East Hanover, NJ. January 20, 2019. A recent article by Kessler Foundation researchers demonstrated g people with multiple sclerosis (MS). The article, "Brain activation patterns associated with paragraph learning in persons with multiple sclerosis: The MEMREHAB trial," (doi: 10.1016/j.ijpsycho.2019.09.008 ) was epublished on October 20, 2019 by the International Journal of Psychophysiology. The authors are Olga Boukrina, PhD, Ekaterina Dobryakova, PhD, Veronica Schneider, BA, John DeLuca, PhD, and Nancy Chiaravalloti, PhD, of Kessler Foundation.
Link to abstract: https://www.sciencedirect.com/science/article/abs/pii/S016787601930501X
This study furthers understanding of the findings of prior MEMREHAB studies using the modified Story Memory Technique for memory rehabilitation in the population with multiple sclerosis (MS). Prior studies at Kessler Foundation showed improvement in learning and memory in response to treatment with mSMT in individuals with MS, and associated changes in brain activity on functional magnetic resonance imaging (fMRI) related to working memory and word encoding. Findings suggested that the treatment resulted in effects on cerebral activation and functional connectivity. In this study, brain activation was examined in a subset of 16 participants with MS from the MEMREHAB trial. The participants were randomized to treatment (n=6) or placebo control (n=10) groups, and tested for their ability to remember a paragraph, before and after treatment with mSMT. It was hypothesized that mSMT treatment may produce different brain activation patterns during paragraph encoding in the treatment group compared to the control group.
Participants in the treatment c=group exhibited decreased brain activity in the language network (LAN), default mode network (DMN), and executive control network (ECN). This pattern of reduced activation was associated with marginally significant improvement on the Rivermead Behavioral Memory Test with a large effect size noted between baseline and follow-up performance for the treatment group.
"The decreased brain activation seen in this study may be a sign of more efficient processing after treatment," said Dr. Boukrina, research scientist in the Center for Stroke Rehabilitation Research at Kessler Foundation. "At baseline, individuals with MS often show hyperactivation of cortical areas during cognitive tasks," she explained, "which may be a necessary compensation in order to complete the task like their counterparts without MS. After treatment, the task becomes less demanding for them, and this lower demand may account for the reduction in activation."
This study has important implications for cognitive research in MS. Identifying the regions of the brain associated with improvements in learning and memory may foster investigation into methods that may augment the beneficial activation patterns, such as pharmacological agents or transcranial magnetic stimulation. Combining therapies may be a means of achieving optimal behavioral response in individuals with MS affected by cognitive deficits.
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About MS Research at Kessler Foundation
Kessler Foundation's cognitive rehabilitation research in MS is funded by grants from the National Institutes of Health, the National Institute on Disability, Independent Living, and Rehabilitation Research, National MS Society, Consortium of Multiple Sclerosis Centers, the Patterson Trust, Biogen Idec, Hearst Foundations, the International Progressive MS Alliance, and Kessler Foundation. Under the leadership of John DeLuca, PhD, senior VP for Research & Training, and Nancy Chiaravalloti, PhD, director of the Centers for Neuropsychology, Neuroscience and Traumatic Brain Injury Research, scientists have made important contributions to the knowledge of cognitive decline in MS and developed new treatments. Collaborations with the Center for Mobility and Rehabilitation Engineering Research have resulted in new lines of research aimed at improved both cognitive and motor functions. Clinical studies span new learning, memory, executive function, attention and processing speed, emotional processing, employment, cognitive fatigue, mobility, and the interrelatedness of cognitive and physical deficits. Research tools include innovative applications of neuroimaging, mobile imaging technologies, robotics, eye-tracking, virtual reality, and other technologies. Neuroimaging studies are conducted at the research-dedicated Rocco Ortenzio Neuroimaging Center at Kessler Foundation. Kessler researchers and clinicians have faculty appointments in the department of Physical Medicine and Rehabilitation at Rutgers New Jersey Medical School.
About Kessler Foundation
Kessler Foundation, a major nonprofit organization in the field of disability, is a global leader in rehabilitation research that seeks to improve cognition, mobility and long-term outcomes, including employment, for people with neurological disabilities caused by diseases and injuries of the brain and spinal cord. Kessler Foundation leads the nation in funding innovative programs that expand opportunities for employment for people with disabilities. For more information, visit KesslerFoundation.org.
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Journal
International Journal of Psychophysiology