Cognitive therapy for multiple sclerosis: a preliminary study

Abstract

Background: Drug treatments for multiple sclerosis are expensive, may cause side effects, and do not have demonstrated efficacy for cognitive deficits associated with this disease.

Objective: To test the effectiveness of a multimodal cognitive therapy on cognitive and physical measures known to be affected in multiple sclerosis.

Design: Quasi-experimental wait-list control.

Setting: Alternative medicine clinic.

Patients: 27 persons with clinically definite multiple sclerosis.

Intervention: Multimodal cognitive therapy.

Main outcome measures: Neuropsychological measures of verbal learning and memory, abstraction, vocabulary, and information processing speed; Beck Depression Inventory; tactile sensitivity of the hands; grip strength; and visual acuity.

Main results: 12 of 14 patients in the therapy group and 10 of 13 patients in the control group completed 24 weeks of treatment and all assessments. Patients who received therapy showed significantly greater improvement in verbal learning, verbal abstraction, depression, and some measures of grip strength and tactile sensitivity than did patients in the untreated control group. The groups did not differ in the magnitude of change on vocabulary, information processing speed, or visual acuity.

Conclusion: Cognitive therapy appears to be a promising treatment for ameliorating some symptoms of multiple sclerosis. A larger study with a randomized design and additional outcome measures is warranted.