Cognitive rehabilitation program boosts brain function in MS patients

A three-month cognitive rehabilitation programme, with or without aerobic exercise, has been shown to increase tissue volume and activity in brain regions linked to cognition among people with progressive multiple sclerosis (MS), clinical trial data reveals.

Participants were randomly assigned to one of four groups – cognitive rehabilitation, aerobic exercise, cognitive rehabilitation with aerobic exercise, or neither. The interventions were carried out for 12 weeks, with a follow-up six months later. Cognitive rehabilitation involved computer-based brain tasks. For groups not doing cognitive rehabilitation, a placebo exercise of basic internet searches and computer use was used. Aerobic exercise involved a step machine, while balance and stretching activities served as sham interventions for groups not assigned aerobic exercise.

The primary analysis showed that combining cognitive rehabilitation with aerobic exercise did not improve cognitive performance more than either intervention alone. However, many participants saw improvements in information processing speed.

A subgroup of 104 participants underwent MRI scans to examine changes in brain tissue volume and connectivity. The sub-study found significant differences in grey matter volume among the groups, mainly due to increases in those who performed only cognitive rehabilitation. Those undertaking cognitive rehabilitation, with or without aerobic exercise, showed significant increases in grey matter volume in multiple brain regions after 12 weeks. Increased grey matter volume was linked to improved verbal learning and memory.

While the study did not find a ‘synergistic effect’ of combining interventions, it highlighted that cognitive rehabilitation alone may lead to beneficial changes in brain regions linked to cognition.