Targeted cognitive game training enhances cognitive performance in multiple sclerosis patients treated with interferon beta 1-a

Abstract Background Prevention of cognitive decline in Multiple Sclerosis (MS) is of major importance. We explored the effect of a 6 months computerized game training program on cognitive performance in MS patients with mild cognitive impairment. Methods This was a single-center, randomized prospective study. We enrolled in this study 100 eligible MS patients treated with Interferon-beta-1a (Rebif). All had mild cognitive impairment in either executive function or information processing speed. Patients were randomized 1:1 to either use the cognitive games platform by HappyNeuron (HN) or receive no intervention. Executive function and information processing speed scores were measured at 3 and 6 months from baseline to evaluate the effect of game training on cognitive scores. Results In both executive function and information processing speed, the game Training group showed significant improvement after 3 and 6 months. The Non-Training group showed mild deterioration in both domains at 3 months, and further deterioration that became significant at 6 months in executive function. Furthermore, at 6 months, the percent of patients in the Training group that improved or remained stable in both cognitive domains was significantly higher compared to the Non-Training group. Conclusions Our findings suggest that cognitive game training has a beneficial effect on cognitive performance in MS patients suffering from mild cognitive impairment. While further evaluation is required to assess the longevity of that effect, we nonetheless recommend to MS patients to be engaged in cognitive gaming practice as part of a holistic approach to treating their condition.

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Targeted Cognitive Game Training Enhances Cognitive Performance in Multiple Sclerosis Patients Treated With Interferon Beta 1-a

10.21203/rs.3.rs-725383/v1 ◽

2021 ◽

Author(s):

Shay Menascu ◽

Roy Aloni ◽

Mark Dolev ◽

David Magalashvili ◽

Keren Gutman ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cognitive Impairment ◽

Information Processing ◽

Executive Function ◽

Mild Cognitive Impairment ◽

Cognitive Performance ◽

Processing Speed ◽

Interferon Beta ◽

Training Group ◽

Information Processing Speed

Abstract BackgroundPrevention of cognitive decline in Multiple Sclerosis (MS) is of major importance. We explored the effect of short-term computerized game training on cognitive performance in MS patients with mild cognitive impairment.MethodsWe enrolled in this prospective study 100 eligible MS patients treated with Interferon-beta-1a (Rebif). All had mild cognitive impairment in either executive function or information processing speed. Patients were randomized 1:1 to either use the cognitive games platform byHappyNeuron (HN) or receive no intervention. Executive function and information processing speed scores were measured at 3 and 6 months from baseline to evaluate the effect of game training on cognitive scores.ResultsIn both executive function and information processing speed, the game Training group showed significant improvement after 3 and 6 months. The Non-Training group showed mild deterioration in both domains at 3 months, and further deterioration that became significant at 6 months in executive function. Furthermore, at 6 months, the percent of patients in the Training group that improved or remained stable in both cognitive domains was significantly higher compared to the Non-Training group.ConclusionsOur findings suggest that cognitive game training has a beneficial effect on cognitive performance in MS patients suffering from mild cognitive impairment. While further evaluation is required to assess the longevity of that effect, we nonetheless recommend to MS patients to be engaged in cognitive gaming practice as part of a holistic approach to treating their condition.

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A comparison of cognitive performances between neuromyelitis optica spectrum disorder and multiple sclerosis patients in Indian context

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-021-00351-y ◽

2021 ◽

Vol 57 (1) ◽

Author(s):

Swati Kumar ◽

Goutam Gangopadhyay ◽

Atanu Biswas ◽

Souvik Dubey ◽

Alak Pandit ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cognitive Impairment ◽

Information Processing ◽

Executive Function ◽

Neuromyelitis Optica ◽

Processing Speed ◽

Verbal Fluency ◽

Spectrum Disorder ◽

Neuromyelitis Optica Spectrum Disorder ◽

Information Processing Speed

Abstract Background To compare the frequency and pattern of cognitive impairment in neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) patients. Results Twenty NMOSD and forty MS patients were included. Clinical and detailed neuropsychological assessment was done using frontal assessment battery and Kolkata cognitive battery supplemented with additional standard tests for different domains of cognitive functions. Domain wise tests were performed and compared. 15/20 (75%) NMOSD and 32/40 (80%) MS patients had cognitive impairment (p = 0.65). Executive function, verbal fluency, information processing speed, visuo-constructional ability, attention, complex calculation, and memory were more commonly involved in NMOSD in decreasing order. Compared to MS, the pattern was similar except that verbal fluency was more impaired in NMOSD. Expanded Disability Status scale (EDSS) correlated with cognitive involvement in NMOSD (p = 0.02) as against MS. Conclusions Executive function, verbal fluencies, and information processing speed were more affected compared to visual and verbal memory in NMOSD patients. The pattern of cognitive performance was similar in the MS group, even though clinical and radiological characteristics and pathophysiology is different, suggesting similar brain involvement.

