An RCT to treat learning impairment in multiple sclerosis: The MEMREHAB trial

Abstract

Objective: To examine the efficacy of the modified Story Memory Technique (mSMT), a 10-session behavioral intervention teaching context and imagery to facilitate learning, to improve learning and memory abilities in persons with multiple sclerosis (MS). Methods: This double-blind, placebo-controlled, randomized clinical trial included 86 participants with clinically definite MS, 41 in the treatment group and 45 in the placebo control group. Participants completed a baseline neuropsychological assessment, including questionnaires assessing everyday memory, a repeat assessment immediately posttreatment, and a long-term follow-up assessment 6 months after treatment. After completion of the treatment phase, persons in the treatment group were assigned to a booster session or a non-booster session group to examine the efficacy of monthly booster sessions in facilitating the treatment effect over time. Results: The treatment group showed a significantly improved learning slope relative to the placebo group posttreatment. Similar results were noted on objectivemeasures of everydaymemory, general contentment, and family report of apathy and executive dysfunction. Long-term follow-up data showed that posttreatment improvement in the treatment group continued to be noted on the list learning and self-report measures. The provision of booster sessions demonstrated little benefit. Conclusion: The mSMT is effective for improving learning and memory in MS. Classification of evidence: This study provides Class I evidence that the mSMT behavioral intervention improves both objective memory and everyday memory in patients with MS over 5 weeks, with treatment effects lasting over a 6-month period. © 2013 American Academy of Neurology.