Multiple sclerosis (MS) is an autoimmune disease that causes cognitive and motor disabilities and contributes to decrease patients life quality. Previous results described that there are some MS patients that showed (at least in some phases of the disease) neuroplasticity processes that are able to compensate some cognitive deficits. Moreover, neuroplasticity processes seem to be limited and related to the degree of gray matter atrophy (patients with less atrophy show grater neuroplasticity than those with higher atrophy level). The aims of this project are: 1. to study behavioral changes (post-training) induced by two different rehabilitation programs: a)cognitive training focused on exclusively enhancing working memory and b) aerobic + cognitive training aimed to enhance attention, working memory processes and motor capabilities using a virtual reality game. 2. to study neuroplasticity changes (post-training functional connectivity changes) induced by these rehabilitation programs 3. to observe the role of the atrophy in brain neuroplasticity processes. Neuropathological status and neuroplasticity processes (studied using neuroimaging tools) as well as cognitive performance using neuropsychological tools will be assessed in a group of MS patients (with different phenotypes) at two different time points: before any training (S1) and after 10 days of training (S2). This project will be financed by the Ministerio de ciencia, innovación y universidades of the Spanish government and also have been approved by the Ethical committee of Universitat Jaume I.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
94
N-back task mainly trains working memory and information processing speed. This training lasts 10 days (1 hour per day).
Virtual Reality "Ball Task" mainly trains inhibitory control, attention, working memory and motor functions. This training lasts 10 days (30 minutes per day)
Universitat Jaume I (ImagoBrain Research Group)
Castellon, Castellón, Spain
Change from baseline in Correct Responses
Number of correct responses in both tasks (n-back computerized task and balls Virtual Reality task)
Time frame: Baseline and 10 training days after.
Change from baseline in Reaction Time
This is a primary outcome of the n-back task, which refers to the amount of time (in milliseconds) that elapse from the moment the correct stimulus appears and the correct response is given.
Time frame: Baseline and 10 training days after.
Change from baseline in Omissions
In both tasks will be assessed the number of times that a correct stimulus appear and non-response is given.
Time frame: Baseline and 10 training days after.
Change from baseline in Errors
The number of times that a distractor stimulus appears and a response is given.
Time frame: Baseline and 10 training days after.
Change from baseline in Functional Connectivity in resting state
This is a brain activity measure during resting state through functional magnetic resonance imaging. This outcome will be assessed in both studies. fMRI sequence: T2-weighted echoplanar imaging sequence.
Time frame: Baseline and 10 training days after.
Change from baseline in Functional Connectivity in task performance
This is a brain activity measure during a task performance through functional magnetic resonance imaging. This outcome will be assessed in Virtual Reality study. fMRI sequence: T2-weighted echoplanar imaging sequence.
Time frame: Baseline and 10 training days after.
Change from baseline in SRT-S: Selective Reminding Test (Storing)
A subtest of the BRB-N (The Brief Repeatable Battery of Neuropsychological Tests for MS) which measures memory storage capacity.
Time frame: Baseline and 10 training days after.
Change from baseline in SRT-R: Selective Reminding Test (Retrieval)
This subtest of the BRB-N is a measure of memory retrieval capacity.
Time frame: Baseline and 10 training days after.
Change from baseline in SRT-D: Selective Reminding Test (Delayed)
This BRB-N subtest measures the delayed memory.
Time frame: Baseline and 10 training days after.
Change from baseline in SPART: Spatial Recall Test
A subtest of the BRB-N that measures spatial memory.
Time frame: Baseline and 10 training days after.
Change from baseline in SPART-D: Spatial Recall Test (Delayed)
This BRB-N subtest measures the spatial delayed memory.
Time frame: Baseline and 10 training days after.
Change from baseline in SDMT: Symbol Digit Modalities Test
A BRB-N subtest which measures information processing speed.
Time frame: Baseline and 10 training days after.
Change from baseline in PASAT: Paced Auditory Serial Addition Task
A BRB-N subtest which measures working memory.
Time frame: Baseline and 10 training days after.
Change from baseline in Phonemic Fluency
A language measure that assesses phonemic fluency.
Time frame: Baseline and 10 training days after.
Change from baseline in Semantic Fluency
A language measure that assesses semantic fluency.
Time frame: Baseline and 10 training days after.
Change from baseline in Digit Span Forward
A subtest of the Wechsler Adult Intelligence Scale (WAIS-III) that is an attention measure.
Time frame: Baseline and 10 training days after.
Change from baseline in Digit Span Backward
A WAIS-III subtest that is a working memory measure.
Time frame: Baseline and 10 training days after.
Change from baseline in Letters and Numbers
A WAIS-III subtest that measures working memory.
Time frame: Baseline and 10 training days after.
Total Intracranial Volume (TIV)
A measure of brain volumetry. MRI sequence: structural T1-weighted MPRAGE sequence.
Time frame: Baseline
Brain Parenchymal Fraction (BPF)
MRI sequence: structural T1-weighted MPRAGE sequence.
Time frame: Baseline
Lesion Volume in white matter tissue
A brain damage volumetry measure. MRI sequence: structural T1-weighted MPRAGE sequence and T2-FLAIR sequence
Time frame: Baseline
Cortical Lesions
Number of brain cortical lesions. MRI Sequence: inversion recovery MRI pulse sequence (DIR).
Time frame: Baseline
Cortical Thickness
Brain cortical thickness measure. MRI sequence: structural T1-weighted MPRAGE sequence.
Time frame: Baseline
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