Cognitive therapy

A deterioration in multiple sclerosis patients' handwriting aligns with drops in their movement, sensory and cognitive skills, a study reports. MS includes loss of hand dexterity and finger movement control. This affects a patient's capacity to manipulate objects and coordinate hand movement, skills needed in handwriting. Previous studies have shown that MS patients had less handwriting rhythm and control than healthy people. This time researchers decided to compare the handwriting movements of both MS patients and healthy volunteers. The research involved 19 MS patients and 22 healthy age-matched controls. The team asked participants to write a specific sentence on a digitizing tablet. They discovered that the way MS patients wrote was much different than those of the controls. The patients took a lot longer to write each word and to achieve spacing between words. This led to them taking a much longer time overall to write a sentence than healthy people. In addition, analysis of handwriting strokes showed that MS patients' writing wasn't as smooth as that of healthy people. Researchers also found a correlation between patients’ movement abilities and cognitive status on the one hand and their handwriting ability on the other. The team said it believed “these findings might be very useful when planning rehabilitative task-oriented interventions focused on handwriting abilities.” In fact, rehabilitation specialists should consider evaluating “both the motor movement and the cognitive status of PwMS [patients with MS] in order to tailor the intervention."

So-called silent brain lesions in patients with early-stage relapsing-remitting multiple sclerosis (RRMS) may, in fact, not be silent at all, according to a French study that linked such lesions to cognitive decline in early MS. This link has likely been missed since the major tool for measuring disability in MS…

Using strategies to promote intellectual enrichment among patients with pediatric-onset multiple sclerosis could be essential to achieving better cognitive, social, and professional performances during adult life, according to researchers at the University of Florence in Italy. The finding was the subject of an oral presentation titled, “Cognitive reserve is…

Behavioral therapy focusing on goal attainment might reduce cognitive fatigue in multiple sclerosis patients, finds a study that used brain imaging to examine goal-oriented tasks involving rewards. Since fatigue is one of the most common MS symptoms, affecting up to 90 percent of patients, researchers at the Kessler Foundation in East Hanover, New Jersey, say their findings could open the door to new non-medication approaches to treating MS-related fatigue. Scientists believe that a part of the brain, called the fronto-striatal network, causes fatigue. But studies also show that the network is active during goal attainment tasks, and that such tasks can reduce fatigue in healthy people. Equipped with this knowledge, Kessler researchers recruited 19 MS patients and 14 healthy controls, and exposed them to one of two conditions. In the first, they had the chance to win money while gambling. Researchers called this the outcome condition. The second condition did not include the prospect of a reward, or outcome. The tasks were performed in a brain scanner. Using functional magnetic resonance imaging of the brain — a method that tracks brain activity by monitoring blood flow — researchers could study how different tasks activated the fronto-striatal network. It turned out that the prospect of a reward activated parts of the network in deep brain structures, while parts of the prefrontal cortex were more active during the task without a potential reward. Importantly, the activation seen during the reward condition was linked to significantly lower levels of fatigue, which researchers measured outside the scanner. While researchers used a gambling task to study the process, similar exercises like achieving a good score on a test, might work equally well, researchers said. In fact, goal attainment is already incorporated in many neuropsychological rehabilitation efforts, including in MS.

