Chiaravalloti Nancy D, Weber Erica, Dobryakova Ekaterina, Botticello Amanda, Goverover Yael, Moore Nancy B, DeLuca John
Kessler Foundation, Center for Neuropsychology and Neuroscience Research, East Hanover, NJ, USA.
Rutgers -New Jersey Medical School, Department of Physical Medicine and Rehabilitation, Newark, NJ, USA.
Contemp Clin Trials Commun. 2022 Nov 3;30:101026. doi: 10.1016/j.conctc.2022.101026. eCollection 2022 Dec.
New learning and memory impairments are common in Multiple Sclerosis (MS) and negatively impact everyday life, including occupational and social functioning. Despite the demand for learning and memory treatments, few cognitive rehabilitation protocols are supported by Class I research evidence, limiting the degree to which effective treatments may be utilized with persons with MS. The present double-blind, placebo controlled randomized clinical trial (RCT) examines the efficacy of an 8-session cognitive rehabilitation protocol encompassing training in the application of three strategies with the strongest empirical evidence (self-generation, spaced learning and retrieval practice) to treat impaired learning and memory in persons with MS, ™. A sample of 120 participants with clinically definite MS who have impairments in new learning and memory will be enrolled. Outcomes will be assessed via three mechanisms, an Assessment of Global Functioning, which examines everyday functioning and quality of life, a Neuropsychological Evaluation to examine objective cognitive performance, and functional Magnetic Resonance Imaging to examine the impact of treatment on patterns of cerebral activation. We will additionally evaluate the longer-term efficacy of KF-STEM™ on everyday functioning and neuropsychological assessment through a 6-month follow-up evaluation and evaluate the impact of booster sessions in maintaining the treatment effect over time. The methodologically rigorous design of the current study will provide Class I evidence for the KF-STEM™ treatment protocol for persons with MS.
新的学习和记忆障碍在多发性硬化症(MS)中很常见,并且会对日常生活产生负面影响,包括职业和社交功能。尽管对学习和记忆治疗有需求,但很少有认知康复方案得到I类研究证据的支持,这限制了有效治疗方法在MS患者中应用的程度。目前这项双盲、安慰剂对照的随机临床试验(RCT)检验了一个为期8节的认知康复方案的疗效,该方案包括应用三种有最强实证证据的策略(自我生成、间隔学习和检索练习)进行训练,以治疗MS患者的学习和记忆障碍,即KF-STEM™。将招募120名临床确诊为MS且存在新的学习和记忆障碍的参与者作为样本。将通过三种机制评估结果,一种是整体功能评估,用于检查日常功能和生活质量;一种是神经心理学评估,用于检查客观认知表现;还有功能磁共振成像,用于检查治疗对大脑激活模式的影响。我们还将通过6个月的随访评估来评估KF-STEM™对日常功能和神经心理学评估的长期疗效,并评估强化训练课程对随着时间推移维持治疗效果的影响。本研究严格的方法学设计将为MS患者的KF-STEM™治疗方案提供I类证据。