Cognitive Rehabilitation Training Research Articles

Effects of a cognitive rehabilitation training program in school-aged children with specific learning disorder

ABSTRACT Objective This study investigated the effect of Cognitive Rehabilitation Training (CRT) on executive functions, problem solving, and attention in students with a specific learning disorder (SLD). Method Forty-two SLD students from the third to sixth grade (8–12 years old) were randomly assigned to 16 sessions of CRT (n = 21) or to a control (n = 21) group. Executive functions were assessed by the Behavior Rating Inventory of Executive Function (2nd ed.), problem solving by the Tower of London test, and attention by the Stroop test. Results Analyses of variance and post-hoc analyses revealed that there were significant improvements in the CRT group in most aspects of executive functions, problem solving, and attention, and these improvements were maintained over a two-month follow-up. Conclusion These findings suggest that a CRT program may have positive implications for cognitive functioning and may provide preliminary support for alternative therapeutic interventions for use in children with SLD.

Effects of Cognitive Intervention and Rehabilitation Training on the Expression of miR-134-5p in Elderly Patients with Diabetes Mellitus and Cognitive Impairment

ABSTRACT Objective This study aimed to analyze the effect and potential mechanism of cognitive intervention and rehabilitation training in elderly patients with diabetes mellitus complicated with mild cognitive impairment. Methods In this study, 128 elderly patients with diabetes mellitus complicated with mild cognitive impairment were randomly divided into the control group and the training group. The effects of the two groups were compared before and after the cognitive intervention. The expression of miR-134-5p was assessed by qRT-PCR. The relationships between miR-134-5p and Mini-Mental State Examination Scale and Montreal Cognitive Assessment Scale were evaluated. Results After 3-month management, the Mini-Mental State Examination Scale, Montreal Cognitive Assessment Scale, the Chinese version of the diabetes self-efficacy rating scale, and WHO quality of life brief were improved in both control group and training group, and the training group showed better improvement. Cognitive intervention and rehabilitation training restricted the expression of miR-134-5p. The levels of miR-134-5p were pertinent to cognitive function. Conclusion Cognitive intervention and rehabilitation training might prevent the development of diabetes mellitus complicated with mild cognitive impairment by inhibiting miR-134-5p.

Improvement of the Cognitive Abilities in a Chronic Generalized Anxiety Disorder and Moderate Depression Case using a Novel Integrated Approach: The Cognitome Program

Cognitive impairment has been increasingly observed among patients with anxiety disorders and major depressive disorders impacting their normal daily functioning as well as quality of life. A multitude of evidence suggests that the most affected cognitive abilities are memory, attention, perception, and executive functioning in patients with anxiety and depression. Impairment in these higher-order cognitive functions can be attributed to age, education, diet, hormonal changes, stress, and prolonged use of drugs/alcohol/ medicines. To address the issues related to cognitive impairment various non-pharmacological therapeutic modalities such as Cognitive remediation approaches viz; cognitive rehabilitation, cognitive stimulation, and cognitive training; Audio-visual entrainment; mindfulness-based interventions; and neurofeedback have come into play in recent years. It is imperative to understand that the ability to test, measure, and monitor cognitive performance along with implementing cognitive remediation approaches viz; cognitive stimulation, cognitive training, etc. across the lifespan helps in early identification, accessing treatments faster, staying healthy for longer, and improving overall quality of life. This article discusses a case study of a client suffering from generalized anxiety disorder and moderate depression who after undergoing and following a novel therapeutic approach, ‘The Cognitome Program’ has shown credible improvement in cognitive abilities, along with a prominent reduction in the symptoms of anxiety, depression, and better psychological and physical well-being. Guided by the concept of neuroplasticity and cognitive plasticity, our innovative neuroscientific holistic program- ‘The Cognitome Program’ empowers unlocking hidden cognitive potential using cutting-edge methodologies and personalized strategies.

Network meta-analysis of non-pharmacological interventions for cognitive impairment after an ischemic stroke.