Patients with primary progressive multiple sclerosis have more severe cognitive impairment than those with relapsing-remitting multiple sclerosis, according to a German study that analyzed published data on the topic. PPMS patients did especially poorly on verbal learning and verbal memory tests, said the study, which suggested that PPMS patients need disease management that specifically focuses on their cognitive difficulties, which do not necessarily correlate with the degree of overall disability. The study gathered data from 47 previously published studies in an attempt to analyze potential differences in cognitive performance between patients with RRMS and PPMS. These studies included 4,460 patients — 3,456 with RRMS and 1,004 with PPMS — and plenty of information about patient and disease features. This allowed researchers to perform a meta-analysis of pooled data from various studies, that is considered the highest level of scientific evidence. Researchers noted that PPMS patients performed worse on cognitive tests, both when considering global scores and tests of specific cognitive domains. Yet both groups scored similarly in levels of anxiety, depression and fatigue. Using statistical analyses, the research team found that differences in sex, education, disease duration, manual dexterity and fatigue could not explain the poorer test results among PPMS patients. On the other hand, PPMS patients were, on average, older than those with relapsing disease, and the team found that this difference accounted for poorer test results in cognitive tests of processing speed and working memory. Yet differences in other cognitive aspects also remained when researchers took age into account. Differences in disability, measured by the Expanded Disability Status Scale, could also not explain why PPMS patients performed worse on the cognitive tests. A detailed look revealed that the largest differences between RRMS and PPMS patients were in verbal learning and verbal memory, along with the age-associated difference in processing speed. Depression and anxiety also brought down processing speed, researchers said, even though the two groups did not differ in their levels of anxiety and depression. The data shows that cognitive impairment in MS is not directly related to the course of the disease. Research may explain differences in other factors including genetics, the degree of brain tissue loss and medications.

The U.S. Food and Drug Administration (FDA) has approved the marketing of Cognigram, a medical device developed by the cognitive science company Cogstate to evaluate a patient’s cognitive health. This device may be a…

At times it can be difficult to know whether the cognitive issues I experience are the result of aging or multiple sclerosis. According to The National Multiple Sclerosis Society (NMSS) more than half of those living with MS develop problems with cognition, and in some cases…

A high daily dose of simvastatin improves multiple sclerosis patients’ cognitive function, according to a new analysis of Phase 2 clinical trial results. The British team that did the research will start a study soon on whether simvastatin, which goes by the brand name Zocor and other labels, can also slow…

How multiple sclerosis affects the “social brain,” which governs the ability to understand how others think and feel — a skill called social cognition — is linked to specific types of brain damage that occur in MS: both lesions and microscopic changes taking place in the brain’s white matter, a research team…

The online BrainHQ adaptive training program developed by Posit Science is better than any computer game at helping multiple sclerosis (MS) patients improve their cognitive skills, according to a study by researchers at New York University (NYU). The study, “Cognitive function in multiple sclerosis improves with telerehabilitation: Results from…

Brain fog is one of the most common symptoms of many chronic illnesses, including lupus, multiple sclerosis and fibromyalgia. In this Mind Over Meniere’s video, Glenn describes how brain fog affects him on a daily basis. Discover some Pilates exercises suitable for multiple sclerosis patients.  Brain fog is more…

Multiple sclerosis (MS) patients given gentle electrical stimulation to their tongues during physical and cognitive rehabilitation training benefited more than those who did not have the stimulation, a small pilot study demonstrated. Those who received the weak stimulation had significant improvements in balance and better scores than controls in cognition and other…

Here’s my Pick of the Week’s News, as published by Multiple Sclerosis News Today. Clinical Trial Supports Stem Cell Transplants to Treat RMS Patients with High Disease Activity It’s no secret to readers of this column and, indeed, to the wider MS community, that I am convinced…

Multiple sclerosis (MS) patients who received transcranial direct current stimulation (tDCS) while playing brain-training video games improved their learning and understanding skills to a greater extent than those who only brain-trained. Researchers at NYU Langone’s Multiple Sclerosis Comprehensive Care Center underscored that while more research is needed to explore the procedure’s…

Multiple sclerosis (MS) patients who are showing signs of cognitive impairment may benefit from computer-assisted cognitive rehabilitation programs, according to a new study. Difficulties with short-term memory, or with processing information and concentrating, are believed to affect 40% to 65% of MS patients. Studies have suggested that cognitive rehabilitation may help, and that computer-assisted therapy used…

In a recent talk, titled “Income and cognitive impairment among multiple sclerosis patients,” scientists investigated how cognitive impairment impacts the life of patients with multiple sclerosis (MS), and reported significant differences in income that correlated with levels of MS-cognitive deficit. These findings were recently presented at the 32nd Congress of the European Committee for…

