Computer-assisted rehabilitation of attention in patients with multiple sclerosis: results of a randomized, double-blind trial

Background: There is controversial information on the efficacy of cognitive rehabilitation in multiple sclerosis (MS). Objective: The objective of this paper is to test a home-based computerized program for retraining attention dysfunction in MS. Methods: Relapsing-remitting patients who failed > 2 tests of attention on an extensive neuropsychological battery were randomized to specific or nonspecific computerized training (ST, n-ST), in one-hour sessions, twice a week for three months. Outcome measures included neuropsychological assessment, depression, fatigue, everyday activities and a visual analogue scale assessing attentive performance (VAS). Assessments were repeated after the interventions and after a further three months. Statistical analysis included the analysis of variance (ANOVA) for repeated measures. Results: Eighty-eight out of 102 randomized patients completed the study (69 women, age 40.9 11.5 years, disease duration 13.0 +/- 8.7 years, Expanded Disability Status Scale score 2.7 +/- 1.5). Fifty-five patients were randomized to ST, 33 to n-ST. A benefit of the ST was observed on the Paced Auditory Serial Addition Test (p < 0.002). However, patient self-report did not reveal differences between ST and n-ST patient groups. Conclusion: Although our program trained different attention components, we could detect some improvements exclusively on tasks of sustained attention. Moreover, patient self-perceived results may be independent of the training program.