This study aims to evaluate the effectiveness of non-pharmacological interventions in improving cognitive function in patients with ischemic stroke through network meta-analysis. We searched databases including the Cochrane Library, PubMed, EmBase, and Web of Science for randomized controlled trials (RCTs) on non-pharmacological treatments to improve cognitive impairment following ischemic stroke. The publication date was up to 15 March 2023. Due to the insufficiency of included studies, supplementary searches for high-quality Chinese literature were performed in databases such as CNKI, WanFang Data, and VIP Chinese Science Journals Database. Two reviewers independently went through the literature, extracted data, and assessed the risk of bias in the included studies using the risk of bias assessment tool recommended by the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0. By utilizing R 4.2.3 RStudio software and the GeMTC package, a Bayesian network meta-analysis was conducted to assess the improvement in Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores under a variety of non-pharmacological interventions. A total of 22 RCTs involving 2,111 patients and 14 different non-pharmacological treatments were included. These interventions were transcranial direct current stimulation (tDCS), reminiscence therapy (RT), remote ischemic conditioning (RIC), physical fitness training (PFT), intensive patient care program (IPCP), moderate-intensity continuous training + high-intensity interval training (MICT + HIIT), medium intensity continuous training (MICT), grip training (GT), acupuncture, cognitive behavioral therapy (CBT), cognitive rehabilitation training (CRT), high pressure oxygen (HPO), moxibustion, and repetitive transcranial magnetic stimulation (rTMS). The results of the network meta-analysis indicated that rTMS had the highest likelihood of being the most effective intervention for improving MMSE and MoCA scores. The evidence from this study suggests that rTMS holds promise for improving MMSE and MoCA scores in patients with cognitive impairment following ischemic stroke. However, further high-quality research is needed to confirm and validate this finding.

A systematic review about the importance of neuropsychological features in heart failure: is at heart the only failure?

Heart failure can lead to cognitive impairment that is estimated to be present in over a quarter of patients. It is important to intervene at a cognitive level to promote brain plasticity through cognitive training programs. Interventions transformed by technology offer the promise of improved cognitive health for heart failure patients. This review was conducted on studies evaluating the role of cognitive rehabilitation in patients with heart failure. We examined clinical trials involving patients with heart failure. Our search was performed on Pubmed, Web of Science and Cochrane library databases. Of the initial 256 studies, 10 studies met the inclusion criteria. Cognitive rehabilitation training has important implications for the treatment and prevention of cognitive decline in heart failure patients with significant recovery for delayed recall memory and a significant time effect for total recall memory and delayed, psychomotor speed and IADL performance. It is important to include the assessment of cognitive functioning in the routine clinical examinations of patients with heart failure, discover the relationship between cognitive function and heart failure, and target cognitive rehabilitation programs that promote brain plasticity.

Cognitive Interventions: Symptomatic or Disease-Modifying Treatments in the Brain?

Recent findings suggest that brain-stimulating activities may have beneficial effects on both Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD). However, whether cognitive interventions merely enhance cognitive reserve or truly attenuate, or even reverse, the disease's pathophysiology is still controversial. The aim of the present article is to discuss the potential for brain-stimulating activities, including cognitive stimulation (CS), cognitive rehabilitation (CR), and cognitive training (CT), to be symptomatic or disease-modifying interventions in the context of cognitive decline. While emerging evidence indicates that CT can enhance synaptic plasticity, suggesting a potential role in augmenting cognitive reserve, its impact on AD pathology remains uncertain. Small-scale studies suggest that CT and CS may slow down neurodegeneration in MCI patients and that multidomain interventions combining physical activity with CT may benefit Aβ pathology. However, the considerable heterogeneity across studies limits the comparability of findings. It underscores the necessity for a more standardized approach to cognitive interventions in future guidelines for preventing and managing cognitive decline.

Comparing the Effectiveness of Cognitive Rehabilitation Training and Sensory Integration on Attention and Impulsivity of Hyperactive Students

Comparing the Effectiveness of Cognitive Rehabilitation Training and Sensory Integration on Attention and Impulsivity of Hyperactive Students

The effect of repeated transcranial magnetic stimulation combined with cognitive rehabilitation training on post-stroke cognitive impairment.

