Abstract
Objective Cognitive impairment is a common symptom of multiple sclerosis (MS), yet treatment is currently limited. The primary goal of this pilot study was to assess the feasibility and acceptability of an at-home, five-week computerized speed of processing (SOP) training intervention for MS patients. In addition, we examined the utility of the intervention to improve speed of information processing, memory, executive function, and health-related quality of life (HRQOL). Method Fifteen subjects were assigned five weeks of SOP training, two times per week, for a total of ten sessions. Subjects were trained on five computerized SOP tasks that required processing of increasingly complex visual stimuli in successively shorter presentation times. Subjects were given a neuropsychological test battery that included measures of speed of information processing, verbal memory, visual spatial memory, and executive function. Subjects were also administered patient-reported outcome (PRO) measures to assess HRQOL, depression, and work productivity. Neuropsychological and PRO batteries were completed at baseline and after five weeks. Results Eighty percent of subjects completed the five-week intervention (n = 12). Significant improvements were observed on some, but not all, measures of speed of information processing, verbal memory, and executive function. There were no significant changes in HRQOL. Conclusion This pilot study supports the feasibility of an at-home SOP training intervention for individuals with MS. SOP training was associated with improvements in several cognitive domains. Larger, randomized controlled trials are warranted.
Highlights
Cognitive impairment is a key feature of multiple sclerosis (MS), affecting between 40 and 65% of patients at some point in the course of the disease [1, 2]
We examined the utility of the speed of processing (SOP) training intervention to improve speed of information processing, memory, executive function, self-reported functional activities, emotional function, and health-related quality of life (HRQOL)
Of the 15 subjects who enrolled, 12 completed the intervention
Summary
Cognitive impairment is a key feature of multiple sclerosis (MS), affecting between 40 and 65% of patients at some point in the course of the disease [1, 2]. Cognitive dysfunction can occur early in the disease process [4, 5] and decline may be seen over periods ranging from one to 10 years [6, 7]. Cognitive impairment is associated with significant patient morbidity, impacting employment [8, 9], social functioning [10], treatment adherence [11], and health-related quality of life (HRQOL) [12, 13]. The treatment of cognitive dysfunction in patients with MS has proved to be challenging. No effective symptomatic treatments have been identified [17,18,19,20]
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