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Old 09-28-2018, 02:20 PM
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Default Physical exercise and cognitive training improve cognitive deficits, processing speed

Releasing at ECTRIMS 2018

Physical exercise and cognitive training improve self-perceived cognitive deficits and information processing speed in multiple sclerosis

M. Filser, J. Graf, S.J. Baetge, et al

Background: A recent European survey impressively showed that 71% of patients with multiple sclerosis (MS) report cognitive deficits which have tremendous effects on working ability (Kobelt et al., 2017). Due to a lack of effective pharmacological therapies for patients suffering from cognitive impairment, non-pharmacological treatment approaches are warranted.

Objectives: To evaluate the effectiveness of physical exercise and cognitive training as single and combined treatment options on subjectively perceived cognitive deficits and objective information processing speed as primary outcomes.

Methods: Included patients received one of the following interventions for 3 months: physical exercise training twice a week for 45 min. each (treadmill walking), computer-based training twice a week for 45 min. each (using the software BrainStim) or a combination of both. Before and after the training period a comprehensive neuropsychological assessment was administered. To determine self-reported deficits, the perceived cognitive deficits questionnaire (PDQ-20) was applied including the following cognitive subscales: attention and concentration; retrospective memory; prospective memory; planning and organization. To measure information processing speed the symbol digit modalities test (SDMT) was used. The Wilcoxon signed-rank test was applied to evaluate treatment effects.

Results: In total, 44 MS patients (39 relapsing-remitting MS and 5 secondary-progressive MS, 33 female; mean age 43.70, SD = 10.35; mean EDSS 2.44) were included so far. First analyses indicate a significant improvement in both primary outcomes over all three training groups: PDQ-20: z= -3.093, p= .002; SDMT: z= 1.961, p= .05. Cohen's d supports these findings by strong effect sizes for both measures: PDQ-20 (d= -1.63) and SDMT (d= 0.87), with no differences between the different training groups. The analysis of the PDQ subscales showed significant improvement on the following cognitive domains: attention and concentration (z = -2.890, p= .004); retrospective memory (z= -2.589, p= .010); prospective memory (z= -2.894, p= .004). Planning and organization showed no significant improvement (z= -.969, p= .333).

Conclusions: Physical exercise and cognitive training improve patients' self-perceived cognitive deficits and the ability to quickly process information (objective measure). Thus, physical exercise and computer-based cognitive training can be recommended to treat cognitive problems in MS patients.

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