The aim of this study was to explore the effect of repetitive transcranial magnetic stimulation (rTMS) combined with cognitive rehabilitation training on post-stroke cognitive impairment (PSCI). We retrospectively reviewed clinical data from 119 patients with PSCI admitted to our hospital from December 2021 to April 2023, of which 58 received pure cognitive rehabilitation training (control group) and 61 received rTMS combined with cognitive rehabilitation training (observation group). We calculated measures of cognitive function rehabilitation, daily living activity abilities, latency and amplitude of P300 wave of evoked potential, and serum biochemical index levels before and after the intervention in the two groups. After the intervention, the scores of the Montreal Cognitive Assessment (MoCA) scale and Rivermead behavioral memory test (RBMT) had improved in the two groups. Also, the Modified Barthel Index (MBI) scores of the two groups increased after the intervention. The P300 wave latencies in both groups decreased and their amplitudes increased after the intervention. The levels of serum neurotrophin-3 (NT-3) and brain-derived neurotrophic factor (BDNF) in the two groups were higher, and the levels of brain glial fibrillary acidic protein (GFAP) were lower after the intervention. All these improvements were more marked in the observation group than in the control group (all p<0.05). Compared with simple cognitive rehabilitation training, the training combined with rTMS was more effective at restoring cognitive function, improving daily living activity abilities, and improving the treatment outcome of patients with PSCI.

26 Improvement in Executive Function Following Goal-Oriented Attentional Self-Regulation Training in Veterans with mTBI

Objective:Goal-Oriented Attentional Self-Regulation (GOALS) is a cognitive rehabilitation training that targets difficulties with executive control functions. Prior research has found that GOALS training improves executive function, functional outcomes, and PTSD symptoms in Veterans with comorbid PTSD and TBI. The objective of this study is to assess the effects of GOALS training versus an active time-matched Behavioral Health Education (BHE) intervention in military Veterans with history of mTBI and executive function difficulties.Participants and Methods:Thirty-four veterans with a history of mild TBI (&gt;6 months post-injury) and cognitive difficulties were randomized to GOALS or BHE group intervention. GOALS is a cognitive rehabilitation intervention that incorporates mindfulness-based attention regulation training, and goal management strategies applied to participant-defined goals. It consists of ten 2-hour sessions administered in small group format, and three individual 1-hour sessions. The BHE group is a matched control condition that mirrors GOALS in terms of duration and level of involvement. Participants completed a comprehensive evaluation consisting of neuropsychological and ecologically valid functional performance measures of complex attention and executive function, before and after GOALS or BHE intervention. Overall neuropsychological attention/executive functioning included measures of working memory (Letter Number Sequencing, Auditory Consonant Trigrams), mental flexibility (Design &amp; Verbal Fluency Switching, Trails B, Stroop Inhibition/Switching), inhibition (Stroop Inhibition), and sustained attention (Digit Vigilance). The Goal Processing Scale (GPS) was used to measure ecologically valid complex functional performance.Results:Post GOALS training, but not post BHE, participants significantly improved on measures of attention /executive function including overall performance (p=.02), working memory (p=.04), sustained attention (p=.03)., and inhibition (p=.01). On measures of complex functional task performance, post GOALS participants significantly improved in the domain of planning (p=.02).Conclusions:GOALS training improved performance on neuropsychological and ecologically valid functional measures of complex attention and executive function in Veterans with mild TBI and cognitive difficulties. The current study highlights how mindfulness-based attention regulation and goalmanagement strategies applied to personal goals has positive effects across various outcomes. A percentage of individuals with mTBI continue to report persistent problems with cognition and daily functioning. Cognitive rehabilitation training such as GOALS may be beneficial for those with persistent difficulties following mTBI, even in chronic phase.

Design of Cognitive Rehabilitation Training System using Artificial Intelligence

This study is a study to design a cognitive(dementia) rehabilitation training system using the MMSE-DS protocol and the GDS protocol using artificial intelligence to analyze the user's cognitive ability and infer cognitive domain content correlation inference algorithms. For research on cognitive judgment technology using artificial intelligence, We provide an integrated cognitive rehabilitation service platform, provide customized training content by building a cognitive rehabilitation evaluation and training user data storage and analysis database, and design an algorithm to help improve users' learning ability by building an artificial intelligence system.&#x0D; The user's cognitive ability analysis and cognitive domain content inference algorithm using artificial intelligence is the purpose is to design a cognitive judgment platform and implement a system to apply cognitive evaluation to people with mild cognitive impairment and utilize cognitive rehabilitation content based on cognitive judgment technology system design technology. Through this study, we aim to provide direction for the future field of cognitive rehabilitation combined with artificial intelligence

H - 05 Non-Pharmacological Treatment for Older Adults with Mild Cognitive Impairment: Expanding Diversity into Clinical Practice and Research.

