Multiple Sclerosis
Conditions
Keywords
Cognition, Multiple Sclerosis, Cognitive Rehabilitation, Cognitive Reserve, Cognitive Leisure Activities, Leisure Activities, Intellectual Enrichment, Relapsing-remitting multiple sclerosis, Secondary progressive multiple sclerosis, Progressive multiple sclerosis
Brief summary
The study is a crossover randomized controlled trial investigating the effect of increasing engagement in cognitive leisure activities for individuals with multiple sclerosis.
Detailed description
The study is a crossover randomized controlled trial investigating the impact of cognitive leisure activities on the cognitive functioning of individuals with multiple sclerosis (MS). The goal is to investigate whether increasing leisure activities may help prevent cognitive impairment in individuals with MS. The trial consists of two studies. The first is a randomized controlled trial examining the effects of increasing engagement in cognitive leisure activities. The second is a qualitative interview-based study to identify factors that may improve adherence and acceptance of the intervention. The study employs a randomized, controlled crossover design, with 60 participants (30 with relapsing-remitting MS, 30 with progressive MS) assigned to either an intervention group or a passive control group for 12 weeks. After the initial 12 weeks the groups are crossed over and followed up after an additional 12 weeks. The intervention group will receive instruction and support to engage in cognitive leisure activities, while the control group will continue with their usual daily activities. For a detailed description of the project, the full protocol can be found at: https://dmsc.dk/onewebmedia/CRAMS%20research%20protocol.pdf
Interventions
BEHAVIORALCognitive Leisure Activities
Participants in the active phase of the study will be asked to increase engagement in certain cognitive leisure activities. The activities are chosen on the basis of previous research and measures of cognitive reserve-building activities.
Sponsors
University of Copenhagen
Rigshospitalet, Denmark
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
Outcome assessors will be blinded as to the participant's assigned intervention.
Intervention model description
The study will use a randomized, controlled crossover design to investigate the impact of cognitive leisure activities on cognitive function in individuals with multiple sclerosis (MS). 60 participants with RRMS or progressive MS (30 RRMS, 30 PPMS/SPMS) will be randomly assigned to either an intervention group (Group A) or a passive control group (Group B) for 12 weeks. Participants will be randomized using a computer-based random number generator in blocks of 6 based on MS subtype (RRMS/progressive MS). After the initial 12 weeks, the groups will be crossed over and followed for an additional 12 weeks. The passive control group will also receive an additional follow-up after 36 weeks. The total time from enrollment to last follow-up will be 24 weeks for Group A and 36 weeks for Group B.
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* RRMS, SPMS or PPMS * Age 18-65 * EDSS score ≤ 6.5 * SDMT (or PASAT) score below -1 SD * No depression based on the MDI * Able to use computer or smartphone and has internet access * If in treatment with one or more of the following medications, the dosage must be stable: * Cannabinoids * Anticholinergic medications * Sedatives e.g., benzodiazepines * Opioids * Antispasmodics * Beta-blockers * Antidepressant medication * Fampridine
Exclusion criteria
* Planned start-up or discontinuation of one or more of the above-mentioned medications * Structural brain changes following previous head trauma or neurological conditions other than which lead to structural changes or affect cognitive abilities * Epilepsy * Significant psychiatric co-morbidity * Significant somatic co-morbidity including, but not limited to, severe cardiovascular disease as well as liver, kidney, and endocrine diseases * Relapse 3 months prior to inclusion
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in score on the Symbol Digit Modality Test (SDMT) | Baseline, week 12, week 24 | An objective measure of cognitive efficiency |
| Change in score on the Multiple Sclerosis Neuropsychological Questionnaire (MSNQ) | Baseline, week 12, week 24 | A subjective measure of cognitive symptoms for patients with MS |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in score on the Word Fluency Test (phonological) | Baseline, week 12, week 24 | A test of executive functioning and verbal fluency |
| Change in score on the California Verbal Learning Test II (CVLT II) | Baseline, week 12, week 24 | A test of verbal memory |
| Change in score on the Cognitive Leisure and Activity Scale (CLAS) | Baseline, week 12, week 24, week 36 | A questionnaire assessing the participant's degree of participation in cognitive leisure activities. The scale consists of 16 items (leisure activities) on which participants rate their activity level on a scale from 0-5, with 0 indicating no participation and 5 indicating daily participation in the activity. Scores are summed, yielding a total score ranging from 0 - 80 with lower scores indicating less participation in cognitive leisure activities and higher scores indicating a higher degree of participation. |
| Change in score on the Five-point Test | Baseline, week 12, week 24 | A test of executive functioning |
| Change in score on the Brief Visuospatial Memory Test Revised (BVMT-R) | Baseline, week 12, week 24 | A test of visuospatial memory |
Countries
Denmark
Outcome results
None listed