Effectiveness of cognitive rehabilitation in comparison with routine rehabilitation methods in patients with multiple sclerosis: A systematic review and meta-analysis.

Abstract

Cognitive rehabilitation includes a set of programs to train the brain, which leads to the improvement of mental and neuro-psychological functions. This meta-analysis was conducted with the aim of investigating the effectiveness of cognitive rehabilitation in comparison with routine rehabilitation methods in patients with multiple sclerosis (MS). The Cochrane Library, ProQuest, PubMed, PsycINFO, and Web of Science databases were searched from inception to August 2022. Google Scholar was used to find relevant sources and complete the search coverage. Two authors independently selected studies based on predefined inclusion criteria. Data analysis was performed using RevMan (version 5.3). Out of the 578 studies found, 20 studies were finally included in this review. The results of the meta-analysis on four outcomes (Paced Auditory Serial Addition Test (PASAT), Brief Visuospatial Memory Test (BVMT), MS Neuropsychological Screening Questionnaire (MSNQ), and Beck Depression Inventory (BDI)) indicated that the outcome was significant in favor of the cognitive rehabilitation group. However, for five outcomes (Controlled Oral Word Association Test (COWAT), California Verbal Learning Test (CVLT), Everyday Memory Questionnaire (EMQ), Symbol Digit Modalities Test (SDMT), and Expanded Disability Status Scale (EDSS)), the differences between the two groups were not significant. The results of this meta-analysis showed that cognitive rehabilitation has an effect on improving the performance of patients with MS. However, further studies with more accurate methodologies are required to determine which of the outcomes cognitive rehabilitation has a greater effect on.