Multiple sclerosis and related disorders · 2025
A meta-analysis of the effect of computerized cognitive training on cognitive function in patients with Multiple Sclerosis.
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Pei Hu, Shunshan Song, Can Liu, Haiying Xiao
Аннотация
OBJECTIVE: To systematically evaluate whether computer-based cognitive training can effectively improve cognitive function in patients with multiple sclerosis (MS), whether the improvement is influenced by the duration of the disease, and whether the type, duration, frequency, and other factors of the training exhibit a dose-response effect on cognitive improvement.
METHODS: Randomized controlled trials on the effects of computer-based cognitive training on cognitive function in patients with multiple sclerosis were included. Literature was searched in PubMed, Web of Science, EMbase, The Cochrane Library, CNKI, China Biomedical Literature Database, Wanfang Database, and VIP Database, covering publications from the inception of the databases until July 2025. Two researchers independently conducted literature screening. The PEDro scale was used for assessing literature quality, while Stata 17.0 software was employed for meta-analysis and publication bias testing, and the GRADE profiler was utilized to evaluate the quality of evidence. Standardized mean differences and 95% confidence intervals were used as effect statistics.
RESULTS: A total of 19 studies (725 participants) were included, with 376 in the experimental group and 349 in the control group, primarily from Europe, the United States, and the Middle East; the majority had a disease duration of over 5 years. The average PEDro scale score was 8.0. The quality of evidence was rated as moderate for attention and executive function, and high for information processing speed and memory. The meta-analysis results indicated that computer-based cognitive training had a positive effect on information processing speed (SMD=0.49, 95% CI=0.32, 0.66, P<0.001) and memory (SMD=0.56, 95% CI=0.15, 0.96, P<0.001) in patients with multiple sclerosis, but not on attention (SMD=0.33, 95% CI=-0.04, 0.69, P=0.08) or executive function (SMD=0.28, 95% CI=-0.13, 0.69, P=0.18). Subgroup analysis showed that the RehaCom software, applied 1-3 times per week for 46-60 minutes each session, was most effective in improving information processing speed in MS patients with a disease duration of less than 10 years (corresponding combined effect sizes were SMD=0.702, SMD=0.588, SMD=0.724, SMD=0.858, P<0.001); The task programs that were conducted for at least 8 weeks, 3-4 times per week for 46-60 minutes each session, showed the best improvement in memory for MS patients with a disease duration of 10 years or more (corresponding combined effect sizes were SMD=0.719, SMD=0.702, SMD=1.310, SMD=0.873, SMD=0.291, P<0.05).
CONCLUSION: Computer-based cognitive training has a positive effect on information processing speed and memory in MS patients, but does not improve attention or executive function. The RehaCom software, applied 1-3 times per week for 46-60 minutes, is most effective in improving information processing speed in MS patients with a disease duration of less than 10 years; Task programs conducted for at least 8 weeks, 3-4 times per week for 46-60 minutes each session, are most effective in improving memory in MS patients with a disease duration of 10 years or more.
METHODS: Randomized controlled trials on the effects of computer-based cognitive training on cognitive function in patients with multiple sclerosis were included. Literature was searched in PubMed, Web of Science, EMbase, The Cochrane Library, CNKI, China Biomedical Literature Database, Wanfang Database, and VIP Database, covering publications from the inception of the databases until July 2025. Two researchers independently conducted literature screening. The PEDro scale was used for assessing literature quality, while Stata 17.0 software was employed for meta-analysis and publication bias testing, and the GRADE profiler was utilized to evaluate the quality of evidence. Standardized mean differences and 95% confidence intervals were used as effect statistics.
RESULTS: A total of 19 studies (725 participants) were included, with 376 in the experimental group and 349 in the control group, primarily from Europe, the United States, and the Middle East; the majority had a disease duration of over 5 years. The average PEDro scale score was 8.0. The quality of evidence was rated as moderate for attention and executive function, and high for information processing speed and memory. The meta-analysis results indicated that computer-based cognitive training had a positive effect on information processing speed (SMD=0.49, 95% CI=0.32, 0.66, P<0.001) and memory (SMD=0.56, 95% CI=0.15, 0.96, P<0.001) in patients with multiple sclerosis, but not on attention (SMD=0.33, 95% CI=-0.04, 0.69, P=0.08) or executive function (SMD=0.28, 95% CI=-0.13, 0.69, P=0.18). Subgroup analysis showed that the RehaCom software, applied 1-3 times per week for 46-60 minutes each session, was most effective in improving information processing speed in MS patients with a disease duration of less than 10 years (corresponding combined effect sizes were SMD=0.702, SMD=0.588, SMD=0.724, SMD=0.858, P<0.001); The task programs that were conducted for at least 8 weeks, 3-4 times per week for 46-60 minutes each session, showed the best improvement in memory for MS patients with a disease duration of 10 years or more (corresponding combined effect sizes were SMD=0.719, SMD=0.702, SMD=1.310, SMD=0.873, SMD=0.291, P<0.05).
CONCLUSION: Computer-based cognitive training has a positive effect on information processing speed and memory in MS patients, but does not improve attention or executive function. The RehaCom software, applied 1-3 times per week for 46-60 minutes, is most effective in improving information processing speed in MS patients with a disease duration of less than 10 years; Task programs conducted for at least 8 weeks, 3-4 times per week for 46-60 minutes each session, are most effective in improving memory in MS patients with a disease duration of 10 years or more.