The review indicates low level evidence for the positive effects of neuropsychological rehabilitation in MS. Interventions included in the review were heterogeneous. Consequently, clinical inferences can basically be drawn from single studies. Therefore, new trials may change the strength and direction of the evidence. To further strengthen the evidence, well-designed high quality studies are needed. In this systematic review, recommendations are given for improving the quality of future studies on the effects of neuropsychological rehabilitation in MS.
Home-based personalized cognitive training in MS patients: a study of adherence and cognitive performance.
To explore unprompted adherence to a personalized, home-based, computerized cognitive training program in patients with multiple sclerosis (MS), and to examine the impact of training on cognitive performance.
                Participants were assigned to a training (n=59) or a control group (n=48). Those in the training group were instructed to train three times a week for 12 weeks. The control group received no training. All participants were evaluated with a Neuropsychological Examination (N-CPC) at baseline and at the end of the study.
                In the training group, 42 (71.2%) participants adhered to the training schedule and 22 (37.3%) completed the entire training regimen. In the control group, 24 (50.0%) participants agreed to be retested on the N-CPC. The training group showed a significant improvement over that shown by the control group in three memory-based cognitive abilities (general memory, visual working memory and verbal working memory). Post-hoc exploration of data from the N-CPC showed that cognitive training was also associated with increased naming speed, speed of information recall, focused attention and visuo-motor vigilance.
                The appreciable rates of adherence and cognitive improvements observed indicate that personalized cognitive training is a practical and valuable tool to improve cognitive skills and encourage neuronal plasticity in patients with MS.