Numerous non-pharmacological treatments (NPT) have been developed for older adults with mild cognitive impairment (MCI) (Bahar-Fuchs, Mowszowski, Lautenschlager, & Cox, 2021). Two forms of NPTs, namely cognitive rehabilitation (CR) and cognitive training (CT) may demonstrate cognitive benefit, but there remain significant methodological challenges in the field (Barban et al., 2016; McPhee, Downey & Stough, 2019; Sherman et al., 2020). One such limitation is the contribution of cultural and demographic factors to study outcome heterogeneity. Our goal was to highlight examples of select culturally informed NPTs and provide recommendations to expand diversity into clinical practice and research. Discussed results and limitations of recent meta-analyses and systematic reviews that focused on NPTs for MCI in older adults. We completed a review of culturally informed NPTs from the past two years. Clinician experiences informed the inclusion of additional diversity variables (e.g., methodological, demographic, social, systemic) that could be integrated into clinical practice and research. There is a paucity of research considering cultural and demographic factors when delivering NPTs. Results of culturally informed CR or CT highlighted themes in the adaptation of language, cognition, function, diet, and physical activity. Additional provider, patient, and systemic factors can be considered to promote diversity, equity, and inclusion (DEI). Culturally informed NPTs are understudied. Practical recommendations for US-based clinicians and researchers are provided that could increase access/recruitment, retention, and outcome in CT and CR for diverse populations.

Psychodynamic-based virtual reality cognitive training system with personalized emotional arousal elements for mild cognitive impairment patients

Background and objectiveMild cognitive impairment (MCI) is a serious threat to the physical health and quality of life of the elderly, as well as a heavy burden on families and society. The current computer-based rehabilitation training ignores the role of emotions in cognitive impairment rehabilitation, making it difficult to improve patient engagement and efficiency. To address this, a psychodynamics-based cognitive rehabilitation training method with personalized emotional arousal elements was proposed using virtual reality technology. MethodsOur proposed method contains four training tasks, which cover (audiovisual memory, attention & processing, working memory, abstract & Logic, spatial pathfinding) and six positive emotional arousal elements (sensory feedback, achievement system, multiplayer interaction, score comparison, relaxation scenarios, and peaceful videos) to motivate participants to persist during cognitive training continuously and maintain a positive mental attitude toward training. The six emotional arousal elements were divided into two personalized combinations—full combination and half combination—based on the results of the pre-assessment and were dynamically distributed throughout both the training tasks and post-training. ResultsFifteen participants with MCI were recruited to complete the proposed experiment and validate the effectiveness of the system. They were first asked to complete two assessments (e.g., the big five scale and the positive and negative affect scale) to investigate their personalities. Based on the results of the assessments, they were provided with a full or half combination of arousal elements in the training tasks and post-training. Finally, the acceptability of the system and task experience were assessed using questionnaires. Notably, there was a significant increase in training scores for participants who completed a six-week training period (66.7%, 33.4%, and 25.0% for attention and processing, working memory, and abstraction and logic, respectively). The results show that positive emotional arousal had a positive effect on the MCI participants. The training tasks and arousal elements can improve cognitive function and enhance the confidence and engagement of participants. There were no significant differences in cognitive domain training scores between the two groups. ConclusionsThis personalized cognitive training system has the potential to serve as a convenient solution for complementary treatment of MCI.

System Development and Evaluation of Human–Computer Interaction Approach for Assessing Functional Impairment for People with Mild Cognitive Impairment: A Pilot Study

