To evaluate the efficacy of group cognitive rehabilitation therapy (CRT) in multiple sclerosis (MS) on improving cognition, fatigue and quality of life, and assess patients’ satisfaction towards this intervention.

Cognitive impairment is highly prevalent in MS and affects functional status and quality of life. CRT could positively impact cognitive function. Various methods of intervention have been used, with a recent meta-analysis suggesting increased benefit from a group environment¹.

We conducted a prospective randomised-controlled study in patients with MS aged between 18 and 55 years and presenting objective cognitive impairment on neuropsychological testing. Patients were randomized to group CRT, provided by a qualified neuropsychologist in 10 sessions over 12 weeks, or no intervention. At screening (week -4) and at week 18, cognition was assessed using the Brief International Cognitive Assessment for MS (BICAMS), Paced Auditory Serial Addition Test (PASAT) and Stroop Test, and the Fatigue score scale (FSS) and 36-Item Short Form Survey (SF-36) questionnaires were self-administered. Patients’ satisfaction was assessed on four aspects at week 18 using Likert scales.

Eleven patients in the intervention group and 7 controls (median age: 43 years, median disease duration: 8.5 years, females 88.9%) completed the study. PASAT score improved by a median of 49% in patients who received CRT, in comparison to 0% in controls (p=0.02). California verbal test also improved significantly in the CRT group compared to the control group (median improvements : first recall: 3.5 SD vs 0 SD, p=0.01; free recall 0.5 SD vs 0 SD, p=0.008; delayed recall 1 SD vs 0 SD, p=0.02). There was no significant change in fatigue or quality of life over time. Overall patients’ satisfaction of the intervention was 8.79/10.

Group CRT lead to significant improvements in episodic and working memory in patients with MS when compared to controls. Patients showed high satisfaction towards the intervention.