Objective:Cognitive impairment is observed in up to two-thirds of persons with Multiple Sclerosis (MS). Impairments in cognitive processing speed (PS) is the most prevalent cognitive disturbance, occurs early in the course of disease and is strongly associated with disease progression, various brain parameters and everyday life functional activities. As such, cognitive rehabilitation for PS impairments should be an integral part of MS treatment and management. The current study examines the efficacy of Speed of Processing Training (SOPT) to improve processing speed (PS) in individuals with Multiple Sclerosis (MS). SOPT was chosen because of its significant positive results in the aging populations.Participants and Methods:This double-blind, placebo-controlled randomized clinical trial included 84 participants with clinically definite MS and impaired PS, 43 in the treatment group and 41 in the placebo control group. Outcomes included changes in the Useful Field of View (UFOV) and neuropsychological evaluation (NPE) including measure of PS (e.g., Pattern Comparison and Letter Comparison). Participants completed a baseline NPE and a repeat NPE post-treatment. Treatment consisted of 10 sessions delivered twice per week for 5 weeks. After the 5 weeks, the treatment group was randomized to booster sessions or no contact. Long-term follow-up assessments were completed 6 months after completion of treatment. The primary outcome were tests of PS including UFOV and neuropsychological testing.Results:A significant effect of SOPT was observed on both the UFOV (large effect) and Pattern Comparison with a similar pattern of results noted on Letter Comparison, albeit at a trend level. The treatment effect was maintained 6-months later. The impact of booster sessions was not significant. Correlations between degree of improvement on the UFOV and the number of levels completed within each training task were significant for both Speed and Divided Attention indicating that completion of more levels of training correlated with greater benefit.Conclusions:SOPT is effective for treating PS deficits in MS with benefit documented on both the UFOV and a neuropsychological measure of PS. Less benefit was observed as the outcome measures became more distinct in cognitive demands from the treatment. Long-term maintenance was observed. The number of training levels completed within the 10-sessions exerted a significant impact on treatment benefit, with more levels completed resulting in greater benefit.

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2 多发性硬化症患者的认知处理速度训练

目的：多达三分之二的多发性硬化症 (MS) 患者存在认知障碍。认知处理速度（PS）受损是最普遍的认知障碍，发生在病程早期，与疾病进展、各种大脑参数和日常生活功能活动密切相关。因此，PS 损伤的认知康复应该是 MS 治疗和管理的一个组成部分。当前的研究检验了处理速度训练 (SOPT) 对提高多发性硬化症 (MS) 患者处理速度 (PS) 的功效。选择 SOPT 是因为它在老龄化人群中具有显着的积极效果。 参与者和方法：这项双盲、安慰剂对照随机临床试验包括 84 名患有临床明确 MS 和 PS 受损的参与者，其中 43 名属于治疗组，41 名属于安慰剂控制组。结果包括有用视野 (UFOV) 和神经心理学评估 (NPE) 的变化，包括 PS 测量（例如，模式比较和字母比较）。参与者完成了基线 NPE 和重复 NPE 治疗后。治疗包括 10 个疗程，每周两次，持续 5 周。5周后，治疗组被随机分配至加强疗程或不接触。治疗完成后6个月完成长期随访评估。主要结果是 PS 测试，包括 UFOV 和神经心理学测试。结果：在 UFOV（大效应）和模式比较上观察到 SOPT 的显着效果，与字母比较中指出的结果模式类似，尽管处于趋势水平。6个月后治疗效果仍维持。加强会议的影响并不显着。UFOV 的改善程度与每项训练任务中完成的级别数量之间的相关性对于速度和分散注意力均显着，表明完成更多级别的训练与更大的益处相关。结论：SOPT 可有效治疗 MS 的 PS 缺陷UFOV 和 PS 神经心理学测量均记录了其益处。随着治疗结果指标在认知需求方面变得更加明显，观察到的益处较少。观察长期维护。10 个疗程内完成的训练级别数量对治疗效果产生重大影响，完成的级别越多，效果越大。