Home-based personalized cognitive training in MS patients: a study of adherence and cognitive performance.

OBJECTIVES To explore unprompted adherence to a personalized, home-based, computerized cognitive training program in patients with multiple sclerosis (MS), and to examine the impact of training on cognitive performance. METHODS Participants were assigned to a training (n=59) or a control group (n=48). Those in the training group were instructed to train three times a week for 12 weeks. The control group received no training. All participants were evaluated with a Neuropsychological Examination (N-CPC) at baseline and at the end of the study. RESULTS In the training group, 42 (71.2%) participants adhered to the training schedule and 22 (37.3%) completed the entire training regimen. In the control group, 24 (50.0%) participants agreed to be retested on the N-CPC. The training group showed a significant improvement over that shown by the control group in three memory-based cognitive abilities (general memory, visual working memory and verbal working memory). Post-hoc exploration of data from the N-CPC showed that cognitive training was also associated with increased naming speed, speed of information recall, focused attention and visuo-motor vigilance. CONCLUSIONS The appreciable rates of adherence and cognitive improvements observed indicate that personalized cognitive training is a practical and valuable tool to improve cognitive skills and encourage neuronal plasticity in patients with MS.

[1]  D. Goldstein,et al.  Improved delayed visual reproduction test performance in multiple sclerosis patients receiving interferon beta-1b , 1996, Neurology.

[2]  L. Nyberg,et al.  Altered brain activity in healthy seniors: what does it mean? , 2006, Progress in brain research.

[3]  I. Haimov,et al.  Chronic Insomnia and Cognitive Functioning Among Older Adults , 2008, Behavioral sleep medicine.

[4]  J. Grafman,et al.  Neuropsychological effects of interferon beta-1a in relapsing multiple sclerosis. Multiple Sclerosis Collaborative Research Group. , 2000, Annals of neurology.

[5]  N. Larocca,et al.  The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. , 1989, Archives of neurology.

[6]  A. Kramer,et al.  Transfer Effects in Task-Set Cost and Dual-Task Cost After Dual-Task Training in Older and Younger Adults: Further Evidence for Cognitive Plasticity in Attentional Control in Late Adulthood , 2008, Experimental aging research.

[7]  A. Feinstein.  Mood disorders in multiple sclerosis and the effects on cognition , 2006, Journal of the Neurological Sciences.

[8]  U. Baumhackl,et al.  Efficacy of a neuropsychological training programme for patients with multiple sclerosis – a randomised controlled trial , 2005, Wiener klinische Wochenschrift.

[9]  J. Grafman,et al.  Neuropsychological effects of interferon β‐1a in relapsing multiple sclerosis , 2000 .

[10]  A. Verma.  Donepezil Improved Memory in Multiple Sclerosis in a Randomized Clinical Trial , 2006 .

[11]  C. Pozzilli,et al.  Computer-aided retraining of memory and attention in people with multiple sclerosis: a randomized, double-blind controlled trial , 2004, Journal of the Neurological Sciences.

[12]  M. Amato,et al.  Are there protective treatments for cognitive decline in MS? , 2006, Journal of the Neurological Sciences.

[13]  P. Tariot,et al.  A 12-week, open trial of donepezil hydrochloride in patients with multiple sclerosis and associated cognitive impairments. , 2000, Journal of clinical psychopharmacology.

[14]  Wolfgang Brück,et al.  The pathology of multiple sclerosis is the result of focal inflammatory demyelination with axonal damage , 2005, Journal of Neurology.

[15]  J. Kurtzke.  Rating neurologic impairment in multiple sclerosis , 1983, Neurology.

[16]  Jacob Cohen,et al.  Statistical Power Analysis For The Behavioral Sciences Revised Edition , 1987 .

[17]  G. Nagels,et al.  A rapid screening tool for fatigue impact in multiple sclerosis , 2006, BMC neurology.

[18]  Emilio Portaccio,et al.  Multiple sclerosis-related cognitive changes: A review of cross-sectional and longitudinal studies , 2006, Journal of the Neurological Sciences.

[19]  H. Rossman,et al.  Managing the symptoms of multiple sclerosis: a multimodal approach. , 2006, Clinical therapeutics.

[20]  S. Huber,et al.  Computer assisted retraining of attentional impairments in patients with multiple sclerosis , 1998, Journal of neurology, neurosurgery, and psychiatry.

[21]  M. Amato,et al.  Clinical management of cognitive impairment in multiple sclerosis: a review of current evidence. , 2003, International MS journal.

[22]  Jacob Cohen.  Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[23]  S. Channon,et al.  The relationship between subjective fatigue and cognitive fatigue in advanced multiple sclerosis , 2007, Multiple sclerosis.

[24]  S. Rao,et al.  Cognitive dysfunction in multiple sclerosis. , 1991, Neurology.

[25]  H. Hahn,et al.  Cognitive training in MS: effects and relation to brain atrophy. , 2005, Restorative neurology and neuroscience.

[26]  M. Sá,et al.  Cognitive Dysfunction in Multiple Sclerosis , 2012, Front. Neur..

[27]  S. Rao,et al.  fMRI study of episodic memory in relapsing-remitting MS , 2006, Neurology.

[28]  W. Zung.  A SELF-RATING DEPRESSION SCALE. , 1965, Archives of general psychiatry.

[29]  Massimo Filippi,et al.  Functional MRI in Multiple Sclerosis , 2007, Journal of neuroimaging : official journal of the American Society of Neuroimaging.

[30]  J. DeLuca,et al.  Evidenced-based cognitive rehabilitation for persons with multiple sclerosis: a review of the literature. , 2008, Archives of physical medicine and rehabilitation.