ABSTRACT Cognitive impairment affects more than half of persons with multiple sclerosis (PwMS), and it is associated with difficulties in multiple aspects of daily functioning. There is a growing body of literature that has explored the use of cognitive-focused interventions in PwMS, which aim to improve cognition-related function through drill and practice exercises, training in compensatory strategies, or a combination of the two. The current study aimed to expand upon previously published meta-analyses in this area, exploring the effects of cognitive-focused interventions on objective and subjective functioning in PwMS, as well as determining demographic and treatment-related factors that may influence intervention efficacy. Thirty-three studies, with a total of 1890 participants, were included in the meta-analysis. Outcome measures were categorised based on the domain they presumably assessed. For objective cognitive functioning, weighted effect-size analysis revealed small effects of cognitive-focused interventions on working memory (g = 0.31) and visual learning (g = 0.32). Small mean effect sizes were also noted on self-reported anxiety (g = −0.30) and depression (g = −0.23). Cognitive-focused interventions did not produce changes in subjective cognitive functioning. Moderating variables and clinical applications are also discussed.

中文翻译：

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以认知为重点的干预措施对多发性硬化症患者认知和心理健康的影响：荟萃分析

摘要 认知障碍影响超过一半的多发性硬化症 (PwMS) 患者，并且与日常功能的多个方面的困难有关。越来越多的文献探讨了在 PwMS 中使用以认知为重点的干预措施，旨在通过演习和实践练习、补偿策略培训或两者的结合来改善与认知相关的功能。目前的研究旨在扩展该领域先前发表的荟萃分析，探索以认知为重点的干预措施对 PwMS 客观和主观功能的影响，以及确定可能影响干预效果的人口统计学和治疗相关因素。共有 1890 名参与者的 33 项研究被纳入荟萃分析。结果测量根据他们可能评估的领域进行分类。对于客观认知功能，加权效应大小分析显示以认知为重点的干预对工作记忆 (g = 0.31) 和视觉学习 (g = 0.32) 的影响很小。在自我报告的焦虑 (g = -0.30) 和抑郁 (g = -0.23) 中也注意到小的平均效应量。以认知为重点的干预措施不会改变主观认知功能。还讨论了调节变量和临床应用。30）和抑郁症（g = -0.23）。以认知为重点的干预措施不会改变主观认知功能。还讨论了调节变量和临床应用。30）和抑郁症（g = -0.23）。以认知为重点的干预措施不会改变主观认知功能。还讨论了调节变量和临床应用。