Summary: A substudy of the MS Canada-funded clinical trial to improve cognition in people with progressive MS (CogEx) showed that cognitive rehabilitation was associated with increased grey matter volume and the activation of brain regions involved in cognitive function and information processing. These beneficial changes in the brain may have contributed to the cognitive improvements seen among people with progressive MS in the CogEx trial.
Background: The CogEx clinical trial led by Dr. Anthony Feinstein (University of Toronto / Sunnybrook Health Sciences Centre) found that cognition, particularly information processing speed, was improved in people with progressive MS regardless of the type of intervention they received*: 1) Cognitive rehabilitation plus sham exercise, 2) Aerobic exercise plus sham cognitive task, 3) Cognitive rehabilitation and Aerobic exercise (combined intervention), 4) Sham cognitive task and sham exercise (see CogEx study results). More research is needed to identify specific factors that could improve cognition in progressive MS.
Details: In this substudy, the researchers used magnetic resonance imaging (MRI) to examine structural or functional changes in the brain of people with progressive MS following the 12-week intervention. MRI scans were acquired from a total of 84 participants across four CogEx study sites before the intervention started, at the end of the intervention, and 6 months after the intervention.
Results: The study showed that participants who received cognitive rehabilitation, with or without aerobic exercise, had increases in grey matter volume particularly in regions of the brain that control cognitive function. These participants also showed increased activation of a brain region called the ‘insula’, which is involved in attention and information processing.
Impact: The findings of this study suggest that cognitive rehabilitation is associated with beneficial changes to regions of the brain that are important for proper cognitive functioning. These results may explain the cognitive improvements among people with progressive MS in the CogEx trial.
*Description of treatments/interventions:
- Cognitive rehabilitation intervention was individualized, computer-based, incremental approach to improve processing speed (i.e. RehaCom program).
- Exercise intervention was individualized aerobic training using a recumbent arm–leg stepper.
- Sham cognitive task consisted of internet training provided individually.
- Sham exercise consisted of stretching and balance tasks without inducing cardiovascular strain.
Reference:
Article published in Neurology on April 9, 2024 – Effects of Cognitive Rehabilitation on Brain Grey Matter Volume and Go-noGo Activity in Progressive Multiple Sclerosis: Results from the CogEx Study. Link to article – here.
Additional Information:
• Learn more about the CogEx study – here.
• See primary results of the CogEx study – here.
This study was funded by MS Canada by way of a generous philanthropic investment by the FDC Foundation.