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
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Nicholas

Nicholas LaRocca, PhD

Dr. Nicholas LaRocca 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. He currently serves as Vice President of Health Care Delivery and Policy Research in the Research Programs Department of the Society. In this role he has responsibility for Society funding of research to address the symptoms of MS, rehabilitation, epidemiology, psychosocial aspects of MS as well as health policy studies.

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    17 Comments

  • Wendy   Apr 18, 2016 5:12 PM
    In wonder
  • Linda L Halvorson   Apr 18, 2016 5:23 PM
    I have meditated for 15 years and ride a Theracycle 30 minutes daily. There a lot of apps for meditation. Combined with Ampyra, I have never felt better since diagnosis 40 years ago. I use a scooter full time.
  • Roisin Kelly   Apr 18, 2016 7:00 PM
    This doesn't comply with those who can't do exercise, what can help this, my mother was a member of gym and.nothing helped, she is now struggling to walk and carry out menial household jobs.
  • sian   Apr 18, 2016 7:13 PM
    The cognitive side can be the most difficult to cope with. My husband has MS and when he gets cognitive impairment due to fatigue he seems to regress and that can be distressing at times. If my resolve is not strong it really gets me down.
  • Shelley   Apr 18, 2016 7:41 PM
    great topic and biggest thing i suffer from. cognitive impairment from this disease has taken so much from me. its made me feel stupid and i hate where i am now mentally. when you have these types of topics it would be only fair to list where the games are located. without it is only cruel.
  • Carolyn Cordon   Apr 18, 2016 9:16 PM
    I do a variety of things, to try to maintain my quality of life. Wii Fit training has certainly helped me. Being a member of a variety of writing groups has also helped to keep me involved with my broader community, and this helps me to stay positive and happy. I also eat o healthy diet, with gives my body the fuel it needs.
  • maurice davidson   Apr 19, 2016 4:52 AM
    i have ms i suffer with depression and suicidel thoughts .i do feel lonely even thou im married with a 18 year old daughter .i live in warmley ,bristol ,england and i am still waiting for cognitive care
  • Jeanetta   Apr 19, 2016 2:55 PM
    I have had MS for 37 years. My attitude has always been and remains that just because MS could do something doesn't mean that it will. Whenever symptoms pop up I meet them head on. Depression can be treated. When my son became seriously ill Ptistiq allowed me to function through his illness and death as well as my husband's two years later. I fell 15 years ago and between my neurologist who denied that MS could be the cause of spasticity and pain and my primary Dr who blamed it all on MS I fell through the cracks unto I went to a physiatrist who as a rehabilitation Dr only cares about restoring function to improve my life. Never giving up is hard. My fatigue overwhelms me and sometimes win but I keep fighting.
  • loretta parente   Apr 21, 2016 9:45 AM
    Excellent paper.There must be a success story with all the wonderfulpeople
    trying to make extreme research on a growing problem. My hat is off to the dedicated people who are making this happen. Thank you Loretta Parente
  • Jan   Apr 26, 2016 8:26 AM
    Does anger over very minute matters occur often in MS?
  • Nancy Rodman   Apr 26, 2016 2:01 PM
    These articles are great to read. I wa diagnosed about 15 years ago, with MS but I am fortunate my MS is mild. Though I also have chronic migraines and Celiacs disease..and a few other autoimmune issues.. This makes fighting fatigue, depression and cognitive impairment hard to combat. While the Celiacs make restaurant dates risky. Migraines make any plans iffy, and the cognition make me loose time ...depression is a constant issue,
    I have always been a huge puzzle lover and have enjoyed the new brain strengthening apps offered now too. Who knows if it helps.. Although they are solitary activities..
    But I keep trying to stay on top of it all and out of trouble!
  • Avatar
    MS Navigator Jess  May 4, 2016 10:10 AM
    Hi Maurice, I'm so sorry that you're feeling so down- we are concerned about you.

    Though we are in the US, we do have an international resource that may be helpful to you, and of course as always please do tell your medical team about how you're feeling, there's definitely help out there!

    I hope this is helpful to you, you are not alone: http://www.befrienders.org/index.asp

    Jess
  • joannec592  May 4, 2016 12:00 PM
    With MS, as in life, you must believe in yourself, in your innate capabilities, your own inner strength. The best advice I was given when dx in 1992 was "Do everything you desire now while you're able. How you deal with the future is up to you." The humidity is 87% today, so I'm going to do what little I have energy for. Even a little is better than nothing. And hope tomorrow is cooler!
  • Danielle   May 7, 2016 1:54 AM
    I had the most emotionally, turn everything upside down day. I've done nothing but cry and be completely negative and hide inside my own head. I don't think I can do this. I want to just waive the white flag and surrender. MS already knows it won. I lose. I hate everything right now including myself. What do I do? Please, I'm completely lost and alone and feel like I'm at my rock bottom!
  • Ruth   May 21, 2016 8:42 AM
    Thanks for writing this article. Dealing with fatigue and cognitive issues has been hard but is made even more difficult with those who are close to you who are in denial. I have been battling hard but it hurts when the person closest to you is harsh and impatient.
  • tracy-short  May 31, 2016 12:24 PM
    I have new damage to my cerebellum that resulted in PBA. The depression I have had since diagnosis is nothing compared to this! I don't recognize myself and I can't believe my reaction to things! When I get mad I feel mad about everything that has EVER made me mad. I was already isolated and lonely but now I have lost what made me me. I miss my old self, the rational problem solving peace making person who I actually respected. I HATE THE NEW ME
  • tracy-short  Jun 17, 2016 1:17 AM
    Cognitive changes are tough for sure! Especially when loved ones say "I don't think you are any different from the rest of us- we all forget stuff", or "I can't tell any difference in you." It is trying to be helpful but it just denies the validity of our anguish. Since they don't see a difference (RIGHT), then the changes we complain of aren't real! It is quite convenient for them and incredibly damaging to my fragile soul