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Cognitive rehabilitation of working memory in juvenile multiple sclerosis-effects on cognitive functioning, functional MRI and network related connectivity.

Cognitive rehabilitation of working memory in juvenile multiple sclerosis-effects on cognitive functioning, functional MRI and network related connectivity.
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Hubacher M, DeLuca J, Weber P, Steinlin M, Kappos L, Opwis K, Penner IK,


Hubacher M, DeLuca J, Weber P, Steinlin M, Kappos L, Opwis K, Penner IK, (click to view)

Hubacher M, DeLuca J, Weber P, Steinlin M, Kappos L, Opwis K, Penner IK,

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Restorative neurology and neuroscience 33(5) 713-25 doi 10.3233/RNN-150497

Abstract
PURPOSE
To assess possible effects of working memory (WM) training on cognitive functionality, functional MRI and brain connectivity in patients with juvenile MS.

METHODS
Cognitive status, fMRI and inter-network connectivity were assessed in 5 cases with juvenile MS aged between 12 and 18 years. Afterwards they received a computerized WM training for four weeks. Primary cognitive outcome measures were WM (visual and verbal) and alertness. Activation patterns related to WM were assessed during fMRI using an N-Back task with increasing difficulty. Inter-network connectivity analyses were focused on fronto-parietal (left and right), default-mode (dorsal and ventral) and the anterior salience network. Cognitive functioning, fMRI and inter-network connectivity were reassessed directly after the training and again nine months following training.

RESULTS
Response to treatment was seen in two patients. These patients showed increased performance in WM and alertness after the training. These behavioural changes were accompanied by increased WM network activation and systematic changes in inter-network connectivity. The remaining participants were non-responders to treatment. Effects on cognitive performance were maintained up to nine months after training, whereas effects observed by fMRI disappeared.

CONCLUSIONS
Responders revealed training effects on all applied outcome measures. Disease activity and general intelligence may be factors associated with response to treatment.

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