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T1 Relaxation Times in the Cortex and Thalamus Are Associated With Working Memory and Information Processing Speed in Patients With Multiple Sclerosis

Frontiers in Neurology ◽

10.3389/fneur.2021.789812 ◽

2021 ◽

Vol 12 ◽

Author(s):

Christian Thaler ◽

Isabelle Hartramph ◽

Jan-Patrick Stellmann ◽

Christoph Heesen ◽

Maxim Bester ◽

...

Keyword(s):

Multiple Sclerosis ◽

Working Memory ◽

Cognitive Impairment ◽

Information Processing ◽

Processing Speed ◽

T1 Mapping ◽

Relaxation Times ◽

Healthy Controls ◽

Information Processing Speed ◽

T1 Relaxation

Background: Cortical and thalamic pathologies have been associated with cognitive impairment in patients with multiple sclerosis (MS).Objective: We aimed to quantify cortical and thalamic damage in patients with MS using a high-resolution T1 mapping technique and to evaluate the association of these changes with clinical and cognitive impairment.Methods: The study group consisted of 49 patients with mainly relapsing-remitting MS and 17 age-matched healthy controls who received 3T MRIs including a T1 mapping sequence (MP2RAGE). Mean T1 relaxation times (T1-RT) in the cortex and thalami were compared between patients with MS and healthy controls. Additionally, correlation analysis was performed to assess the relationship between MRI parameters and clinical and cognitive disability.Results: Patients with MS had significantly decreased normalized brain, gray matter, and white matter volumes, as well as increased T1-RT in the normal-appearing white matter, compared to healthy controls (p < 0.001). Partial correlation analysis with age, sex, and disease duration as covariates revealed correlations for T1-RT in the cortex (r = −0.33, p < 0.05), and thalami (right thalamus: r = −0.37, left thalamus: r = −0.50, both p < 0.05) with working memory and information processing speed, as measured by the Symbol-Digit Modalities Test.Conclusion: T1-RT in the cortex and thalamus correlate with information processing speed in patients with MS.

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Associations of the Lifestyle for Brain Health Index With Structural Brain Changes and Cognition: Results From the Maastricht Study

Neurology ◽

10.1212/wnl.0000000000012572 ◽

2021 ◽

pp. 10.1212/WNL.0000000000012572

Author(s):

Irene S Heger ◽

Kay Deckers ◽

Miranda T Schram ◽

Coen DA Stehouwer ◽

Pieter C Dagnelie ◽

...

Keyword(s):

Cognitive Impairment ◽

Information Processing ◽

Executive Function ◽

White Matter ◽

Processing Speed ◽

Grey Matter ◽

White Matter Hyperintensities ◽

Information Processing Speed ◽

Brain Health ◽

Dementia Risk

Background and Objectives:Observational research has shown that a substantial proportion of all dementia cases worldwide is attributable to modifiable risk factors. Dementia risk scores might be useful to identify high-risk individuals and monitor treatment adherence. The objective of this study was to investigate whether a dementia risk score, the LIfestyle for BRAin health (LIBRA) index, is associated with MRI markers and cognitive functioning/impairment in the general population.Methods:Cross-sectional data was used from the observational population-based cohort of The Maastricht Study.. The weighted compound score of LIBRA (including twelve dementia risk and protective factors, e.g. hypertension, physical inactivity) was calculated, with higher scores indicating higher dementia risk. Standardized volumes of white matter, grey matter, CSF (as proxy for general brain atrophy), white matter hyperintensities, and presence of cerebral small vessel disease were derived from 3T MRI. Cognitive functioning was tested in three domains: memory, information processing speed, and executive function and attention. Values ≤1.5 SD below the average were defined as cognitive impairment. Multiple regression analyses and structural equation modelling were used, adjusted for age, sex, education, intracranial volume and type-2 diabetes.Results:Participants (n=4,164; mean age 59y; 49.7% men) with higher LIBRA scores (mean=1.19, range=-2.7 to +9.2), denoting higher dementia risk, had higher volumes of white matter hyperintensities (β=0.051, p=.002), and lower scores on information processing speed (β=-0.067, p=.001) and executive function and attention (β=-0.065, p=.004). Only in men, associations between LIBRA and volumes of grey matter (β=-0.093, p<.001), CSF (β=0.104, p<.001) and memory (β=-0.054, p=.026) were found. White matter hyperintensities and CSF volume partly mediated the association between LIBRA and cognition.Discussion:Higher health- and lifestyle-based dementia risk is associated with markers of general brain atrophy, cerebrovascular pathology and worse cognition, suggesting that LIBRA meaningfully summarizes individual lifestyle-related brain health. Improving LIBRA factors on an individual level might improve population brain health. Sex differences in lifestyle-related pathology and cognition need to be further explored.Classification of Evidence:This study provides Class II evidence that higher LIBRA scores are significantly associated with lower scores on some cognitive domains and a higher risk of cognitive impairment.

