M. Prosiegel et C. Michael, NEUROPSYCHOLOGY AND MULTIPLE-SCLEROSIS - DIAGNOSTIC AND REHABILITATIVE APPROACHES, Journal of the neurological sciences, 115, 1993, pp. 190000051-190000054
The frequency of cognitive deficits in multiple sclerosis (MS) patient
s is rather high and the estimates vary between 43% and 72% depending
on the patient samples studied as well as on the methods of cognitive
assessment. Despite the great impact of cognitive dysfunction on sever
al aspects of the quality of life, the importance of accurate assessme
nt and rehabilitation of neuropsychological deficits in MS patients ha
s long been ignored. In this article, we first describe tests for the
assessment of impairments, disabilities and handicaps. We emphasize th
at after screening with brief assessment instruments, detailed testing
of the basic target deficits is mandatory for the planning of special
cognitive training programs. Second, the correlation of certain cogni
tive deficit patterns with important magnetic resonance imaging (MRI)
variables such as total lesion area, size of the corpus callosum and s
pecific lesion location is outlined in detail. Third, some recommendat
ions are made with regard to general rehabilitation principles such as
restitution, compensation and adaptation as well as for special rehab
ilitation techniques including cognitive retraining of basic deficits
and/or training of activities of daily living. Finally, we emphasize t
hat there is a need for the development of tailor-made neuropsychologi
cal rehabilitation techniques for MS patients, which take into account
the course and stage of the disease as well as the specific psychosoc
ial problems of the individual patient.