How Multiple Sclerosis Limits the Ability to Perform Tasks

Autobiographical memory and episodic future thinking reduced in MS patients.

Autobiographical memory and episodic future thinking reduced in MS patients.

The quality of life for many patients with relapsing-remitting multiple sclerosis (RR-MS) is lessened by deficits in 2 neuropsychological functions, including autobiographical memory (AM) and episodic future thinking (EFT). This affects a patient’s ability to perform present and future tasks.

AM involved a patient’s ability to remember personal detailed events within a specific location and timeframe. EFT enables people to imagine future personal detailed events as they might happen. Having impaired AM or EFT affects daily life for many patients with RR-MS, the most common form of the disease.

“Several functions have been attributed to AM, such as its role in the construction of sense of self temporally extended, the development of new social relationships and the nurturing of existing ones, and a directive function where the past serves as a basis to guide present and future behaviors,” said Liliann Manning, PhD, Cognitive Neuropsychology and Physiopathology of Schizophrenia, University of Strasbourg. “Taken together, AM constitutes a central process in any individual’s life.”

EFT contributes to coping skills, goal achievement, implementation of intentions and to a sense of personal continuity over time.

The MVI program to improve patients’ AM/EFT is based on the ability to mentally construct scenes and pay close attention to details in the mind’s eye. The program required that participating patients attend 6 two-hour sessions, once or twice per week depending on the patient’s availability.

The program consisted of 4 steps with increasing difficulty of mental visualization exercises. During the exercises, neuropsychologists provided continuous guidance to the patient in which they asked the patient to recall general aspects to more detailed specifics, adopting a “funnel-approach,” and learning to work in a sequential manner.

There were 40 participants in the study, all of whom were diagnosed with RR-MS and all of whom were receiving regular drug therapy and were being evaluated for disease progression through clinical examination. Participants were also scanned with an MRI to make sure there were no brain abnormalities and that significant signs of atrophy were present.

After these tests were completed, AM and EFT were assessed using an adapted version of the Autobiographical Interview. Patient commentaries about the MVI program collected during this investigation noted a more general feeling of self-confidence in life, with higher levels of control and vitality.

“In summary, the major finding of this study is that AM and EFT impairment could be efficiently improved by means of a facilitation program and that the use of an MVI strategy seemed easily integrated and resulted in significant benefits in their daily life functioning,” Dr. Manning said. “More generally, we hope that this study and its positive outcomes could encourage future investigations in different clinical settings.”