economía y Competitividad RD16/0015/0003 |
| Rights: | Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.  |
| Language: | Anglès |
| Document: | Article ; recerca ; Versió publicada |
| Subject: | Cognition ; Cognitive rehabilitation ; MRI ; Multiple sclerosis ; Structural networks |
| Published in: | NeuroImage. Clinical, Vol. 46 (january 2025) , p. 103775, ISSN 2213-1582 |
