Studies advance emotional and cognitive health in MS

Finding solutions that advance emotional wellness and cognitive function can make every aspect of living with MS better. As a clinical psychologist who has treated people living with this disease, I find it heartening to see how researchers presenting this week at the American Academy of Neurology’s Annual Meeting are propelling this search forward. Here is just a small sample of their work. (Links are included to abstracts on the AAN site - access is free.)

Let’s start with cognition – half or more of all people with MS will experience cognitive issues at some point. The fact that there is such a thing called “cognitive rehabilitation” rightfully suggests that there are options open to many that may help improve cognitive function. For example, Dr. Leigh Charvet and colleagues at New York University Langone Medical Center and the State University of New York at Stony Brook tested a computer-based cognitive training program in 135 people with MS. Of this group, 71 people used the training program – a series of brain-training games that are continuously adapted to keep the individual challenged – and 64 played regular video games for one hour per day, five days per week, over 12 weeks. Although the “placebo” video game group logged more playing time, those in the training group showed significantly greater improvement in cognitive function, as shown by a number of neuropsychological tests. I hope further testing makes this and similar programs easily accessible for improving cognition in MS. (Abstract P2.170)

Computer-based rehab is especially attractive for improving cognition in children. Dr. Pietro Iaffaldano (University of Bari Aldo Moro, Italy) and colleagues administered attention-specific computerized training or nonspecified computerized training to 16 children with MS and 20 children with ADHD. The attention-specific training improved attention in both groups, and improved processing speed and memory in the kids with MS as well. Cognitive problems can have a devastating effect on school performance and adaptation to school among youngsters with MS and so it would be great to see programs like this readily available. (Abstract S9.003)

We have heard a lot recently about the benefits of exercise for the general population, but what about for people with MS?  Dr. Rebecca Spain and a team from Oregon Health & Science University tested whether walking on a treadmill for 30 minutes, four times per week for eight weeks, would improve fitness, cognition, and fatigue in 11 people with MS. They found significant improvements in cardiovascular fitness and cognition. Although the study was small, it adds to growing evidence that exercise can improve mental and physical fitness in people with MS. It’s important to note that one participant fainted and could not complete the program, so it’s a good idea to team up with your doctor to find an exercise program that’s suitable for you. (Abstract P2.174)

It’s thought that as many as one out of two people who have MS may experience depression at some point. The fact that it isn’t discussed much – not with doctors, family or loved ones – can make loneliness a real factor as well. Occupational therapist Jennifer Kalina (New York University Langone Medical Center) examined whether a 12-week program aimed at increasing socialization would reduce loneliness and depression among people with MS. She reported that participants improved in “self-efficacy” (this is a belief in one’s abilities) and were less lonely compared with people who did not participate. Unfortunately the program didn’t impact depression.  We really can’t rest until we know more about the complicated nature of depression in MS and the best ways to treat it. (Abstract P2.195)

A type of meditation, called mindfulness-based intervention, is mental training aimed at reducing reactions that may worsen any pain or emotional distress. However, traveling to weekly sessions can be difficult for people with mobility issues, so Ariana Frontario and others on Dr. Charvet’s team tested the feasibility of delivering mindfulness training via group phone teleconference. They found that 25 people who underwent a six-week program improved in cognition and sleep quality, and had reduced fatigue and depression, compared with 10 people who did not complete the program. We’re seeing more and more of these “telehealth” approaches to increase access to life-changing programs for all people affected by MS. (Abstract P3.092)

Addressing cognitive and emotional issues is so important, but it’s not often discussed during visits to the doctor. It’s time to shine more light on these issues because there are increasing treatment options that can make a big difference in people’s lives. 
Highlights of MS-related presentations focusing on stopping MS, restoring function, and ending MS forever from AAN Meeting
Tags Healthy Living, Research, Treatment      5

Nicholas LaRocca, PhD

Dr. Nicholas LaRocca is a consultant to the National MS Society. He is a clinical psychologist who has worked in the field of MS for over 30 years. He was an associate professor at Albert Einstein College of Medicine and New York Medical College before joining the Society in 1997. Dr. LaRocca served as vice president of health care delivery and policy research in the research programs department of the Society. In this role, he was responsible for Society funding of research to address the symptoms of MS, and the rehabilitation, epidemiology and psychosocial aspects of MS, as well as health policy studies.