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Study Finds That Cognitive Function in People with MS Improves with an Online Active Cognitive Training Program

May 22, 2017

SUMMARY
  • In a trial funded by the National MS Society, researchers found that a special online active cognitive training program improved cognitive function in people with MS.
  • Participants included 135 people with any type of MS who were experiencing some cognitive problems. They used the training program for 60 hours over 12 weeks, in their own homes.
  • This was the largest, controlled trial that has tested a brain training program in people with MS. Future studies will help make clear what types of training will have the best results, who will respond most successfully, and how long benefits last.  
  • The team (Leigh Charvet, PhD, Lauren Krupp, MD, and colleagues, now at NYU School of Medicine) published their findings in the open-access journal PLOS One on May 11, 2017. 
DETAILS
Background: Cognitive problems are common in people with MS. Among the cognitive functions that may be affected are the ability to learn and remember information, to process information quickly, and to organize, plan, and problem-solve.
 
Up to now there has not been an adequate treatment that successfully meets the goal of improving the speed and accuracy of information processing to improve performance in real-world situations. However, recent computer/online-based training approaches to help people with cognitive difficulties -- known as adaptive cognitive remediation (ACR) programs -- use cutting-edge technology. Much of the training can be done online, making it easier for many people to participate. ACR programs have already shown benefit in normal aging and other disorders. The program used for this study is a version of the online “Brain HQ Exercise” program, specifically designed for research studies.
 
The Study: Participants were 135 people with any type of MS whose cognitive testing indicated some difficulty. They were randomly assigned to either the ACR program (74 people) or to a training program of ordinary computer games (61 people). The participants in the ACR program used a set of 15 exercises targeting speed, attention, working memory, and executive function. The 61 in the control group used a gaming suite with word puzzles and other games. Participants used these programs for 60 hours over 12 weeks, in their own homes. The researchers checked in with the participants regularly, and their computers were monitored to determine their compliance with the training. The primary outcome measured was a battery of neuropsychological tests used to measure cognitive impairment in people with MS.
 
Researchers found that the people in the active brain training group had significantly greater improvement in cognitive function, even though those in the control group spent more time on the computer games program than the active training group. Compliance and participation was high across both groups.  
 
The team, Leigh Charvet, PhD, Lauren Krupp, MD, and colleagues now at NYU School of Medicine, published their findings in the open-access journal PLOS One on May 11, 2017. (The study was conducted when the team was at Stony Brook University Hospital, Stony Brook, NY.)
 
Comment: This was a well-designed study and the largest clinical trial ever done of a brain training program in MS. The results suggest that this kind of online training program, accessed from home, can improve brain functioning in people who have MS. Home training has many potential benefits: high compliance, relatively low cost, and easily personalized programs. “The remote approach is especially exciting for the potential of opening up participation… for individuals who are largely home-based or who are struggling to maintain employment and reluctant to participate in rehabilitative activities that would interfere with their work and family time commitments,” say the researchers.
 
Future studies will help make clear what types of “brain training” will have the best results, who will respond most successfully, and how long the benefits last. The effects of depression and fatigue -- common in MS and known to influence brain functioning -- also need to be taken into account.
 
Learn more about cognitive changes in MS and how to address them

About Multiple Sclerosis

Multiple sclerosis is an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body. Symptoms range from numbness and tingling to blindness and paralysis. The progress, severity and specific symptoms of MS in any one person cannot yet be predicted, but advances in research and treatment are leading to better understanding and moving us closer to a world free of MS. Most people with MS are diagnosed between the ages of 20 and 50, with at least two to three times more women than men being diagnosed with the disease. MS affects more than 2.3 million people worldwide.

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