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Home-based, computer-assisted cognitive rehabilitation for attention in pediatric onset multiple sclerosis: a randomized, multicenter pilot study

  • Camilla Masciulli,
  • E. Portaccio,
  • B. Goretti,
  • C. Niccolai,
  • M. Simone,
  • R. G. Viterbo,
  • M. Zaffaroni,
  • L. Pippolo,
  • E. Cocco,
  • G. Fenu,
  • E. Carta,
  • M. Falautano,
  • C. Celico,
  • M. Pardini,
  • G. L. Mancardi,
  • R. Guerrini,
  • F. Melani,
  • F. Giovannelli,
  • M. Rocca,
  • P. Iaffaldano,
  • A. Tacchino,
  • P. Zaratin,
  • M. Filippi,
  • M. P. Amato

摘要

Objective

Cognitive impairment affects approximately 30% of pediatric onset Multiple Sclerosis (POMS) patients with a negative impact on everyday life. The aim of this study was to evaluate the feasibility and effectiveness of a home-based, computer-assisted training of attention in patients with POMS.

Methods

This was a randomized double-blind study. Subjects were randomized to specific training (ST) or non-specific training (n-ST), delivered through a customized module based on attention exercises (COGNI-TRAcK2). The main feature of the ST is the implementation of working load algorithms and procedures for intensiveness regulation. The effectiveness of the ST on attention was primarily assessed on the Symbol Digit Modalities Test (SDMT), using the Wilcoxon signed-rank test. Secondary objectives included effectiveness on other cognitive tests. The evaluations were performed at baseline, end of training and 3-month follow-up.

Results

22 relapsing-remitting patients were included: data of 8 subjects in n-ST and 5 subjects in ST were available. As for the primary outcome, SDMT score improved in the ST group (from 31.2 at baseline to 42.4 after 3 months, p = 0.043). There was no benefit in other neuropsychological measures.

Conclusions

These preliminary findings point to a potential benefit of a home-based, computer-assisted training of attention in patients with POMS.