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Patients with paediatric-onset multiple sclerosis are at higher risk of cognitive impairment in adulthood: An Italian collaborative study

Multiple Sclerosis Journal ◽

10.1177/1352458517717341 ◽

2017 ◽

Vol 24 (9) ◽

pp. 1234-1242 ◽

Cited By ~ 19

Author(s):

Luis Ruano ◽

Mariana Branco ◽

Emilio Portaccio ◽

Benedetta Goretti ◽

Claudia Niccolai ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cognitive Impairment ◽

Information Processing ◽

Processing Speed ◽

Collaborative Study ◽

Cognitive Disability ◽

Information Processing Speed ◽

Neuropsychological Profile ◽

Increased Risk ◽

History Of

Background: Patients with paediatric-onset multiple sclerosis (POMS) could be at an increased risk for cognitive impairment (CI), given the potential harmful effects of disease activity in neurodevelopment. However, there is scarce information on their long-term cognitive outcomes. Objective: To compare the prevalence and profile of CI between adults with a history of POMS and those with classic, adult-onset multiple sclerosis (AOMS). Methods: Cognitive performance was assessed through the Brief Repeatable Battery (BRB) and the Stroop Test in consecutive patients referred to six Italian MS centres. CI was defined as impairment in ⩾2 cognitive domains. Results: In all, 119 patients with POMS and 712 with AOMS were included in this analysis. The prevalence of CI was 48.0% in AOMS, 44.5% in POMS; with similar neuropsychological profile between the two groups. However, when adjusting for current age, we found a significantly increased risk for CI (odds ratio (OR) = 1.71; p = 0.02) and for impairment in information processing speed (OR = 1.86; p < 0.01) in patients with POMS. A higher Expanded Disability Status Scale (EDSS) was also identified in POMS ( p = 0.03) compared with AOMS patients. Conclusion: Patients with a history of POMS appear to be at higher risk of physical and cognitive disability than AOMS patients, after correcting for age effects, with particular involvement of information processing speed.

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Grey matter damage and overall cognitive impairment in primary progressive multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458511410341 ◽

2011 ◽

Vol 17 (11) ◽

pp. 1324-1332 ◽

Cited By ~ 15

Author(s):

C Tur ◽

S Penny ◽

Z Khaleeli ◽

DR Altmann ◽

L Cipolotti ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cognitive Impairment ◽

Information Processing ◽

Executive Function ◽

Cognitive Performance ◽

Verbal Memory ◽

Visual Information ◽

Grey Matter ◽

Progressive Multiple Sclerosis ◽

Primary Progressive Multiple Sclerosis

Objectives: To identify associations between cognitive impairment and imaging measures in a cross-sectional study of patients with primary progressive multiple sclerosis (PPMS). Methods: Neuropsychological tests were administered to 27 patients with PPMS and 31 controls. Patients underwent brain conventional magnetic resonance imaging (MRI) sequences, volumetric scans and magnetization transfer (MT) imaging; MT ratio (MTR) parameters, grey matter (GM) and normal-appearing white matter (NAWM) volumes, and WM T2 lesion load (T2LL) were obtained. In patients, multiple linear regression models identified the imaging measure associated with the abnormal cognitive tests independently from the other imaging variables. Partial correlation coefficients (PCC) were reported. Results: Patients performed worse on tests of attention/speed of visual information processing, delayed verbal memory, and executive function, and had a worse overall cognitive performance index, when compared with controls. In patients, a lower GM peak location MTR was associated with worse overall cognitive performance ( p < 0.001, PCC = 0.77). GM mean and peak height MTR showed the strongest association with the estimated verbal intelligence quotient (IQ) decline ( p < 0.001, PCC = -0.62), and executive function ( p < 0.001, PCC = 0.79). NAWM volume was associated with attention/speed of visual information processing ( p < 0.001, PCC = 0.74), while T2LL was associated with delayed verbal memory ( p = 0.007, PCC = -0.55). Conclusions: The finding of strong associations between GM MTR, NAWM volume and T2LL and specific cognitive impairments suggests that models that predict cognitive impairment in PPMS should include comprehensive MRI assessments of both GM and WM. However, GM MTR appears to be the main correlate of overall cognitive dysfunction, underlining the role of abnormal GM integrity in determining cognitive impairment in PPMS.