Non-pharmacological treatments have gained significant attention in the field of cognitive impairment. Among them, human–computer interaction-based (HCI) methods have emerged as a promising approach due to their broad applicability and convenience in assessing symptoms associated with this progressively debilitating condition. However, existing rehabilitation training systems for cognitive impairment lack effective assessment methods to meet the diverse rehabilitation needs of users. In this article, we surveyed existing HCI-based cognitive rehabilitation training systems and analyzed their advantages and shortcomings. Drawing from the insights gained from these systems, we propose a novel Leap Motion-based building block training system that incorporates system software capable of generating highly realistic virtual scenes, with the added capability of user behavior detection using Kinect. We conducted user testing of this new system, comparing the performance of a representative cohort with mild cognitive impairment (MCI) (n = 9) to that of disease-free participants (n = 10). Additionally, we conducted ergonomic experiments to assess the system’s performance in elderly people. The experimental results revealed significant differences between the MCI cohort and the control cohort. Specifically, the MCI cohort exhibited a reduced range of motion and longer task completion times compared to the control cohort. These findings have the potential to contribute to the differentiation of cognitive levels. In conclusion, our analysis of existing cognitive rehabilitation training systems provides valuable insights for researchers working on the development of future innovative cognitive rehabilitation training systems and enriches the non-pharmacological treatment models for cognitive impairment. Furthermore, the observed relationship between behavioral data, task completion times, and cognitive levels in older adults offers useful insights for the design of HCI-based approaches for diagnosing and assessing the treatment of MCI.

Effect of repetitive transcranial magnetic stimulation combined with transcranial direct current stimulation on post-stroke dysmnesia: A preliminary study

ObjectiveThis study examined the effect of repetitive transcranial magnetic stimulation (rTMS) combined with transcranial direct current stimulation (tDCS) as a bimodal neuromodulatory approach for post-stroke dysmnesia. MethodsThirty-four patients with post-stroke dysmnesia were randomly allocated into a sham group treated with neither rTMS nor tDCS, a group treated with rTMS, and a group treated with a combination of rTMS and tDCS. All three groups received cognitive rehabilitation training for 4 weeks. The memory function of each group before and after the intervention was assessed using the Montreal Cognitive Assessment (MoCA) and Rivermead Behavioral Memory Test (RBMT) scales, as well as in terms of the Mismatch Negativity（MMN）and P300 of event-related potentials. ResultsThe sham, rTMS, and rTMS–tDCS groups all showed improvement in the total MoCA score after the intervention. Delayed recall, a MoCA item, scored better in the rTMS–tDCS group than in the rTMS and sham groups. Delayed processing, an RBMT item, scored better in the rTMS–tDCS combination group than in the rTMS and sham groups. MMN and P300 latency was significantly shorter in the rTMS–tDCS combination group. ConclusionrTMS–tDCS bimodal stimulation was more effective than cognitive rehabilitation or rTMS alone in treating patients with post-stroke dysmnesia, offering new possibilities for enhancing cognitive function and treating post-stroke dysmnesia.

Antioxidant supplements and cognition in Multiple Sclerosis: a systematic review (P14-3.003)

<h3>Objective:</h3> We aimed to conduct a systematic review to examine whether there is an association between antioxidants supplements and cognitive performance in MS patients. <h3>Background:</h3> Cognitive dysfunction is a debilitating characteristic of multiple sclerosis (MS) that affects approximately 60% of patients. To date, the only effective treatments for cognitive decline are cognitive rehabilitation and exercise training. While previous studies reported the beneficial effect of antioxidants on MS patients, several other studies investigated the effect of antioxidant supplements on the cognitive performance of MS patients. <h3>Design/Methods:</h3> We searched PubMed, Embase, Scopus, and Web of Science for the identification of relevant studies in November 2021. We included control trials, cohort, case-control, and cross-sectional studies which showed the effect of any type of antioxidants on cognitive performance in MS patients. <h3>Results:</h3> After screening 12 papers were included in our study. Our review included three studies that examined the effect of ginkgo Biloba on cognitive performance, two examined the Mediterranean diet, and remained studies each investigated the vitamin A, Omega 5, Omega 3, estriol, epigallocatechin-3-gallate (EGCG), Boswellia papyrifera, and paleolithic diet. Overall, it seems that there were no benefits for antioxidant administration on cognitive performance in MS patients. <h3>Conclusions:</h3> It is complicated to draw a conclusion regarding the effect of an antioxidant-containing regimen and cognitive performance in MS patients. Findings from included studies failed to unequivocally support the beneficial effect of antioxidant consumption on cognitive performance in MS patients. <b>Disclosure:</b> Mr. Nabizadeh has nothing to disclose.