People with multiple sclerosis, especially those with cognitive disabilities, have more problems managing their personal finances — paying bills on time or using a credit card — than those without this disease, researchers report in the study, “Money Management Activities in Persons With Multiple Sclerosis,” published in the…

Quite a mixed bag in the pick of the week’s news: A drug in development, microbiota in the gut, statins and MS, DMTs and cognitive skills, and images of depression. Endece Granted New U.S. Patent for NDC-1308, Therapy to Induce Remyelination in MS This is a bit of an…

Disease-modifying therapies, a group of treatments for people with relapsing-remitting multiple sclerosis (RRMS), work to stabilize patients’ cognitive functions just as they do their physical symptoms. Research, conducted over the course of a year, also reported no differences between two types of DMTs, Gilenya (fingolimod) and Tysabri (natalizumab). The study, “…

As we age, the risk that small blood vessels will start leaking into brain tissue increases, raising our risk of dementia, stroke, and Parkinson’s disease. New research reveals that people with multiple sclerosis (MS) also have these so-called cerebral microbleeds, and links them to increased physical and cognitive disability. When Robert Zivadinov, a professor of…

Clinical pilates can improve cognitive skills and life quality in multiple sclerosis (MS) patients, in addition to helping them physically. But the study, comparing clinical pilates with traditional exercise, also showed that other exercise forms offer important benefits, and more research is needed to determine if clinical pilates is a superior type of exercise for people with…

Merck Biopharma  announced it has entered into a partnership with a French subsidiary called HAPPYneuron, and now has an exclusive license to that company’s cognitive remediation training program for multiple sclerosis (MS). The program, a series of brain training games and exercises, will be made available to people needing it through Merck’s MSdialog platform. An e-Health…

Researchers at the University of Arizona studied the psychosocial symptoms felt by a group of female patients with multiple sclerosis (MS) from the southwestern United States, and found significant relationships between depression, fatigue, and cognitive decline — symptoms also related with poorer quality of life and reduced mental and…

Researchers at Johns Hopkins University in Baltimore found that visual function in multiple sclerosis (MS) patients correlates with cognitive function ands suggests that disease severity and outcomes of neuroprotective therapies in MS patients may be assessed through visual function measurements. The findings were recently presented in the oral presentation “…

Treadmill walking exercise training is beneficial for multiple sclerosis (MS) patients, increasing not only their cardiorespiratory fitness, but also their cognitive processing speed, according to the study “Systematically Developed Pilot Randomized Controlled Trial of Exercise and Cognition in Persons with Multiple Sclerosis,” recently presented at the Consortium of Multiple…

The National Multiple Sclerosis Society has awarded Dr. Bart Rypma, an associate professor at the Center for BrainHealth at the University of Texas at Dallas, a more than $490,000 grant to study how changes in blood flow in the brain might affect cognition in people with multiple sclerosis (MS). The grant builds on previous research…

In a study published in the International Neurology Journal, researchers showed that cognitive deficits, such as memory problems, in a rat model of multiple sclerosis (MS) are mirrored by changes in synaptic transmission and plasticity in the hippocampus, a brain region crucial for memory processing. The findings…

Multiple sclerosis patients using a cognitive remediation computer training program, part of a controlled trial by researchers from NYU Langone Medical Center, had greater improvements in cognitive function than those who used a placebo-training program, according to a presentation at the recent American Academy of Neurology annual meeting in Vancouver, Canada. Problems in attention, memory,…

New data presented by Biogen and AbbVie at the recent 68th annual meeting of the American Academy of Neurology (AAN) showed that Zinbryta (daclizumab high-yield process) improved cognitive outcome measures in patients with relapsing forms of multiple sclerosis (RMS). Additional results — from post-hoc analyses of clinical trials — also offer a better…

Microglial cells in the hippocampus, a brain region crucial for memory processing, may contribute to brain damage associated with cognitive impairment in multiple sclerosis (MS). The finding, published in the journal Scientific Reports, implies that targeting microglia could be a promising strategy to improve cognition in MS. While cognitive…