Brief, personalised rehab may ease cognitive difficulties in MS – study

A brief, personalised rehabilitation programme may help people with MS manage cognitive difficulties, a feasibility study suggests.

Participants in the Neuropsychological Evaluation and Rehabilitation in Multiple Sclerosis (NEuRoMS) programme reported improvements in planning daily activities, using cognitive strategies and managing fatigue.

The intervention was also associated with a moderate improvement in the psychological impact of multiple sclerosis (MS) after three months compared with usual care alone.

Researchers developed NEuRoMS for people with mild-to-moderate cognitive difficulties, combining education, goal-setting and practical strategies tailored to individual needs.

Cognitive problems are common in MS and can affect memory, attention, planning and processing speed, or how quickly the brain receives and responds to information.

These difficulties can interfere with everyday activities, relationships and quality of life, although milder symptoms may go unnoticed.

The feasibility study examined whether the programme and trial procedures were practical and acceptable, rather than establishing whether the treatment was effective.

Of 125 people screened, 79 were enrolled. Forty were assigned to receive NEuRoMS alongside usual care, while 39 received usual care alone.

Participants had an average age of 54.5 years, and 69.6 per cent were women. Most had relapsing-remitting MS, with 81 per cent experiencing mild cognitive difficulties and 19 per cent having moderate difficulties.

Those receiving NEuRoMS were offered up to four hours of individual support across a maximum of six sessions over approximately two months.

Sessions were delivered by supervised assistant psychologists, either online, in person or by telephone. Participants also received a workbook and short educational videos.

Overall, 92 per cent of those assigned to the programme attended at least one session.

At three months, the main improvement compared with usual care concerned the psychological impact of MS, including its emotional, psychological and social effects.

Participants also reported changes in how they perceived their cognitive difficulties, alongside improvements in mood, self-confidence and fatigue management.

Interviews suggested they were using the strategies they had learned to plan and manage daily activities more effectively.

Some said greater awareness of their difficulties had helped them see these problems as manageable.

The reported benefits appeared to continue for six months, with participants describing ongoing improvements in planning, daily activities and the use of cognitive strategies.

Researchers also assessed whether participants could complete the questionnaires required for a larger study.

Around 90 per cent completed the planned primary outcome measure at three and six months, supporting its use in a future trial.

The researchers said their findings suggested that a larger trial was feasible. They also reported that the intervention and trial procedures were acceptable, with people with MS and clinicians finding the programme useful.

They concluded that the findings offered an early indication of possible benefits, particularly for people with mild-to-moderate cognitive difficulties.

A larger trial is now underway to determine whether NEuRoMS can improve cognitive and psychological outcomes for people living with MS.