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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Autores: López-Soley, Elisabet, Munteis Olivas, Elvira, Martínez Rodríguez, José Enrique, Llufriu, Sara
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:dnet:rdupf_______::b96e2f0e2c825c187c72a98a91193c96
Acceso en línea:https://hdl.handle.net/10230/73239
http://dx.doi.org/10.1016/j.nicl.2025.103775
Access Level:acceso abierto
Palabra clave:Cognition
Cognitive rehabilitation
MRI
Multiple sclerosis
Structural networks
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spelling Efficacy of cognitive rehabilitation in cognition and brain networks: a randomised clinical trial in patients with multiple sclerosisLópez-Soley, ElisabetMunteis Olivas, ElviraMartínez Rodríguez, José EnriqueLlufriu, SaraCognitionCognitive rehabilitationMRIMultiple sclerosisStructural networksThis 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.Elsevier2026202620252026info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/10230/73239http://dx.doi.org/10.1016/j.nicl.2025.103775reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésNeuroImage: Clinical. 2025;46:103775© 2025 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/).http://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:dnet:rdupf_______::b96e2f0e2c825c187c72a98a91193c962026-06-12T07:21:37Z
dc.title.none.fl_str_mv Efficacy of cognitive rehabilitation in cognition and brain networks: a randomised clinical trial in patients with multiple sclerosis
title Efficacy of cognitive rehabilitation in cognition and brain networks: a randomised clinical trial in patients with multiple sclerosis
spellingShingle Efficacy of cognitive rehabilitation in cognition and brain networks: a randomised clinical trial in patients with multiple sclerosis
López-Soley, Elisabet
Cognition
Cognitive rehabilitation
MRI
Multiple sclerosis
Structural networks
title_short 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_sort Efficacy of cognitive rehabilitation in cognition and brain networks: a randomised clinical trial in patients with multiple sclerosis
dc.creator.none.fl_str_mv López-Soley, Elisabet
Munteis Olivas, Elvira
Martínez Rodríguez, José Enrique
Llufriu, Sara
author López-Soley, Elisabet
author_facet López-Soley, Elisabet
Munteis Olivas, Elvira
Martínez Rodríguez, José Enrique
Llufriu, Sara
author_role author
author2 Munteis Olivas, Elvira
Martínez Rodríguez, José Enrique
Llufriu, Sara
author2_role author
author
author
dc.subject.none.fl_str_mv Cognition
Cognitive rehabilitation
MRI
Multiple sclerosis
Structural networks
topic Cognition
Cognitive rehabilitation
MRI
Multiple sclerosis
Structural networks
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.
publishDate 2025
dc.date.none.fl_str_mv 2025
2026
2026
2026
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/10230/73239
http://dx.doi.org/10.1016/j.nicl.2025.103775
url https://hdl.handle.net/10230/73239
http://dx.doi.org/10.1016/j.nicl.2025.103775
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv NeuroImage: Clinical. 2025;46:103775
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by-nc/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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