In a small, controlled study, learning and memory improved in people with MS with a technique that uses stories and imagery to cement learning. For the first time, this improvement was shown to be accompanied by biological changes in the brain indicating increased activation of areas related to memory and learning. Nancy D. Chiaravalloti, PhD, John DeLuca, PhD (Kessler Foundation Research Center) and colleagues report their findings in The Journal of Neurology (Published online, January 12, 2012). Victoria Leavitt, PhD – a postdoctoral fellow funded through the National MS Society’s Mentor-Based Postdoctoral Fellowship program – presented preliminary findings from this study at ECTRIMS 2011 and earned an award for the team’s poster presentation. The study was also funded by the National MS Society, the National Institutes of Health and the Kessler Foundation.
Background: Cognitive changes are common in people with MS. Certain functions are more likely to be affected than others, such as memory (acquiring, retaining, and retrieving new information). Researchers are investigating ways to restore function in people with MS who experience cognitive problems, including cognitive rehabilitation techniques.
Kessler Foundation designed a fellowship program to train post-doctoral fellows to conduct such research in neuropsychology, cognitive rehabilitation and cognitive/translational neuroscience. This program is funded through the National MS Society Mentor-Based Postdoctoral Fellowship in Rehabilitation Research, which aims to recruit and train talented clinician-scientists in rehabilitation research specific to MS.
The Study: The team recruited 16 people with MS, and administered neuropsychological assessments and functional magnetic resonance imaging (fMRI). fMRI allows researchers to take active images of the brain while the person is performing memory tasks that require them to learn a list of words or a short story. Participants were then randomly assigned to undergo 10 treatment or placebo sessions, twice a week for five weeks. In the treatment sessions, participants were trained using the modified Story Memory Technique (mSMT), which helps people to learn new information and remember older information using imagery and context. The technique is applied to real-life situations, such as remembering a shopping list or a list of errands. A control group met for 10 sessions as well, working on the same tasks, but by reading and answering questions. Neuropsychological and fMRI assessments were repeated after the sessions were completed.
The results show that the treatment group improved by more than 10% over the control group in the ability to recall information. For the first time, the team was also able to show that fMRI scans revealed increased activation in all participants in the treatment group in areas of the brain related to learning and memory. The fMRI scans did not change after the sessions in the control group.
Comment: This innovative study identifies regions of the brain associated with improvements in learning and memory, and suggests that further research might help to develop therapeutic strategies that increase activation of these regions – and thus increase learning and memory. The authors note that such strategies might use mSMT in combination with pharmacological treatment for maximized effect.
“These findings are a great example of why we need to increase rehabilitation research,” says Nicholas LaRocca, Vice President of Health Care Deliver and Policy Research for the Society. “We need to show that rehabilitation interventions can restore function in people with MS – conclusively – to health care providers and payers. Our fellowship program is helping us to reach this goal.”
The National MS Society’s Strategic Response to MS emphasizes a focus on rehabilitation research aimed at restoring function and improving quality of life. Read more about this research.