Contributions
Abstract: EP1687
Type: Poster Sessions
Abstract Category: Therapy - Symptomatic treatment
Background: Cognitive impairment is common in persons with MS (PwMS), with estimates ranging from 40-65%. It is frequently cited as the reason for work disability and lower quality of life. Improving cognitive functioning in PwMS represents an important therapeutic target. Recent work has shown promise for cognitive rehabilitation to improve attention/working memory, defined as the ability to maintain and process/manipulate information in the mind. As attention/working memory deficits are common in MS, training this cognitive domain may improve cognition and thus lead to improved function in PwMS.
Objective: To determine whether cognitive training with Cogmed Working Memory Training (CWMT) improves attention/working memory in PwMS.
Methods: PwMS, either relapsing or progressive, aged 18-64, who demonstrated impaired attention/working memory on 2 of 3 measures (Paced Auditory Serial Addition Test (PASAT), Symbol Digit Modality Test (SDMT), and/or Stroop Colour Word Test (Stroop)) were randomized to CWMT training for 5 weeks (5 days per week, 30-60 minutes daily) or to a no treatment group. These 3 measures served as the co-primary outcomes. Upon recruitment, other measures of mood, cognition and quality of life served as secondary outcomes. Participants were not blinded to group assignment but all assessors were blinded. Participants received follow up assessments 6 weeks and 6 months post-intervention (the no treatment group received the same assessments at equivalent time frames). Analysis of covariance was performed to compare treatment and control groups at pre and post-intervention on primary outcomes.
Results: At the time of this submission, 22 participants had completed baseline and 6-week post intervention assessments; 12 were assigned to CWMT. There was no difference between the two groups on age (CWMT (51.0) vs. no treatment (53.1) years, p=0.32), gender (CWMT (8) vs no treatment (7) females, p=0.29) or type of MS (CWMT (6) vs. no treatment (8) relapsing, p=0.53). After 6 weeks, the CWMT group showed significant improvement on the PASAT compared to the no treatment group: 28.6 ± 4.6 and 30.0 ± 3.2 at baseline, compared to 35.9 ± 3.8 and 30.8 ± 3.2 at 6 weeks, in the CWMT and no treatment groups respectively (p< 0.001). There was no significant improvement noted on the SDMT or Stroop.
Conclusion: This pilot study demonstrates that cognitive training with CWMT has the potential to improve attention/working memory in PwMS.
Disclosure: Dr. Orenczuk, Dr. Blair, Ms. Marshall, Ms. Rosehart and Ms Bowman have no disclosures.
In the past 3 years, Dr. Morrow has served on advisory boards for Biogen Idec, EMD Serono, Genzyme Canada, Novartis and Roche. She has received Investigator Initiated Grant Funds from Genzyme Canada and acted as site PI for multi-center trials funded by Novartis, Genzyme, Roche.
Abstract: EP1687
Type: Poster Sessions
Abstract Category: Therapy - Symptomatic treatment
Background: Cognitive impairment is common in persons with MS (PwMS), with estimates ranging from 40-65%. It is frequently cited as the reason for work disability and lower quality of life. Improving cognitive functioning in PwMS represents an important therapeutic target. Recent work has shown promise for cognitive rehabilitation to improve attention/working memory, defined as the ability to maintain and process/manipulate information in the mind. As attention/working memory deficits are common in MS, training this cognitive domain may improve cognition and thus lead to improved function in PwMS.
Objective: To determine whether cognitive training with Cogmed Working Memory Training (CWMT) improves attention/working memory in PwMS.
Methods: PwMS, either relapsing or progressive, aged 18-64, who demonstrated impaired attention/working memory on 2 of 3 measures (Paced Auditory Serial Addition Test (PASAT), Symbol Digit Modality Test (SDMT), and/or Stroop Colour Word Test (Stroop)) were randomized to CWMT training for 5 weeks (5 days per week, 30-60 minutes daily) or to a no treatment group. These 3 measures served as the co-primary outcomes. Upon recruitment, other measures of mood, cognition and quality of life served as secondary outcomes. Participants were not blinded to group assignment but all assessors were blinded. Participants received follow up assessments 6 weeks and 6 months post-intervention (the no treatment group received the same assessments at equivalent time frames). Analysis of covariance was performed to compare treatment and control groups at pre and post-intervention on primary outcomes.
Results: At the time of this submission, 22 participants had completed baseline and 6-week post intervention assessments; 12 were assigned to CWMT. There was no difference between the two groups on age (CWMT (51.0) vs. no treatment (53.1) years, p=0.32), gender (CWMT (8) vs no treatment (7) females, p=0.29) or type of MS (CWMT (6) vs. no treatment (8) relapsing, p=0.53). After 6 weeks, the CWMT group showed significant improvement on the PASAT compared to the no treatment group: 28.6 ± 4.6 and 30.0 ± 3.2 at baseline, compared to 35.9 ± 3.8 and 30.8 ± 3.2 at 6 weeks, in the CWMT and no treatment groups respectively (p< 0.001). There was no significant improvement noted on the SDMT or Stroop.
Conclusion: This pilot study demonstrates that cognitive training with CWMT has the potential to improve attention/working memory in PwMS.
Disclosure: Dr. Orenczuk, Dr. Blair, Ms. Marshall, Ms. Rosehart and Ms Bowman have no disclosures.
In the past 3 years, Dr. Morrow has served on advisory boards for Biogen Idec, EMD Serono, Genzyme Canada, Novartis and Roche. She has received Investigator Initiated Grant Funds from Genzyme Canada and acted as site PI for multi-center trials funded by Novartis, Genzyme, Roche.