Online brain training games improved cognition in small MS trial

PhD student used BrainHQ program in thesis work on computerized training

Marisa Wexler, MS avatar

by Marisa Wexler, MS |

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The use of a computer-based program called BrainHQ led to significantly improved scores on cognitive tests among people with multiple sclerosis (MS), according to data from a small clinical trial in Nebraska.

The study was led by Samantha Jack, PhD, as part of work she did as a graduate student at the University of Nebraska. Jack published the findings in a PhD thesis titled “Effect of Computerized Cognitive Training in Persons with Multiple Sclerosis.”

“With the continued development of computerized cognitive testing and computerized cognitive training, clinicians hopefully will start incorporating cognitive performance into their regular discussions with patients,” Jack wrote.

“As the field of MS continues to evolve, my hope is that these convenient options will help make cognition a priority,” she added.

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Benefits seen for patients using online brain training games

Cognitive difficulties, such as trouble with memory and attention, are a common symptom of MS. The mechanisms leading to cognitive impairment in MS patients are not fully understood, but such problems are believed to arise primarily due to lesions and shrinkage of specific brain areas.

A number of strategies have been shown to help ease or reverse cognitive decline in MS patients. These include cognitive rehabilitation programs, exercise, and medications.

BrainHQ is a computer-based system of games that are designed to exercise cognitive faculties. A free version is available to try online, or consumers can subscribe for greater access. An annual subscription is $96 per person, or a monthly subscription is available for $14.

To fulfill some of her degree requirements, Jack, along with colleagues, conducted a small clinical trial to test whether the games in BrainHQ could help with cognitive issues in people with MS.

The study included 52 adults with relapsing-remitting MS, who were mostly white and female individuals, had mild to moderate disability, and had been living with MS for a mean of 8.3 years.

The participants were divided into two groups. One group had training with the BrainHQ system for 30 minutes three times weekly for six weeks, using games designed to improve attention, processing speed, and memory. The other patients played casual online games through the BrainHQ portal at the same time schedule.

Before and after the intervention, the participants underwent an assessment of cognitive function called the Brief International Cognitive Assessment for MS, or BICAMS.

This test includes three measures of cognition. The Symbol Digit Modalities Test (SDMT) assesses attention and processing speed, while the Brief Visuospatial Memory Test – Revised (BVMT-R) tests memory. The California Verbal Learning Test 2nd Edition (CVLT-II) evaluates both verbal learning and memory.

The results showed that BICAMS scores improved significantly more for patients who underwent the BrainHQ training, compared with the control group that played casual games.

This study provides evidence that computerized cognitive training with BrainHQ is a valuable option for [people with] MS suffering from cognitive decline.

A statistically significant improvement with BrainHQ was seen for all three subscores on the BICAMS. A particularly strong effect was seen for the CVLT-II, with an average improvement of more than nine points in the BrainHQ group, compared with less than one point in the control group.

“This study provides evidence that computerized cognitive training with BrainHQ is a valuable option for [people with] MS suffering from cognitive decline,” Jack concluded.

She added that this type of computer-based intervention “is convenient for the patient because they can do it at home when they have time and not at a specific time with a neuropsychologist.”

Jack noted, as a study limitation, that there were “very few males and very few non-Caucasian subjects.”

“While MS is more common in Caucasians and females, future studies should try to enroll a more diverse population. Furthermore, future studies should include subjects over age 60 to determine if the BrainHQ program can improve their cognitive functioning,” the researcher wrote.

The BrainHQ system is sold by Posit Science, which was not involved in this study. Henry Mahncke, PhD, the company’s CEO, said “these are very exciting results from independent researchers,” in a Posit Science press release.

“We hope this spurs not just further research, but targeted chronic care improvement programs at leading medical centers and health plans to help patients in need,” Mahncke said.