A randomized trial predicting response to cognitive rehabilitation in multiple sclerosis: Is there a window of opportunity?
| Autor: | Prouskas SE; Department of Anatomy and Neurosciences, MS Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands., Schoonheim MM; Department of Anatomy and Neurosciences, MS Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands., Huiskamp M; Department of Anatomy and Neurosciences, MS Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands., Steenwijk MD; Department of Anatomy and Neurosciences, MS Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands., Gehring K; Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands/Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands., Barkhof F; Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands/Institutes of Neurology and Healthcare Engineering, UCL, London, UK., de Jong BA; Department of Neurology, MS Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands., Sitskoorn MM; Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands., Geurts JJ; Department of Anatomy and Neurosciences, MS Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands., Hulst HE; Department of Anatomy and Neurosciences, MS Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. |
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| Jazyk: | angličtina |
| Zdroj: | Multiple sclerosis (Houndmills, Basingstoke, England) [Mult Scler] 2022 Nov; Vol. 28 (13), pp. 2124-2136. Date of Electronic Publication: 2022 Jun 28. |
| DOI: | 10.1177/13524585221103134 |
| Abstrakt: | Background: Cognitive training elicits mild-to-moderate improvements in cognitive functioning in people with multiple sclerosis (PwMS), although response heterogeneity limits overall effectiveness. Objective: To identify patient characteristics associated with response and non-response to cognitive training. Methods: Eighty-two PwMS were randomized into a 7-week attention training ( n = 58, age = 48.4 ± 10.2 years) or a waiting-list control group ( n = 24, age = 48.5 ± 9.4 years). Structural and functional magnetic resonance imaging (MRI) was obtained at baseline and post-intervention. Twenty-one healthy controls (HCs, age = 50.27 ± 10.15 years) were included at baseline. Responders were defined with a reliable change index of 1.64 on at least 2/6 cognitive domains. General linear models and logistic regression were applied. Results: Responders ( n = 36) and non-responders ( n = 22) did not differ on demographics, clinical variables and baseline cognition and structural MRI. However, non-responders exhibited a higher baseline functional connectivity (FC) between the default-mode network (DMN) and the ventral attention network (VAN), compared with responders ( p = 0.018) and HCs ( p = 0.001). Conversely, responders exhibited no significant baseline differences in FC compared with HCs. Response to cognitive training was predicted by lower DMN-VAN FC ( p = 0.004) and DMN-frontoparietal FC ( p = 0.029) (Nagelkerke R 2 = 0.25). Conclusion: An intact pre-intervention FC is associated with cognitive training responsivity in pwMS, suggesting a window of opportunity for successful cognitive interventions. |
| Databáze: | MEDLINE |
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