Efficacy of cognitive rehabilitation in cognition and brain networks

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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Detalles Bibliográficos
Autores: Lopez-Soley, Elisabet, Martinez-Heras, Eloy|||0000-0001-9937-3162, Vivó Pascual, Francesc|||0000-0002-6409-1197, Calvi, Alberto|||0000-0002-1953-2803, Alba-Arbalat, Salut|||0000-0003-1662-2317, Romero Pinel, Lucía|||0000-0001-8054-0565, Martínez Yélamos, Sergio|||0000-0001-9889-2040, Ramo-Tello, Cristina|||0000-0001-8643-5053, Presas Rodríguez, Sílvia|||0000-0001-8545-2476, Munteis, Elvira|||0000-0002-6195-9106, Martínez-Rodríguez, José Enrique, Sastre-Garriga, Jaume|||0000-0002-1589-2254, Anglada, E.|||0000-0001-5074-4970, Meza-Murillo, Edwin Roger|||0000-0001-6065-3546, Arévalo, María Jesús|||0000-0003-0626-5555, Sánchez Carrión, Rocío, Pelayo, Raúl|||0000-0002-1313-0686, Bernabeu Guitart, Montserrat|||0000-0003-2037-3069, Sola-Valls, Nuria, Hervas, M., Sepúlveda, María, Saiz, Albert|||0000-0002-5793-8791, Blanco Morgado, Yolanda|||0000-0002-1834-0498, Solana, Elisabeth|||0000-0001-7973-2439, Llufriu, Sara|||0000-0003-4273-9121
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:319531
Acceso en línea:https://ddd.uab.cat/record/319531
https://dx.doi.org/urn:doi:10.1016/j.nicl.2025.103775
Access Level:acceso abierto
Palabra clave:Cognition
Cognitive rehabilitation
MRI
Multiple sclerosis
Structural networks
Descripción
Sumario: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.

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