Improving thinking and memory in those living with progressive multiple sclerosis

Findings of a Canadian-led study published in The Lancet Neurology show there is promise in improving processing speed in people with progressive multiple sclerosis (MS), with further investigation required.

Up to 70 percent of patients with progressive MS experience cognitive dysfunction, which can affect aspects of everyday life from relationships to employment, social activities, and beyond. Processing speed refers to the time it takes a person to understand and react to the information they receive and is seen as a pivotal cognitive deficit in those living with MS.

“These issues are critically important to people with MS, and there is a lack of data on how to improve processing speed in people with progressive MS,” explains Dr. Anthony Feinstein, principal investigator and Director of Sunnybrook’s Neuropsychiatry Program.

The multi-arm, randomized trial looked at 311 people with progressive MS over 12 weeks across four study groups: cognitive rehabilitation with exercise, cognitive rehabilitation with sham exercise, sham cognitive rehabilitation with exercise, and both sham cognitive rehabilitation and exercise.

While the combined cognitive rehabilitation plus exercise participants did not differ in terms of processing speed as compared with the sham group, a post-study analysis revealed two-thirds of all participants showed a clinically significant improvement in processing speed after 12 weeks of therapy, compared to baseline. Processing speed benefits were still present in over a third of participants six months after completing their interventions.

“We saw improvements across all four groups, suggesting cognitive rehabilitation and exercise individually may indeed improve processing speed,” says Dr. Feinstein, while noting that boosting cognitive reserve through increasing intellectual, physical, and social activities may also play a role.

Dr. Feinstein spearheaded the study, funded by MS Canada, with recruitment from six countries including Canada, the United States, the U.K., Denmark, Belgium, and Italy.

“This study shows how cognitive and physical rehabilitation can improve some of the cognitive decline observed in people living with progressive MS,” remarked Dr. Pamela Valentine, President and CEO of MS Canada. “These findings provide valuable information that can help develop treatment plans, by incorporating both cognitive and physical rehabilitation to preserve cognitive capabilities, impacting everyday life for those suffering from MS.”

"Throughout the 12-week trial, I participated in various cognitive and physical exercises to improve my overall well-being,” said Susan McCoy, trial participant who was diagnosed with progressive MS in 1993. “Taking part in the study was extremely beneficial for my cognitive and physical health, and I felt proud of my ability to persevere through the interval training. Research paves the way for the progress we're all hoping to see in finding a cure for MS, and I'm grateful I got to experience that first-hand."