Telehealth delivery of group-format cognitive rehabilitation to older veterans with TBI: a mixed-methods pilot study

Traumatic brain injury (TBI) is common among Veterans and may interact with aging, increasing risk for negative cognitive, emotional, and functional outcomes. However, no accessible (i.e., in-home) group interventions for TBI targeted to older adults exist. Goal Oriented Attentional Self-Regulation (GOALS) is a manualized, group cognitive rehabilitation training that improves executive function and emotional regulation among Veterans with TBI and healthy older adults. Our objectives were to adapt GOALS for delivery to older Veterans via in-home video telehealth (IVT) and evaluate feasibility and participant-rated acceptability of the telehealth GOALS intervention (TeleGOALS). Six Veterans 69+, with multiple TBIs completed the 10-session intervention in groups of 2. One participant withdrew, and another completed the remaining sessions alone (total n enrolled = 8). Required adaptations were noted; questionnaire responses were quantified; and feedback was analyzed and coded to identify themes. Quantitative and qualitative methods were used to examine feasibility (i.e., recruitment and retention) and participant-rated acceptability. Minimal adaptations were required for IVT delivery. Key themes emerged: (a) the importance of telehealth logistics, (b) facilitators’ roles in prioritizing interpersonal connection, and (c) telehealth’s capability to create opportunities for community reintegration. Thematic saturation (the point at which feedback from respondents is consistent and no further adaptations are required) was achieved. Participants stated they would likely recommend TeleGOALS to other Veterans. Although further study with a larger, more diverse sample is required, the adapted TeleGOALS intervention appears highly feasible and acceptable for older Veterans with TBI able and willing to participate in a group-format IVT intervention.

Meta-analysis of Acupuncture Combined with Cognitive Rehabilitation Training in the Treatment of Cognitive Impairment after Stroke

Meta-analysis of Acupuncture Combined with Cognitive Rehabilitation Training in the Treatment of Cognitive Impairment after Stroke

Comparison of the efficacy of computer cognitive rehabilitation training methods and concept map training on the attention, focus and comprehension of add students

Comparison of the efficacy of computer cognitive rehabilitation training methods and concept map training on the attention, focus and comprehension of add students

Effects of Home Based Serious Game Training (Brain Talk™) in the Elderly With Mild Cognitive Impairment: Randomized, a Single-Blind, Controlled Trial.

Mild cognitive impairment (MCI) increases with aging society. Serious games may be effective in improving cognitive function in patients with MCI; however, research on their effects remains insufficient. This study aimed to confirm the efficacy and safety of cognitive rehabilitation training using a serious game (Brain Talk™) for the elderly with MCI. Twenty-four elderly individuals with MCI were randomized into study and control groups. The study group received 12 training sessions (30 min/session, 3 times/week), whereas the control group did not receive training. Blinded evaluations were conducted before and after the training and four weeks after the training. The primary outcome measures were the Korean Mini-Mental State Examination (K-MMSE) and K-MoCA (Korean Montreal Cognitive Assessment). Secondary outcome measures were the Semantic Verbal Fluency Task (SVFT), Trail-Making Test-B, and 2-back test. In the study group, the K-MMSE, K-MoCA, and SVFT scores after finishing the training and 4 weeks after training showed a significant increase; however, there was no significant change in the control group. No significant differences were observed between the two groups. Cognitive function significantly improved in the study group after training. Home-based serious games are considered helpful in improving cognitive function.

Antioxidant supplements and cognition in Multiple Sclerosis: a systematic review

Background: Cognitive dysfunction is a debilitating characteristic of multiple sclerosis (MS) that affects approximately 60% of patients. To date, the only effective treatments for cognitive decline are cognitive rehabilitation and exercise training. While previous studies reported the beneficial effect of antioxidants on MS patients, several other studies investigated the effect of antioxidant supplements on the cognitive performance of MS patients. We aimed to conduct a systematic review to examine whether there is an association between antioxidants supplements and cognitive performance in MS patients.Methods: We searched PubMed, Embase, Scopus, and Web of Science for the identification of relevant studies in November 2021. We included control trials, cohort, case-control, and cross-sectional studies which showed the effect of any type of antioxidants on cognitive performance in MS patients.Results: After screening 12 papers were included in our study. Our review included three studies that examined the effect of ginkgo Biloba on cognitive performance, two examined the Mediterranean diet, and remained studies each investigated the vitamin A, Omega 5, Omega 3, estriol, epigallocatechin-3-gallate (EGCG), Boswellia papyrifera, and paleolithic diet. Overall, it seems that there were no benefits of antioxidant administration on cognitive performance in MS patients.