Cognitive training in Multiple Sclerosis: behavioural and neuroimaging evidence from a restorative working memory training.

Abstract

People with Multiple Sclerosis (PwMS) often experience cognitive impairment, particularly affecting working memory (WM) and information processing speed (IPS). This thesis aimed to evaluate the effects of an intensive WM training program in PwMS and identify clinical and neurobiological predictors of its efficacy. Thirty-five PwMS completed a 10-day n-back training and underwent neuropsychological and neuroimaging assessments before and after the intervention. Results showed significant improvements in both the trained task and untrained WM/IPS tasks, indicating near transfer effects. Thalamic volume and baseline WM/IPS performance had a direct influence on training outcomes, with the latter mediating the impact of other variables. Resting-state functional connectivity of the default mode network (rsFC-DMN) emerged as the most robust predictor. Overall, the training proved effective in PwMS, and both structural and cognitive integrity, along with baseline rsFC-DMN, predicted the extent of the benefits. This project underscores the relevance of timely cognitive rehabilitation.