Plasticity-Based Cognitive Remediation in Multiple Sclerosis (MS) (P3.134)

OBJECTIVE: Our goals were to assess plasticity-based, adaptive, computerized cognitive remediation (“PACR”) program compliance and treatment outcomes in adults with multiple sclerosis (MS) who report cognitive dysfunction. BACKGROUND: PACR is web-based cognitive remediation program currently considered an investigational device and limited by Federal (or United States) law to investigational use. DESIGN/METHODS: After having received Institutional Review Board approval as a non-significant risk study, 10 participants, three men and seven women ranging in age from 27 to 64 years (mean of 49 years) enrolled in the PACR program. Six participants were diagnosed with relapsing-remitting and four with primary progressive MS, with a median EDSS score of 3.7 and a range from 1 to 6.5. At baseline, participants completed a neuropsychological evaluation, received a laptop computer, and were given PACR program usage instructions. During the home-based treatment period, participants completed the study games for five hours per week for a total of 40 hours over eight weeks. Compliance data were collected remotely and provided by the developer Brain Plasticity, Inc. At the end of study, participants were re-evaluated. RESULTS: All participants completed approximately 40 target study hours, and showed improvement in their percentile ranking with the average group gain of 30.9 points, indicating marked improvement on program tasks. A composite of the participants’ baseline neuropsychological test scores indicated a range of cognitive abilities across the sample trending towards low average to mild impairment (mean composite score z = -0.75). After completing the PACR program, all but one participant showed improvement (mean composite score increase z =0.33). CONCLUSIONS: We found: 1) a high rate of PACR program compliance and 2) a positive treatment signal with improvement on PACR program exercises, participant ratings, and standardized cognitive measures. Home delivery of the PACR program may be an option for MS patients experiencing cognitive dysfunction if made commercially available. Disclosure: Dr. Charvet has received personal compensation for activities with Biogen Idec as a consultant. Dr. Charvet holds stock and/or stock options in Johnson & Johnson. Dr. Amella has nothing to disclose. Dr. Scherl has nothing to disclose. Dr. Serafin has nothing to disclose. Dr. Taub has nothing to disclose. Dr. Melville has nothing to disclose. Dr. Krupp has received personal compensation for activities with Teva Neurosciences, Biogen Idec, EMD Serono, Betaseron/Bayer Healthcare Pharmaceuticals, Guidepoint Consultants, and Novartis. Dr. Krupp has received royalty payments from Genzyme Corporation, Bristol-Myers Squibb Company, Biogen Idec, and Johnson & Johnson. Dr. Krupp has received research support from EMD Serono and Biogen Idec.