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Measuring Information Processing Speed in Mild Cognitive Impairment: Clinical Versus Research Dichotomy

Journal of Alzheimer s Disease ◽

10.3233/jad-150791 ◽

2016 ◽

Vol 51 (1) ◽

pp. 263-275 ◽

Cited By ~ 20

Author(s):

Judy Haworth ◽

Michelle Phillips ◽

Margaret Newson ◽

Peter J. Rogers ◽

Anna Torrens-Burton ◽

...

Keyword(s):

Cognitive Impairment ◽

Information Processing ◽

Mild Cognitive Impairment ◽

Processing Speed ◽

Information Processing Speed

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Can we define a rehabilitation strategy for cognitive impairment in progressive multiple sclerosis? A critical appraisal

Multiple Sclerosis Journal ◽

10.1177/1352458516632066 ◽

2016 ◽

Vol 22 (5) ◽

pp. 581-589 ◽

Cited By ~ 11

Author(s):

Emanuele D’Amico ◽

Carmela Leone ◽

Tumani Hayrettin ◽

Francesco Patti

Keyword(s):

Multiple Sclerosis ◽

Cognitive Impairment ◽

Information Processing ◽

Processing Speed ◽

Cognitive Rehabilitation ◽

Critical Appraisal ◽

Progressive Multiple Sclerosis ◽

Information Processing Speed ◽

Specific Approach ◽

Rehabilitation Strategy

Cognitive impairment (CI) has been shown to be severe in patients with progressive forms of multiple sclerosis (MS), and the most frequently impaired domains are sustained attention, information processing speed, memory, and executive functions. In contrast to relapsing forms of MS, where studies have shown favorable results from cognitive rehabilitation, there is a lack of data on cognitive rehabilitation in progressive forms of MS. A specific approach in assessing CI and in designing and administering rehabilitation training for patients with progressive forms of MS is needed.

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Validity of a Novel Touch Screen Tablet-Based Assessment for Mild Cognitive Impairment and Probable AD in Older Adults

Assessment ◽

10.1177/1073191117748395 ◽

2017 ◽

Vol 26 (8) ◽

pp. 1540-1553 ◽

Cited By ~ 2

Author(s):

Yo-Ping Huang ◽

Avichandra Singh ◽

Sheng Chen ◽

Fang-Ju Sun ◽

Chiu-Ron Huang ◽

...

Keyword(s):

Older Adults ◽

Motor Control ◽

Cognitive Impairment ◽

Information Processing ◽

Mild Cognitive Impairment ◽

Processing Speed ◽

Touch Screen ◽

Cognitive Test ◽

Information Processing Speed ◽

Visuospatial Perception

This study aimed to develop a psychometrically valid touch screen tablet-based cognitive test battery to identify early cognitive impairment due to dementia in older adults. The battery includes eight tests with 13 subscores, evaluating visual attention, auditory attention, information processing speed, visual memory, motor control, and visuospatial perception. Among the participants, 43 had been diagnosed with mild cognitive impairment (MCI) and 36 with probable Alzheimer’s disease (AD); 41 had no cognitive impairment. The average time to administer the tablet-based tests was 10 minutes. Significant correlations with the Mini-Mental State Examination were found in 9 out of 13 subscores. Patients with probable AD scored significantly lower than controls in 8 out of 13 subscores, whereas those with MCI scored significantly lower in 4 out of 13 subscores. Confirmatory factor analysis using Promax rotation showed that four factors caused lower subscores in the MCI group compared with the controls: information processing speed, memory, visuospatial perception, and motor control. All four factors significantly discriminated the controls from the MCI and probable AD groups, and in the expected direction. The touch screen tablet-based cognitive test battery is psychometrically valid for evaluating cognition in older adults.

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