RESUMEN
Objective: To investigate the feasibility and experiences of paediatric-onset multiple sclerosis (MS) patients completing a working memory training programme. Methods: Nine paediatric-onset MS patients (mean age 19.3 ± 4.1 years) identified as having attention and/or working memory difficulties underwent a five-week (five days/week) internet-based working memory training programme (Cogmed™); weekly coaching was provided. Measures of adherence and tolerance were used to establish the feasibility of implementing computerised cognitive training. Qualitative experiences reported by the patients were analysed and factors that may modulate the effects of training were explored. Results: Six of the nine enrolled patients completed the programme within the recommended time, and all individuals, with the exception of one, were considered to tolerate the training well. Eight of the nine participants acknowledged that training was helpful in one or more ways. All but one participant reported improvements in working memory, although evidence for improvement on objective neuropsychological testing was limited. Lower normalised brain volume emerged as a potentially important variable in predicting extent of improvement on the training programme. Conclusion: Selected paediatric-onset MS patients can tolerate and complete an intensive cognitive rehabilitation programme. Future investigation of moderators of training effects and the stability of the findings over time is needed.
Asunto(s)
Aprendizaje , Memoria a Corto Plazo , Esclerosis Múltiple Recurrente-Remitente/psicología , Esclerosis Múltiple Recurrente-Remitente/rehabilitación , Adolescente , Disfunción Cognitiva/etiología , Disfunción Cognitiva/rehabilitación , Estudios de Factibilidad , Femenino , Humanos , Internet , Masculino , Trastornos de la Memoria/etiología , Trastornos de la Memoria/rehabilitación , Esclerosis Múltiple Recurrente-Remitente/complicaciones , Pruebas Neuropsicológicas , Cooperación del Paciente , Investigación Cualitativa , Resultado del Tratamiento , Adulto JovenRESUMEN
We describe cognitive and behavioral outcomes in 12 males and 7 females diagnosed with acute disseminated encephalomyelitis (ADEM) in childhood. Age at assessment ranged from 6 to 23 years and all participants were at least 2 years post-ADEM presentation (mean 5.4 years). Performance was compared with 18 control subjects. Three of 19 ADEM patients met criteria for cognitive impairment, defined as performance falling ≤1.5 SD on at least three tests. Age at ADEM-onset was not associated with outcome. Despite the transient nature of the illness and absence of persistent physical disability, cognitive sequelae occur in some individuals following childhood ADEM.
