Adaptive Training Improves Cognitive Function in Multiple Sclerosis
Adaptive programs allow for real-time adjustment to a user’s level of performance.
VANCOUVER, British Columbia – Adaptive, computer-based cognitive remediation may improve cognitive function in patients with multiple sclerosis (MS), data indicate.
The study, which compared the cognitive benefits of an adaptive program vs typical computer-based games, was presented at the 2016 annual meeting of the American Academy of Neurology (ANN), in Vancouver.
Compared to ordinary computer games, adaptive cognitive training programs allow for remediation that adjusts in real time to the user's level of performance, promoting constant effort and engagement. In order to assess and compare the benefits of adaptive vs ordinary training programs, Leigh Charvet, PhD, of NYU Langone Medical Center, and colleagues conducted a randomized, double-blind, placebo-controlled trial in patients with MS.
Participants (mean age, 50 years; median Expanded Disability Status Scale [EDSS] score, 3.5; mean Symbol Digit Modalities Test z-score, -2.1) were assigned to either the adaptive training program group (n=71) or the active placebo group (n=64). Both groups underwent a comprehensive battery of neuropsychological tests at baseline and at study end to establish the composite z-score. Using a study-provided laptop computer, participants were instructed to play their assigned game for 1 hour per day, 5 days per week over 12 weeks, for a target of 60 hours of play. Assistance included technical support and weekly coaching.
At the conclusion of the study, researchers found that the placebo group (53.2 ± 31.0 hours) logged longer play-time than the adaptive group (42.0 ± 30.4 hours); however, change in the composite z-score indicated a significantly greater improvement in cognitive functioning in the adaptive group compared to the placebo group (0.20 ± 0.36 vs 0.05 ± 0.31, P=.02).
Noting that there was a marked response observed in some participants, the authors concluded that adaptive computer-based remediation may lead to improved cognitive function in patients with MS.
Charvet L, Yang J, Shaw M, et al. An adaptive computer-based cognitive training program improves cognitive functioning in adults with multiple sclerosis (MS): results of a double-blind randomized active-placebo-controlled 12-week trial. Presented at: 68th Annual Meeting of the American Academy of Neurology. April 15-21, 2016; Vancouver, British Columbia, Canada. Poster P2.170.