The effects of video-game training on broad cognitive transfer in multiple sclerosis: A pilot randomized controlled trial

Abstract

Background: Multiple sclerosis (MS) is a neurodegenerative disease of the central nervous system that results in diffuse nerve damage and associated physical and cognitive impairments. Of the few comprehensive rehabilitation options that exist for populations with lower baseline cognitive functioning, those that have been successful at eliciting broad cognitive improvements have focused on a multimodal training approach, emphasizing complex cognitive processing that utilizes multiple domains simultaneously. Method: The current study sought to determine the feasibility of an 8-week, hybrid-variable priority training (HVT) program, with a secondary aim to assess the success of this training paradigm at eliciting broad cognitive transfer effects. Capitalizing on the multimodal training modalities offered by the Space Fortress platform, we compared the HVT strategy-based intervention with a waitlist control group, to primarily assess skill acquisition and secondarily determine presence of cognitive transfer. Twenty-eight participants met inclusionary criteria for the study and were randomized to either training or waitlist control groups. To assess broad transfer effects, a battery of neuropsychological tests was administered pre- and post-intervention. Results: The results indicated an overall improvement in skill acquisition and evidence for the feasibility of the intervention, but a lack of broad transfer to tasks of cognitive functioning. Participants in the training group, however, did show improvements on a measure of spatial short-term memory. Conclusions: The current investigation provided support for the feasibility of a multimodal training approach, using the HVT strategy, within the MS population, but lacked broad transfer to multiple domains of cognitive functioning. Future improvements to obtain greater cognitive transfer efficacy would include a larger sample size, a longer course of training to evoke greater game score improvement, the inclusion of only cognitively impaired individuals, and integration of subjective measures of improvement in addition to objective tests of cognitive performance.

Keywords:

• Multiple sclerosis
• Cognitive training
• Space Fortress
• Randomized control trial
• Skill acquisition

We would like to thank the members of the Clinical Neuroscience Laboratory for their tireless efforts towards the collection, organization, and analysis of these data. Those individuals involved include Frank Dossman, Danielle Rickert, Kimberley Rolley, Basam Rashwan, Angeline De Leon, Brian Shannon, Sarah Murtha, Matt Grover, Aishwarya Balasubramaniyan, Allison Londeree, and Taylor Wong. We would also like to thank the members of the department that contributed to the research design and analysis of this project, Charles Emery and Dirk Bernhardt-Walther.