CogniFit - Home-based personalized cognitive training in MS patients: a study of adherence and cognitive performance

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Home-based personalized cognitive training in MS patients: a study of adherence and cognitive performance

CogniFit trainings are a reliable tool for stimulating the state of various cognitive abilities in people with Multiple Sclerosis

This page is for information only. We do not sell any products that treat conditions. CogniFit's products to treat conditions are currently in validation process. If you are interested please visit CogniFit Research Platform

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Original Name:Home-based personalized cognitive training in MS patients: a study of adherence and cognitive performance.

Authors: Evelyn Shatil1, Avishag Metzer2, Omer Horvitz3, Ariel Miller2.

  • 1. Department of Psychology and the Center for Psychobiological Research, Max Stern Academic College of Emek Yezreel, and CogniFit Ltd, Yoqneam Ilit, Israel.
  • 2. Neuroimmunology Unit, Multiple Sclerosis & Brain Research Center, Carmel Medical Center, Haifa, Israel.
  • 3. Brain and Behaviour Research Center, Institute for the Study of Affective Neuroscience (ISAN), Department of Psychology, The University of Haifa, Israel.

Journal: NeuroRehabilitation 26 (2010), 143-153.

Reference (APA Style):

  • Shatil, E., Metzer, A., Horvitz, O., & Miller, A. (2010). Home-based personalized cognitive training in MS patients: a study of adherence and cognitive performance. NeuroRehabilitation, 26, pp.145-153.

Study Conclusion

CogniFit training is a practical and valuable tool to improve MS patients' cognitive abilities. Divided attention [P=0.011], eye-hand coordination [P<0.0001], general memory [P<0.0001], naming [P=0.029], reaction time [P=0.001], spatial perception [P<0. 0001], time estimation [P=0.014], visual working memory [P<0.0001], visual perception [P=0.006], visual scanning [P=0.029], and verbal-auditory working memory [P=0.001].

Context

Multiple sclerosis (MS) is a chronic inflammatory disease that not only leads to long-term physical disability but also to a series of cognitive symptoms. The incidence of cognitive disorders in people with multiple sclerosis is between 43 and 65%, with episodic memory, attention, and processing speed being the most affected. Executive functions such as verbal fluency, concept formation, abstract reasoning, planning, and monitoring are also often affected. Incorrect functioning of cognitive skills can lead to a worse quality of life.

Currently, there are no effective drugs to reduce the cognitive symptoms in patients with multiple sclerosis, so it is necessary to use other means to reduce the impact of these cognitive changes. Cognitive rehabilitation has been shown to be an important component when treating cognitive disorders in multiple sclerosis, and in spite of this, there is not much research. More specifically, computerized cognitive stimulation has proven to be effective in improving the cognitive state of people with multiple sclerosis.

Methodology

Study Design

The study consisted of 12 weeks of training with CogniFit, with a pre-training assessment and another assessment at the end of the 12 weeks. Participants were divided between the experimental and control groups. Users without an internet connection were placed in the control group. The aim of the study was to find out the adherence to training and its effects on the cognitive state of people with multiple sclerosis.

The study was conducted at the Multiple Sclerosis & Brain Research Centre, Carmel Medical Centre, Haifa. The protocol was approved by the ethics committee and written consent was obtained from the participants before beginning the pre-assessment.

Participants

The participants were selected from the outpatients of Carmel Medical Centre. These participants had a diagnosis of relapsing-remitting progressive MS. They had good performance of the dominant hand, spoke Hebrew, had a computer at home and were interested in participating in the study.

The criteria for exclusion were the presence of any other neurological disease, drug or alcohol use, as well as the presence of depression or any other disorder requiring the use of psychoactive drugs. Patients with primary progressive Multiple Sclerosis were also excluded.

Analysis

Mixed effects models for repeated measures and general linear models in the SAS statistical program were used to evaluate, the differences between the two groups in the cognitive state before starting the study; the training effect in each of the groups; and finally, the cognitive changes between the two groups after the intervention.

In addition, a different approach was tested, using the statistical program SPSS. They used t-tests for independent samples and paired t-tests to obtain the differences in cognitive scores between both groups at baseline, and within each group before and after training, respectively. Finally, an ANCOVA was performed to assess the differences in cognitive scores after CogniFit training.

The results in both procedures were similar. However, the results explained below are based on the second procedure (performed with SPSS).

Results and Conclusions

Both groups shared clinical and socio-demographic characteristics. The cognitive status of the participants showed significant improvements in seven cognitive abilities of the control group: divided attention, sustained attention (avoiding distractions), naming, response time, cognitive flexibility, spatial perception and time estimation. On the other hand, in the group that performed the CogniFit training, significant improvements were seen in eleven cognitive abilities: divided attention [P=0.011], eye-hand coordination [P<0.0001], general memory (which includes different cognitive abilities related to memory) [P<0. 0001], naming [P=0.029], reaction time [P=0.001], spatial perception [P<0.0001], time estimation [P=0.014], visual working memory [P<0.0001], visual perception [P=0.006], visual scanning [P=0.029], and verbal-auditory working memory [P=0.001]. It is important to highlight that the improvements achieved in the group that performed the CogniFit training were significantly higher than those of the control group in the following cognitive abilities: general memory, visual working memory, and verbal working memory.

In conclusion, it was observed that CogniFit training helped to significantly improve the cognitive state of adults with relapsing-remitting progressive MS. These improvements were especially noticeable regarding memory. CogniFit's personalized cognitive training is shown to be a practical and valuable tool for improving the cognitive abilities of Multiple Sclerosis patients.

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