Cognitive rehabilitation in a number of sclerosis


By: Soraya Vázquez Caro, psychologist at ADEMBI (Multiple Sclerosis Euskadi)

Our association has been offering the neuropsychological service since February 2006 because it is needed for people with multiple sclerosis, as the proportion of cognitive impairments is estimated to be over 60%.

They usually get a neuropsychological evaluation at the beginning, usually repeated every few years, as a follow-up exam or in case of obvious deterioration, or they request a report for a procedure e.g. B. an incapacity for work. The NeuronUP program is widely used in both paper and digital activities in neuropsychological sessions. Some of them also take cards with them that they can do at home.

NeuronUP also gives us the advantage that before the start of each session we can see which exercises you have performed in previous sessions, when you last performed a particular exercise, in order to be able to select a particular function to work on. Compare results in the same activity, give them feedback.

We also use it on a very large touch screen computer that allows them to operate it without having to operate the mouse, given motor and fine motor skills, grip, tremors, etc. Likewise, it makes work easier for everyone, who do have visual impairments; which are many due to the size of the screen and because the instructions and others are also provided on audio level; not just in writing.

Our experience with NeuronUP

To begin

The development of this tool in our association was used almost at the beginning of the creation and dissemination when I believe that only Aita Menni acquired it. It would be around September 2012. In fact, in one of the photos on the platform’s website, a user appears next to me who then used it and continues to do so today.

At that time, we met several times to see how the platform works, what suggestions we had in terms of improvements, adjustments, the needs we saw when we started applying it to our users, and the multiple sclerosis collective in the different Associations of the Spanish Territory. For example, we met in Madrid in March 2014 and in Barcelona in July of the same year.

Study with NeuronUP

From late 2014 to mid-2015, NeuronUP was used to conduct a study entitled “Observational Study to Examine the Effectiveness of a Computerized Cognitive Rehabilitation Program in Multiple Sclerosis, Either Personally or Remotely”. The results were presented at various conferences; at the Spanish Society of Neurology (SEN) in November 2016 and at RIMS in May 2017

Two study groups: face-to-face and distance therapy

In this study, the rehabilitation measure was carried out with the NeuronUP platform. There were two groups; one of them in person and the other at a distance; Telerehabilitation. Both groups were comparable in terms of the functions to be worked on, the exercises to be performed, the duration of the sessions, the frequency of these and the months of treatment. In addition to the follow-up, the feedback provided, the previous and subsequent evaluations, the first meetings to explain the project and the processing of the application, as well as the relevant resolution of any doubts or possible difficulties that have arisen.

Regarding the follow-up and feedback of all subjects participating in the study, the neuropsychologist contacted them by phone to give them feedback and motivation and to dispel possible doubts, even though they had not asked for help themselves. And about every 10 days they also got an email.

The meetings lasted 30 minutes each with a weekly frequency and 3 months; Therefore, they added up to a total of 12 sessions. There was 46 patients;; 24 in their personal group and 22 from their homes. And the neuropsychologist led the program individually.

Cognitive functions are processed

The functions that had to be worked on were: orientation, attention (processing speed, sustained, selective, alternating and hemineglective attention), language (comprehension, repetition, expression, naming, vocabulary, fluency, discrimination, reading and writing), memory ( semantic, episodic) and procedural), viso-constructive practices, gnosis (visual and body schema), visospatial skills (spatial relationship, spatial visualization), executive functions (working memory, cognitive flexibility, planning, reasoning, decision-making) as well as instrumental activities of daily life.

It has also been suggested to work on compensation functions, that is, not only those affected, but also some that are better preserved.

In order to be able to extract variables of effectiveness and make a comparison, the time the subject was connected and whether or not he or she conducted the session could be taken from the application. In the results themselves, we had the following parameters: the phases completed, the number of screens created, in passed and failed, the average time per screen and user feedback; their evaluation of the execution in order to check whether it corresponds to the objective performance, and thus to be able to check whether an anosognosia is present; and they are unaware of their limits, and even if you do, try to make them aware of them by showing them the actual results and their subjective assessment.

Aims of the study

The aim of the study was to evaluate the feasibility of this program, both personally and remotely, as well as its effectiveness.

A patient satisfaction questionnaire and a job satisfaction questionnaire were administered retrospectively.

Results of the study

The results showed that there were no statistically significant differences and that they rated the activities as very good and that the level of difficulty was adjusted according to their cognitive impairments.

Study conclusions

And as for the conclusions, we can say that NeuronUP offers support to a greater number of users, that both groups have found its use comfortable, and that they find the main benefits in terms of coordination, focus, motivation or stimulation and memory.

The association also uses other technologies for cognitive rehabilitation, such as virtual reality glasses.

Therefore we can show our satisfaction with the tool. In addition, we also use it in our residence where the physical and cognitive impairments of people are stronger.

By: Soraya Vázquez Caro, psychologist at ADEMBI (Multiple Sclerosis Euskadi)

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Treatment of multiple sclerosis with NeuronUP

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Treatment of multiple sclerosis with NeuronUP


The ADEMBI psychologist Soraya Vázquez Caro reports on her experiences with NeuronUP in the treatment of multiple sclerosis.


Soraya Vazquez Caro

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