Purpose: To evaluate brain changes after cognitive rehabilitation in MS'ers with clinically stable relapsing-remitting MS (RRMS) by using neuropsychologic assessment and structural and functional MRI techniques.
Structural MRI: delineates the anatomy of the brain, for example lesions and atrophy or shrinkage of the brain.
Functional MRI: delineates function of the brain; how much oxygen and blood a part of the brain requires when doing a particular task.
Materials and Methods: 20 with RR MS and cognitive deficits at baseline were randomly assigned to undergo treatment (n = 10), which entailed computer-assisted cognitive rehabilitation of attention and information processing and executive functions, or to serve as a control subjects (n = 10) without cognitive rehabilitation. All patients underwent a standardized neuropsychologic assessment and MR imaging at baseline and after 12 weeks. Changes in gray matter (GM) volumes on 3D images and changes in normal-appearing white matter (NAWM) architecture on were assessed. Changes in functional activity at functional MR imaging during the Stroop task and at rest were also investigated.
Stroop task: this is a cognitive test that require some thought
Results: As compared with their performance at baseline, the MS'ers in the treatment group improved at tests of attention and information processing and executive functions. Neither structural modifications to GM volume nor modifications to NAWM architecture were detected at follow-up in both groups. Functional MR imaging demonstrated modifications of the activity of several areas of the brain* at rest in the treatment group compared with the control group. In the treatment group, functional MR imaging changes were correlated with cognitive improvement (P < .0001 to .01).
* For those of you who want to know these areas included the posterior cingulate cortex/precuneus and dorsolateral prefrontal cortex during the Stroop task, as well as modifications of the activity of the anterior cingulum, posterior cingulate cortex and/or precuneus, left dorsolateral prefrontal cortex and right inferior parietal lobule.
Conclusion: Rehabilitation of attention and information processing and executive functions in RR MS may be effected through enhanced recruitment of brain networks subserving the trained functions.