image: Dr. Chiaravalloti is director of Neuropsychology, Neuroscience and TBI Research at Kessler Foundation, and project director of the Northern New Jersey TBI Model System. view more
Credit: Kessler Foundation
WEST ORANGE, NJ April 10, 2015. Kessler Foundation researchers published a subanalysis of their MEMREHAB trial, which shows that treatment with the modified Story Memory Technique© (mSMT) may be affected by cognitive dysfunction. Investigators looked at the influence of processing speed on benefits of the mSMT, a 10-session cognitive intervention protocol shown to improve new learning and memory in individuals with MS. The influence of cognitive dysfunction on benefit from learning and memory rehabilitation in MS: A subanalysis of the MEMREHAB trial, was published online ahead of print on February 6 by Multiple Sclerosis Journal (doi: 10.1177/1352458514567726). The authors are John DeLuca, PhD, and Nancy Chiaravalloti, PhD, of Kessler Foundation.
Deficits in processing speed, which are common in MS, have been shown to adversely affect cognitive and everyday functioning. "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."
The MEMREHAB trial included 85 participants with MS; 45 received the intervention and 40 were controls. Half were found to have processing speed deficits; all had memory impairment as a criterion for participation in the trial. Among the participants with deficits in processing speed, the mSMT was not as beneficial. Performance on SDMT (Symbol Digit Modalities Test) was determined to be an indicator for mSMT benefit.
"Processing speed may be an indicator of cognitive decline, which may be a factor in the reduced benefit with mSMT," said 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."
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This subanalysis was based on the Foundation's MEMREHAB Trial, which provided the first Class I evidence for the efficacy of cognitive rehabilitation in MS. (Chiaravalloti N, et al: An RCT to treat learning impairment in MS. Neurology 2013 81(24):2066-72 (doi: 10.1212/01.wnl.0000437295.97946.a8S).
The mSMT protocol, which has also been tested in the brain injury population, is available in English and Spanish. Clinicians may contact mSMT@KesslerFoundation.org for more information about the protocol.
The study was funded by the National Institutes of Health (R01 HD045798), and Kessler Foundation.
About MS Research at Kessler Foundation
Kessler Foundation's internationally recognized cognitive rehabilitation research in MS is funded by grants from the National Institutes of Health, National MS Society, NJ Commission on Brain Injury Research, Consortium of MS Centers, the Patterson Trust, Biogen Idec, Hearst Foundation, the Department of Defense and Kessler Foundation. Under the leadership of John DeLuca, PhD, senior VP of Research & Training, and Nancy Chiaravalloti, PhD, director of Neuropsychology & Neuroscience and TBI Research, scientists have made important contributions to the knowledge of cognitive decline in MS. Clinical studies span new learning, memory, executive function, attention and processing speed, emotional processing and cognitive fatigue. Research tools include innovative applications of neuroimaging and virtual reality. Research findings include the benefits of cognitive reserve and aerobic exercise; correlation between cognitive performance and outdoor temperatures; efficacy of short-term cognitive rehabilitation using modified story technique; and the correlation between memory improvement and cerebral activation on fMRI. The Rocco Ortenzio Neuroimaging Center at Kessler Foundation greatly expanded the Foundation's research capabilities in these areas. Foundation research scientists have faculty appointments at Rutgers New Jersey Medical School.
About Kessler Foundation
Kessler Foundation, a major nonprofit organization in the field of disability, is a global leader in rehabilitation research that seeks to improve cognition, mobility and long-term outcomes, including employment, for people with neurological disabilities caused by diseases and injuries of the brain and spinal cord. Kessler Foundation leads the nation in funding innovative programs that expand opportunities for employment for people with disabilities. For more information, visit KesslerFoundation.org.
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Carolann Murphy, PA; 973.324.8382; CMurphy@KesslerFoundation.org
Lauren Scrivo, 973.324.8384/973.768.6583 (cell); LScrivo@KesslerFoundation.org
Journal
Multiple Sclerosis Journal