Cognitive Impairment in Multiple Sclerosis: A Pilot Study of the Effects of Cognitive Retraining on Quality of Life and Improvement in Cognitive Function

Background: Review of current research reveals mixed findings on the efficacy of cognitive rehabilitation in multiple sclerosis (MS).  Studies suggest that cognitive retraining can improve quality of life and cognitive function in MS, but the applicability of data is limited.  This pilot study will explore the use of cognitive retraining in MS. 

Objectives: To evaluate the improvement in quality of life and cognition after cognitive retraining.  

Methods: Patients with MS will be screened for mild cognitive impairment using a validated short form cognitive test (SFCT).  The SFCT includes the following assessments: Verbal Category Fluency, Boston Naming, Mini-Mental State Examination, Hopkins Verbal Learning, Digit Span (Forward, Backward, and Sequential), Hopkins Verbal Learning Recall, Hopkins Verbal Learning Recognition, Trails A & B, and Beck Depression Inventory.  Up to 40 eligible participants will be randomly assigned to control and treatment groups.  All participants will complete the Perceived Deficits Questionnaire (PDQ).  The PDQ is a component of the Multiple Sclerosis Quality of Life Inventory (MSQLI).  The PDQ was designed specifically for MS to provide a self-report of cognitive impairment.  The PDQ is a 20-item Likert Scale, which addresses several cognitive measures that are affected by MS, including retrospective memory, prospective memory, planning/organization, and attention.  Participants in the treatment group will complete 5 weeks (3 sessions/week) of an online computer-based cognitive retraining program, Brain HQ, accessed from their home.  BrainHQ is supported by over 70 publications in schizophrenia, chemobrain, HIV-associated neurocognitive disorder, traumatic brain injury, stroke, and age-related cognitive decline.  Retraining sessions will focus on memory, attention, and information processing.  Both the control and treatment groups will complete the posttest SFCT and PDQ 5-8 weeks after pretesting.  

Results: This study is ongoing.  The investigators hypothesize an improvement in quality of life and cognitive function will be demonstrated by posttest PDQ and SFCT scores. The short duration of the study may be a limitation for demonstrating an improvement in cognitive function.  

Conclusions: Results of this pilot study should support the need for continued clinical research into cognitive retraining for individuals with MS.  Cognitive retraining may not only improve cognition, but may have positive effects on quality of life.