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Evaluation et prise en charge des troubles neuropsychologiques dans la sclérose en plaques

Abstract : The main objectives of this work were to assess the accurate nature of cognitive impairment in Multiple Sclerosis (MS); to assess impact of these impairments on patient?s disability, and to propose a cognitive rehabilitation program. About cognitive assessment, a retrospective was conducted in verbal episodic memory (VEM), with 426 patients. In this study, results show that 65.9% of patients have a low impairment in VEM, 37.2% a moderate impairment, and 13.6% a severe disturbance. The accurate nature of these deficits in VEM would be located in retrieval capacities in early stage of MS, and could be located in encoding and in storage when disability increases. Another study has compared cognitive impairment in patients with relapsing remitting Multiple Sclerosis (RR), Secondary Progressive MS (SP) and Primary Progressive MS (PP), and to assess the impact of disease duration in RR, with 128 patients. Results suggested an increase of cognitive impairments was reported in the course of MS, with distinct cognitive profiles. Impact of these cognitive disturbances on disability was assessed in a study. And the results show that these cognitive disturbances are under estimated by neurologists and must be considered into the evaluation of the disability. About cognitive rehabilitation, three studies were conducted to evaluate a French cognitive program (ProCogSEP). Improvements were observed, for patients before this cognitive intervention, mainly in verbal and visual memory, and self-generation abilities
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Hélène Brissart. Evaluation et prise en charge des troubles neuropsychologiques dans la sclérose en plaques. Psychologie. Université de Lorraine, 2012. Français. ⟨NNT : 2012LORR0375⟩. ⟨tel-01749675⟩



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