Computer-aided retraining of memory and attention in people with multiple sclerosis: a randomized, double-blind controlled trial

Context: Cognitive compromise is one of the main contributing factors to activity and participation restrictions in people with multiple sclerosis (MS). Computer-aided programs are used for retraining memory and attention, but data on the efficacy of these interventions are scarce. Objective: To assess the efficacy of computer-aided retraining of memory and attention in people with MS impaired in these abilities. Design and setting: Randomized, double-blind, controlled trial. Participants: Outpatients (n = 82) with subjective complaints of poor attention or memory, confirmed by a score <80th percentile in at least two tests of the Brief Repeatable Battery of Neuropsychological Tests (BRBNT). Interventions: Participants were randomized to two computer-assisted retraining interventions: memory and attention (study arm), and visuo-constructional and visuo-motor coordination (control arm). Both groups received 16 training sessions over 8 weeks. Outcome measures: Improvement of 20% or more in at least two BRBNT test scores at 8 weeks compared to baseline (primary end point). Changes in depression and health-related quality of life. Results: An improvement occurred in 45% of study patients vs. 43% of control patients (odds ratio 1.07, 95% confidence interval 0.44-2.64). The study treatment was better than the control treatment only on the word list generation test (p = 0.016). Conclusions: This trial does not support the efficacy of specific memory and attention retraining in MS. (C) 2004 Elsevier B.V. All rights reserved.