ROCHESTER, NY — A new review sought to examine the evidence supporting the use of specific compensatory cognitive strategies in people with multiple sclerosis (PwMS).
University of Rochester, NY, Medical Center-led researchers queried PubMed, MEDLINE, PsycINFO and CINAHL using an optimized string with Medical Subject Headings search terms to identify English language articles published through Dec. 31, 2024. Participating in the study were the VA’s Multiple Sclerosis Center of Excellence West and the Rehabilitation Care Service at the VA Puget Sound Health Care System, both in Seattle.
The results were published in the Archives of Physical Medicine and Rehabilitation.1
Eligible for the study were clinical trials and observations studies (e.g., cohort and case-control studies), and they included adults with PwMS who underwent an intervention with one or more defined cognitive strategies. The studies included had at least one subjective or objective quantifiable cognitive outcome. Screening and eligibility checks were independently done by the first author and then reviewed by the senior author.
The study team extracted demographics, cognitive strategy information and cognitive outcome data, having a second author verify the first authors work. The studies were summarized using established evidence grading criteria, and effect size estimates were calculated for each cognitive domain where a strategy was assessed.
The authors reported that the most frequently used cognitive strategy in the 64 identified studies involving 3,759 patients was visualization/imagery-based mnemonics (34.9%), followed by planning/organization strategies (28.6%), analog memory aids (19.0%), mental rehearsal strategies (15.9%) and mindfulness (15.9%).
“Small-to-medium improvements in objective and subjective learning and memory were observed with several attentional, internal memory and external memory strategies that were used alone and in combination,” the researchers advised. “Attentional and relaxation-based strategies were also associated with significant small effects on processing speed.”
The study team concluded that “several cognitive strategies have been examined in PwMS, with visualization/imagery-based mnemonics having the highest usage and subsequent supporting evidence. These findings can support clinicians when determining which approaches to include in a cognitive rehabilitation program for PwMS.”
- Nicholson R, Turner AP, Gromisch ES. Cognitive Strategy Use for Functional Compensation in Multiple Sclerosis: A Systematic Review. Arch Phys Med Rehabil. 2026 Apr 15:S0003-9993(26)00651-9. doi: 10.1016/j.apmr.2026.04.007. Epub ahead of print. PMID: 41997443.