Clinical Trials Poster Presentation

P0188 - A Tablet-Based Cognitive Battery to Assess Cognitive Function in People with MS: Sensitivity to Change in A Randomized Controlled Trial (ID 270)

Speakers
  • W. Hsu
Authors
  • W. Hsu
  • W. Rowles
  • J. Anguera
  • A. Anderson
  • A. Gazzaley
  • R. Bove
Presentation Number
P0188
Presentation Topic
Clinical Trials

Abstract

Background

Cognitive impairment (CI) is one of the most debilitating manifestations of multiple sclerosis (MS), and digital tools provide promising approaches to overcoming barriers to access to cognitive remediation. Developing reliable, unsupervised tools is an unmet need.

Objectives

To determine the validity and efficacy of a novel digital tool to both query cognitive impairment in MS and capture sensitivity to change after cognitive remediation.

Methods

Fifty-three participants with MS (24 with CI and 29 without CI) and 24 non-MS participants were assessed with a tablet-based cognitive battery (Adaptive Cognitive Evaluation, ACE) and standard cognitive measures: Symbol Digit Modalities Test (SDMT) and the Paced Auditory Serial Addition Test (PASAT). Associations between performance in ACE and SDMT/PASAT were explored, with group comparisons to assess if ACE modules can capture group-level differences. All 53 MS participants were then randomized to complete either a tablet-based, closed-loop digital therapeutic delivered through a video game-like interface (AKL-T03, N=27) or a control game (AKL-T09, N=26) at home for 25 minutes a day, 5 days a week, for 6 weeks. ACE assessment was repeated post-treatment. The primary outcome was performance on an attention task of ACE.

Results

Correlations between performance in SDMT/PASAT and ACE were observed (SDMT vs. ACE: R=-0.57, p<0.001; PASAT vs. ACE: R=-0.39, p=0.005). Compared to non-MS and non-CI MS participants, CI MS participants showed a slower reaction time (p=0.001) and a higher attention cost (p=0.001). Unlike the active control program, the AKL-T03 treatment program significantly improved attention task performance in MS by showing a reduced reaction time from pre- to post-treatment (p<0.001).

Conclusions

These results suggest that ACE, an adaptive, tablet-based cognitive battery, could provide reliable unsupervised cognitive assessment for people with MS. They also support our prior findings that AKL-T03 is an effective home-based cognitive remediation program for MS.

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