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基于家庭的计算机辅助认知康复对儿童多发性硬化症注意力的影响:一项随机多中心试点研究。

Home-based, computer-assisted cognitive rehabilitation for attention in pediatric onset multiple sclerosis: a randomized, multicenter pilot study.

作者信息

Masciulli Camilla, Portaccio E, Goretti B, Niccolai C, Simone M, Viterbo R G, Zaffaroni M, Pippolo L, Cocco E, Fenu G, Carta E, Falautano M, Celico C, Pardini M, Mancardi G L, Guerrini R, Melani F, Giovannelli F, Rocca M, Iaffaldano P, Tacchino A, Zaratin P, Filippi M, Amato M P

机构信息

Department of NEUROFARBA, University of Florence, Largo Piero Palagi, 1, Florence, 50139, Italy.

IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.

出版信息

Neurol Sci. 2025 Feb;46(2):1013-1017. doi: 10.1007/s10072-024-07886-x. Epub 2024 Nov 25.

Abstract

OBJECTIVE

Cognitive impairment affects approximately 30% of pediatric onset Multiple Sclerosis (POMS) patients with a negative impact on everyday life. The aim of this study was to evaluate the feasibility and effectiveness of a home-based, computer-assisted training of attention in patients with POMS.

METHODS

This was a randomized double-blind study. Subjects were randomized to specific training (ST) or non-specific training (n-ST), delivered through a customized module based on attention exercises (COGNI-TRAcK2). The main feature of the ST is the implementation of working load algorithms and procedures for intensiveness regulation. The effectiveness of the ST on attention was primarily assessed on the Symbol Digit Modalities Test (SDMT), using the Wilcoxon signed-rank test. Secondary objectives included effectiveness on other cognitive tests. The evaluations were performed at baseline, end of training and 3-month follow-up.

RESULTS

22 relapsing-remitting patients were included: data of 8 subjects in n-ST and 5 subjects in ST were available. As for the primary outcome, SDMT score improved in the ST group (from 31.2 at baseline to 42.4 after 3 months, p = 0.043). There was no benefit in other neuropsychological measures.

CONCLUSIONS

These preliminary findings point to a potential benefit of a home-based, computer-assisted training of attention in patients with POMS.

摘要

目的

认知障碍影响约30%的儿童期发病的多发性硬化症(POMS)患者,对其日常生活产生负面影响。本研究的目的是评估针对POMS患者的基于家庭的计算机辅助注意力训练的可行性和有效性。

方法

这是一项随机双盲研究。受试者被随机分为接受特定训练(ST)或非特定训练(n-ST),通过基于注意力练习的定制模块(COGNI-TRAcK2)进行训练。ST的主要特点是实施工作负荷算法和强度调节程序。ST对注意力的有效性主要通过符号数字模态测试(SDMT)进行评估,采用Wilcoxon符号秩检验。次要目标包括对其他认知测试的有效性。评估在基线、训练结束时和3个月随访时进行。

结果

纳入22例复发缓解型患者:可获得n-ST组8例受试者和ST组5例受试者的数据。关于主要结局,ST组的SDMT评分有所改善(从基线时的31.2提高到3个月后的42.4,p = 0.043)。在其他神经心理学测量中未发现益处。

结论

这些初步研究结果表明,针对POMS患者的基于家庭的计算机辅助注意力训练可能有益。

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