Cognitive behavioral therapy improves brain function in MS patients
MedWire News: Cognitive behavioral therapy stimulates cerebral activation and helps to improve memory in patients with multiple sclerosis (MS), say researchers.
"This demonstrates that an effective cognitive rehabilitation protocol can lead to changes in the way the brain is actually processing information," explained lead author Nancy Chiaravalloti (New Jersey Medical School, Newark, USA) in a press statement.
Problems with new learning and memory are frequent in patients with MS, but little research has been carried out assessing the efficacy of memory retraining in these patients.
Chiaravalloti and colleagues recruited 16 people with MS, mean age 48 years, to take part in their study; eight were randomly assigned to receive cognitive behavioral treatment and eight to receive placebo.
The intervention group had 10 sessions of treatment using the modified Story Memory Technique (mSMT) twice a week for 5 weeks (45-60 min per session). The technique involves using imagery and context to make learning verbal information easier and helps patients apply the technique to a real-world setting.
The patients in the placebo group met with the therapist for the same period of time and used the same medium (computer) as those in the intervention group, but were not taught the mSMT technique.
The researchers used functional magnetic resonance imaging to compare baseline and post-intervention cerebral activation while performing a memory task in the two groups.
No differences were seen at baseline, but the intervention group had greater activation in the frontal, parietal, precuneus, and parahippocampal regions when completing a memory task than the placebo group following the intervention.
A significant association between increased activation in the right middle frontal gyrus and improved memory performance was seen in the intervention group. This likely reflects an increased use of the strategies for improving memory and learning taught during the intervention, say the authors.
"The present double-blind, placebo-controlled, randomized clinical trial provides the first evidence of changes at the neural level accompanying behavioral improvements following
completion of a behavioral intervention targeting learning and memory in persons with MS with cognitive impairment," write Chiaravalloti and team in the Journal of Neurology.
"These findings highlight the need to further the clinical availability of the treatment as well as the provision of third party reimbursement for its use with the appropriate patients," they conclude.
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By Helen Albert