Contributions
Abstract: P519
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - Neuropsychology
Background: A recent European survey impressively showed that 71% of patients with multiple sclerosis (MS) report cognitive deficits which have tremendous effects on working ability (Kobelt et al., 2017). Due to a lack of effective pharmacological therapies for patients suffering from cognitive impairment, non-pharmacological treatment approaches are warranted.
Objectives: To evaluate the effectiveness of physical exercise and cognitive training as single and combined treatment options on subjectively perceived cognitive deficits and objective information processing speed as primary outcomes.
Methods: Included patients received one of the following interventions for 3 months: physical exercise training twice a week for 45 min. each (treadmill walking), computer-based training twice a week for 45 min. each (using the software BrainStim) or a combination of both. Before and after the training period a comprehensive neuropsychological assessment was administered. To determine self-reported deficits, the perceived cognitive deficits questionnaire (PDQ-20) was applied including the following cognitive subscales: attention and concentration; retrospective memory; prospective memory; planning and organization. To measure information processing speed the symbol digit modalities test (SDMT) was used. The Wilcoxon signed-rank test was applied to evaluate treatment effects.
Results: In total, 44 MS patients (39 relapsing-remitting MS and 5 secondary-progressive MS, 33 female; mean age 43.70, SD = 10.35; mean EDSS 2.44) were included so far. First analyses indicate a significant improvement in both primary outcomes over all three training groups: PDQ-20: z= -3.093, p= .002; SDMT: z= 1.961, p= .05. Cohen's d supports these findings by strong effect sizes for both measures: PDQ-20 (d= -1.63) and SDMT (d= 0.87), with no differences between the different training groups. The analysis of the PDQ subscales showed significant improvement on the following cognitive domains: attention and concentration (z = -2.890, p= .004); retrospective memory (z= -2.589, p= .010); prospective memory (z= -2.894, p= .004). Planning and organization showed no significant improvement (z= -.969, p= .333).
Conclusions: Physical exercise and cognitive training improve patients' self-perceived cognitive deficits and the ability to quickly process information (objective measure). Thus, physical exercise and computer-based cognitive training can be recommended to treat cognitive problems in MS patients.
Disclosure: Melanie Filser has nothing to disclose.
Jonas Graf has nothing to disclose.
Sharon Jean Baetge has nothing to disclose.
Marcia Gasis has nothing to disclose.
Nobert Goebels has received honoraria for speaking/consultation and travel grants from Almirall, Biogen Idec, Merck Serono, Novartis and research grants from Roche, Novartis, Sanofi Genzyme and Teva.
Alina Renner has nothing to disclose.
Nathalie Stute has nothing to disclose.
Hans-Peter Hartung has received fees for consulting, speaking and serving on steering committees from Bayer Healthcare, Biogen, GeNeuro, MedImmune, Merck, Novartis, Opexa, Receptos Celgene, Roche, Sanofi Genzyme and Teva, with approval by the Rector of Heinrich-Heine-University.
Philipp Albrecht has received honoraria for speaking at scientific meetings, serving at scientific advisory boards and consulting activities from Allergan, Bayer Pharma, Biogen, Genzyme, Ipsen, Merck Serono, Roche, Merz Pharma, Novartis and Teva. He has received research support from Allergan, Biogen, Ipsen, Merz Pharma, Novartis, and Teva.
Orhan Aktas has received honoraria for speaking/consultation and travel grants from Almirall, Bayer Healthcare, Biogen Idec, Chugai, Merck Serono, Novartis, Roche, Sanofi Genzyme, and Teva and research grants from Bayer Healthcare, Biogen Idec, Novartis, and Teva.
Iris-Katharina Penner has received honoraria for speaking at scientific meetings, serving at scientific advisory boards and consulting activities from Adamas Pharma, Almirall, Bayer Pharma, Biogen, Desitin, Genzyme, Merck Serono, Roche, Novartis and Teva. She has received research support from Merck Serono, Novartis, the German MS Society and Teva.
Funding:This study is supported by a research grant of TEVA GmbH.
