Modified Story Memory Technique (mSMT) Might be Affected by Cognitive Dysfunction in Patients with Multiple Sclerosis

A team of Kessler Foundation researchers recently published their findings on the MEMREHAB trial, whereby treatment with the modified Story Memory Technique (mSMT) may be affected by cognitive dysfunction. The study entitled “The influence of cognitive dysfunction on benefit from learning and memory rehabilitation in MS: A sub-analysis of the MEMREHAB trial” is published in the journal Clinical Neurology.

Cognitive and everyday function have been found to be affected by the deficits in processing speed, a deficit that many patients with Multiple Sclerosis experience. “This evidence supports the need to investigate the influence of processing speed in performance on cognitive interventions,” said Nancy Chiaravalloti, PhD, director of Neuroscience & Neuropsychology and Traumatic Brain Injury (TBI) Research at Kessler Foundation, in a recent news release.

The MEMREHAB trial was a double-blind, placebo-controlled, randomized clinical study that enrolled a total of 85 patients with a definite diagnosis of Multiple Sclerosis (MS). Patients were randomly allocated either to a treatment group (n= 45) or to a placebo-control group (n=40). All patients completed at baseline and at follow-up a series of neuropsychological assessment tests. The treatment called mSMT is a 10-session cognitive intervention protocol that has recently been shown to improve new learning and memory skills in individuals with MS.

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Results revealed that patients in the treatment group had an improved California Verbal Learning Test (CVLT) learning slope compared to patients in the placebo group, after co-varying for processing speed performance. Among the participants with deficits in processing speed mSMT was not as beneficial. The results also showed that the performance on SDMT (Symbol Digit Modalities Test) was an indicator of the benefit of mSMT.

Based on the findings, the researchers suggest that processing speed may serve as a marker for generalized cognitive dysfunction  “Processing speed may be an indicator of cognitive decline, which may be a factor in the reduced benefit with mSMT,” explained Dr. Chiaravalloti. “Also, learning and memory impairments can have different mechanisms. In individuals with deficits in processing, impaired learning and memory may stem from difficulties with working memory and attention, as well as slowed processing speed. This could also affect outcomes on the mSMT,” she concluded.

With these new findings, researchers may now be in a better position to develop new therapeutics in the near future that help to mitigate cognitive decline in patients with Multiple Sclerosis, leading to an improvement in quality of life.