Benefits of Cognitive Rehabilitation to Improve Learning and Memory in People with MS

Researchers at the Kessler Foundation in New Jersey report results of a clinical trial showing that a specific type of memory training improves learning in people with MS for at least 6 months after the training has ended, and also benefits other aspects of quality of life. This controlled trial, funded by the National Institutes of Health, provides important results that should help promote the benefits of cognitive rehabilitation and improve its coverage by insurers. Nancy Chiaravalloti, PhD, John DeLuca, PhD, and colleagues recently reported their results early online in the journal Neurology.

Background: More than half of people with MS experience cognitive changes, particularly problems with learning and memory. These problems can affect a person’s quality of life by interfering with work, social interactions, and other situations. Because of different methods used to study cognitive rehabilitation, there has been controversy as to whether interventions are effective in improving memory problems in people with MS. Dr. Chiaravalloti and colleagues conducted a clinical trial of people with MS to see if a specific type of behavioral training can improve memory.

The study: The researchers performed a double-blind, randomized controlled trial in which participants and therapists were unaware of the assignment to a particular group. They enrolled 86 people with various subtypes of MS. Forty-five participants were assigned to a “treatment” group, and 41 were assigned to a “placebo” group.

The treatment group met with a therapist and underwent a type of behavioral training, called Story Memory Technique, which involves the use of imagery and context-based memory training. The placebo group also interacted with a therapist but engaged in tasks that did not specifically target learning. Each group completed 10 training sessions (twice a week) over 5 weeks. Memory tests and questionnaires to assess anxiety, depression, and other parameters were completed by trial participants before, immediately following completion of training, and 6 months after completion. In a second part of the study, participants in the treatment group received additional once-monthly “booster” sessions involving applying the Story Memory Technique to real-life situations, while the placebo group had monthly sessions that did not involve this training technique.

Results revealed that more participants in the treatment group than the placebo group showed improved learning and memory, improved general contentment, improved planning and organizing ability, and reduced apathy. These effects of the behavioral training were sustained for at least 6 months. The “booster” training appeared to provide no additional benefit.

Comment: This controlled trial provides important new evidence that cognitive rehabilitation can improve learning and memory in people with MS, and should help promote the benefits of cognitive rehabilitation and improve its coverage by insurers. The results are also consistent with previous studies suggesting that cognitive rehabilitation improves not only the targeted function, but extends to improvement in other parameters such as fatigue, depression, and overall quality of life. Further studies will enhance our understanding of who will benefit most, and the best types and length of training needed to optimize success.

What Is The Story Method?


Use to remember a set of words or sequence of activities.


Develop a story that includes the items to remember, in sequence (if sequence is important).

Make the story vivid and easy to remember, with silly things happening and with strong sensory content.


I want to remember the following list of words:


I make up a story as follows: I see a man with very tall hat, I call him and he runs away, but then bumps into a large, fat bird, sitting on the village green. My grandfather appears out of thin air and grabs him for me.


We understand much of the world around us through stories and use them to communicate not just what happens but how we think. Stories are thus ideal mechanisms for remembering otherwise disjoint things.

The 6 Safety Precautions for Safe Travels

As we launch our new website and Blog, it seems appropriate to reprint these Driving Reminders for the Holiday Season.  We recently had a senior driver who arrived at the evaluation with only 15 pounds of air in each tire.  He had been driving on the freeway.  A blowout might have caused a fatality to him and or his wife who was the passenger in the vehicle.  The other problem we encounter a lot is driving with people who are distracted by their own conversation.  Agree to not talk while driving, especially those people with TBI and or Aging Cognitive Decline.  Drive Safely this season!

CONSUMER ADVISORY: NHTSA Reminds Motorists Traveling this Holiday Season to Drive Sober, Buckle Up, Avoid Distraction and Attend to Vehicle Maintenance before Taking to the Roads 

NHTSA 41-13
Friday, December 20, 2013
Contact: Kathryn Henry, 202-366-9550,

WASHINGTON – Now that winter weather has arrived across most of the nation, the National Highway Traffic Safety Administration (NHTSA) reminds holiday travelers to take a few safety precautions for safe travels for the remainder of 2013 and throughout the New Year. In particular, NHTSA urges motorists to ensure that all vehicles are in optimal driving condition and properly equipped, especially in inclement weather.

  • Ensure your vehicle is road-worthy – No one wants their car to break down in any season, but especially not in cold or snowy winter weather. Start the season off right by ensuring your vehicle is in optimal condition. Motorists can cruise NHTSA’s interactive safety landscape to reveal tips and friendly reminders on winter driving measures to get to their destination safely.
  • Don’t drink and drive – Last year, in the month of December alone, 830 people lost their lives due to drunk driving. Be responsible and don’t drink and drive. If you plan to drink, choose a designated driver before going out.
  • Protect child passengers – If you’re traveling with children, remember the best way to protect them in the car is to put them in the right child safety seat, and use it the right way. All children 13 and younger should ride in the back seat.
  • Don’t drive distracted – Put your phone away when driving. Distracted driving can be anything that pulls your attention away from driving, including cell phone use, texting while driving, eating, drinking, and using in-vehicle technologies and portable electronic devices. According to NHTSA data from 2012, 10 percent of fatal crashes and 18 percent of injury crashes were distraction-related.
  • Avoid the “No Zone” – There are areas around large trucks and buses where you can’t be seen. Crashes are more likely to occur in these No Zones. It is critical that all motorists share the road safely with large trucks and buses by giving them plenty of space to maneuver. Avoid lingering in blind spots, following too closely or making sudden or erratic lane changes.
  • Buckle seat belts – All drivers and passengers should wear seat belts every time when traveling in a vehicle. Wearing a seat belt is one of the best defenses to prevent injury and death in a crash – and it remains your best defense against a drunk driver.