Abstract: P519
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - Neuropsychology
Background: A recent European survey impressively showed that 71% of patients with multiple sclerosis (MS) report cognitive deficits which have tremendous effects on working ability (Kobelt et al., 2017). Due to a lack of effective pharmacological therapies for patients suffering from cognitive impairment, non-pharmacological treatment approaches are warranted.
Objectives: To evaluate the effectiveness of physical exercise and cognitive training as single and combined treatment options on subjectively perceived cognitive deficits and objective information processing speed as primary outcomes.
Methods: Included patients received one of the following interventions for 3 months: physical exercise training twice a week for 45 min. each (treadmill walking), computer-based training twice a week for 45 min. each (using the software BrainStim) or a combination of both. Before and after the training period a comprehensive neuropsychological assessment was administered. To determine self-reported deficits, the perceived cognitive deficits questionnaire (PDQ-20) was applied including the following cognitive subscales: attention and concentration; retrospective memory; prospective memory; planning and organization. To measure information processing speed the symbol digit modalities test (SDMT) was used. The Wilcoxon signed-rank test was applied to evaluate treatment effects.
Results: In total, 44 MS patients (39 relapsing-remitting MS and 5 secondary-progressive MS, 33 female; mean age 43.70, SD = 10.35; mean EDSS 2.44) were included so far. First analyses indicate a significant improvement in both primary outcomes over all three training groups: PDQ-20: z= -3.093, p= .002; SDMT: z= 1.961, p= .05. Cohen's d supports these findings by strong effect sizes for both measures: PDQ-20 (d= -1.63) and SDMT (d= 0.87), with no differences between the different training groups. The analysis of the PDQ subscales showed significant improvement on the following cognitive domains: attention and concentration (z = -2.890, p= .004); retrospective memory (z= -2.589, p= .010); prospective memory (z= -2.894, p= .004). Planning and organization showed no significant improvement (z= -.969, p= .333).
Conclusions: Physical exercise and cognitive training improve patients' self-perceived cognitive deficits and the ability to quickly process information (objective measure). Thus, physical exercise and computer-based cognitive training can be recommended to treat cognitive problems in MS patients.
Disclosure: Melanie Filser has nothing to disclose.
Jonas Graf has nothing to disclose.
Sharon Jean Baetge has nothing to disclose.
Marcia Gasis has nothing to disclose.
Nobert Goebels has received honoraria for speaking/consultation and travel grants from Almirall, Biogen Idec, Merck Serono, Novartis and research grants from Roche, Novartis, Sanofi Genzyme and Teva.
Alina Renner has nothing to disclose.
Nathalie Stute has nothing to disclose.
Hans-Peter Hartung has received fees for consulting, speaking and serving on steering committees from Bayer Healthcare, Biogen, GeNeuro, MedImmune, Merck, Novartis, Opexa, Receptos Celgene, Roche, Sanofi Genzyme and Teva, with approval by the Rector of Heinrich-Heine-University.
Philipp Albrecht has received honoraria for speaking at scientific meetings, serving at scientific advisory boards and consulting activities from Allergan, Bayer Pharma, Biogen, Genzyme, Ipsen, Merck Serono, Roche, Merz Pharma, Novartis and Teva. He has received research support from Allergan, Biogen, Ipsen, Merz Pharma, Novartis, and Teva.
Orhan Aktas has received honoraria for speaking/consultation and travel grants from Almirall, Bayer Healthcare, Biogen Idec, Chugai, Merck Serono, Novartis, Roche, Sanofi Genzyme, and Teva and research grants from Bayer Healthcare, Biogen Idec, Novartis, and Teva.
Iris-Katharina Penner has received honoraria for speaking at scientific meetings, serving at scientific advisory boards and consulting activities from Adamas Pharma, Almirall, Bayer Pharma, Biogen, Desitin, Genzyme, Merck Serono, Roche, Novartis and Teva. She has received research support from Merck Serono, Novartis, the German MS Society and Teva.
Funding:This study is supported by a research grant of TEVA GmbH.