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MS – Cognitive Rehabilitation Evidence — SCE Neurology MCQ

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ModerateMultiple Sclerosis & CNS InflammationMS – Cognitive Rehabilitation EvidenceSCE Neurology

A 50-year-old man with MS has significant cognitive impairment affecting his work. Formal neuropsychological assessment shows deficits in processing speed, working memory, and executive function, with preserved episodic memory. His neurologist discusses cognitive rehabilitation. What does the evidence show about cognitive rehabilitation in MS?

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Correct answer: D — Cognitive rehabilitation programmes (particularly compensatory strategy training and restorative approaches) can improve specific cognitive domains and functional outcomes in MS

Cognitive rehabilitation in MS has growing evidence supporting its effectiveness, particularly for attention, processing speed, and executive function. Both compensatory strategy training (teaching strategies to work around deficits — e.g., using diaries, breaking tasks into steps) and restorative approaches (computer-based cognitive training) have shown benefits. NICE NG100 recommends offering cognitive assessment and rehabilitation to MS patients with cognitive impairment. A: There is evidence of benefit. C: Benefits extend beyond memory. D: Pharmacological options are limited (amantadine for fatigue). E: Well-designed programmes do not worsen fatigue.

Reference: NICE NG100 MS (2022); Chiaravalloti & DeLuca MS Cognition Review