Looking Beyond Dose: Identifying Responders and Non-Responders to RehaCom Computerized Cognitive Rehabilitation in...

Area of Science:

• Neurorehabilitation
• Cognitive Science
• Clinical Neurology

Background:

• Computerized cognitive rehabilitation programs like RehaCom are used for multiple sclerosis (MS).
• Previous research focused on treatment duration and adherence, not specific modules or predictors of response.
• This study examines module progression and participant characteristics influencing cognitive improvement in progressive MS.

Purpose of the Study:

• To investigate the association between progression in specific RehaCom modules and processing speed improvement in people with MS.
• To identify baseline participant characteristics that predict responsiveness to cognitive rehabilitation.
• To support a precision approach in cognitive rehabilitation for progressive MS.

Main Methods:

• A secondary analysis of the CogEx trial involving 153 participants with progressive MS.
• 12 weeks of RehaCom training across 5 attention-based modules.
• Cognitive function assessed using the Symbol Digit Modalities Test (SDMT) at baseline, 12 weeks, and 6 months.

Main Results:

• Progression in 4 RehaCom modules significantly correlated with SDMT improvement, particularly Attention/Concentration and Divided Attention-2.
• Higher baseline SDMT, premorbid IQ, older age, and greater module progression predicted better 12-week SDMT performance.
• At 6 months, baseline SDMT, specific module progression, older age, and female sex predicted better SDMT performance.

Conclusions:

• Processing speed improvements in progressive MS are linked to both specific training module progress and individual participant characteristics.
• Findings support tailoring cognitive rehabilitation content to individual cognitive profiles for enhanced outcomes.
• This research emphasizes a precision medicine approach for cognitive rehabilitation in MS.