Memory Impairment Clinical Trial
Official title:
Treating New Learning and Memory Deficits in Progressive Multiple Sclerosis (MS)
This study is a double-blind placebo-controlled randomized clinical trial (RCT) to provide Class I evidence in support of or in refute of the efficacy of the modified Story Memory Technique (mSMT) in persons with progressive MS, with outcome measured through three mechanisms: (1) a traditional neuropsychological evaluation (NPE) (2) an assessment of global functioning (AGF) examining the impact of the treatment on daily activities, and (3) an optional functional magnetic resonance imaging (fMRI) scan.
There is a clear unmet need in the clinical care of persons with Progressive MS - there are
no treatments for memory dysfunction with demonstrated efficacy in persons with progressive
disease. This is despite the fact that cognitive impairment is a major contributor to
unemployment and decreased functional status in MS and memory deficits are a major source of
such disability. The investigator recent RCT's demonstrated the modified Story Memory
Technique (mSMT) to be effective for improving new learning and memory in individuals with
MS, demonstrating efficacy across three realms of functioning, objective behavior, brain
functioning and everyday life. This convincing data provides Class I evidence supporting the
efficacy of the mSMT for improving new learning and memory in MS. However, treatment efficacy
was not adequately tested in the progressive MS population. This is a major limitation due to
the fact that progressive MS carries with it major cognitive difficulties, of which learning
and memory are one of the most common. The currently proposed RCT will address this
limitation. The investigators will use methodologically vigorous research design to provide
Class I evidence in support of or in refute of the efficacy of the mSMT in persons with
progressive MS, with outcome measured through three mechanisms: (1) a traditional
neuropsychological evaluation (NPE) (2) an assessment of global functioning (AGF) examining
the impact of the treatment on daily activities and (3) an optional functional magnetic
resonance imaging (fMRI) scan. Both groups will undergo baseline, immediate follow-up, and
3-month follow-up assessments
Thus, the current study will objectively evaluate the clinical utility of the mSMT to improve
new learning and memory in individuals with progressive MS with documented deficits in this
area. This protocol has been previously utilized in a Relapsing-Remitting MS sample, yielding
exceptional outcome data. Pilot data in a small sample of progressive MS patients is
promising. The investigators will also increase the generalizability and real life
application of assessment techniques by assessing outcome following cognitive retraining with
more global measures of everyday life. Finally, the long-term efficacy of the mSMT will be
evaluated in progressive MS through the inclusion of a 3-month follow-up assessment. Given
the absence of any treatment for impaired learning and memory in progressive patients, the
results of the present RCT will have a significant impact on symptom management and quality
of life for persons with Progressive MS.
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