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速度处理训练对改善多发性硬化症患者处理速度的疗效:一项随机临床试验。

The efficacy of speed of processing training for improving processing speed in individuals with multiple sclerosis: a randomized clinical trial.

机构信息

Center for Neuropsychology and Neuroscience Research, Kessler Foundation, 120 Eagle Rock Avenue, Suite 100, East Hanover, NJ, 07936, USA.

Department of Physical Medicine and Rehabilitation, Rutgers -New Jersey Medical School, Newark, NJ, 07103, USA.

出版信息

J Neurol. 2022 Jul;269(7):3614-3624. doi: 10.1007/s00415-022-10980-9. Epub 2022 Feb 12.

Abstract

OBJECTIVE

The current study examines the efficacy of speed of processing training (SOPT) to improve processing speed (PS) in individuals with multiple sclerosis (MS). Outcomes included changes in the useful field of view (UFOV) and neuropsychological evaluation (NPE).

METHODS

This double-blind, placebo-controlled randomized clinical trial included 84 participants with clinically definite MS and impaired PS, 43 in the treatment group and 41 in the placebo control group. Participants completed a baseline NPE and a repeat NPE post-treatment. The treatment group was randomized to booster sessions or no contact. Long-term follow-up assessments were completed 6 months after treatment.

RESULTS

A significant effect of SOPT was observed on both the UFOV (large effect) and pattern comparison with a similar pattern of results noted on letter comparison, albeit at a trend level. The treatment effect was maintained 6 months later. The impact of booster sessions was not significant. Correlations between degree of improvement on the UFOV and the number of levels completed within each training task were significant for both speed and divided attention indicating that completion of more levels of training correlated with greater benefit.

CONCLUSION

SOPT is effective for treating PS deficits in MS with benefit documented on both the UFOV and a neuropsychological measure of PS. Less benefit was observed as the outcome measures became more distinct in cognitive demands from the treatment. Long-term maintenance was observed. The number of training levels completed within the 10-sessions exerted a significant impact on treatment benefit, with more levels completed resulting in greater benefit.

摘要

目的

本研究旨在考察速度处理训练(SOPT)对改善多发性硬化症(MS)患者处理速度(PS)的疗效。结果包括有用视野(UFOV)和神经心理学评估(NPE)的变化。

方法

这是一项双盲、安慰剂对照的随机临床试验,纳入了 84 名临床确诊的 MS 且 PS 受损的患者,其中 43 名患者分入治疗组,41 名患者分入安慰剂对照组。所有患者均完成基线 NPE 和治疗后重复 NPE。治疗组随机分为加强治疗组或不接触组。治疗结束后 6 个月进行长期随访评估。

结果

SOPT 对 UFOV(大效应)和模式比较均有显著影响,字母比较的结果也类似,只是处于趋势水平。治疗效果在 6 个月后仍能维持。加强治疗组的影响不显著。UFOV 改善程度与每个训练任务中完成的训练水平数之间的相关性在速度和注意力分散方面均具有统计学意义,表明完成更多的训练水平与更大的益处相关。

结论

SOPT 对 MS 的 PS 缺陷有效,在 UFOV 和 PS 的神经心理学测量上均有获益。随着结果测量在认知需求上与治疗的区别越来越明显,获益减少。长期维持治疗效果。在 10 次治疗中完成的训练水平数对治疗效果有显著影响,完成的水平数越多,获益越大。

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