@article{bc703a0d92654e6388c68a0d0df896d7,
title = "A randomized trial predicting response to cognitive rehabilitation in multiple sclerosis: Is there a window of opportunity?",
abstract = "{\textcopyright} The Author(s), 2022.Background: Cognitive training elicits mild-to-moderate improvements in cognitive functioning in people with multiple sclerosis (PwMS), although response heterogeneity limits overall effectiveness. Objective: To identify patient characteristics associated with response and non-response to cognitive training. Methods: Eighty-two PwMS were randomized into a 7-week attention training (n = 58, age = 48.4 ± 10.2 years) or a waiting-list control group (n = 24, age = 48.5 ± 9.4 years). Structural and functional magnetic resonance imaging (MRI) was obtained at baseline and post-intervention. Twenty-one healthy controls (HCs, age = 50.27 ± 10.15 years) were included at baseline. Responders were defined with a reliable change index of 1.64 on at least 2/6 cognitive domains. General linear models and logistic regression were applied. Results: Responders (n = 36) and non-responders (n = 22) did not differ on demographics, clinical variables and baseline cognition and structural MRI. However, non-responders exhibited a higher baseline functional connectivity (FC) between the default-mode network (DMN) and the ventral attention network (VAN), compared with responders (p = 0.018) and HCs (p = 0.001). Conversely, responders exhibited no significant baseline differences in FC compared with HCs. Response to cognitive training was predicted by lower DMN-VAN FC (p = 0.004) and DMN-frontoparietal FC (p = 0.029) (Nagelkerke R2 = 0.25). Conclusion: An intact pre-intervention FC is associated with cognitive training responsivity in pwMS, suggesting a window of opportunity for successful cognitive interventions.",
keywords = "Functional MRI, multiple sclerosis, quantitative MRI, rehabilitation, resting-state, treatment response",
author = "S.E. Prouskas and M.M. Schoonheim and M. Huiskamp and M.D. Steenwijk and K. Gehring and F. Barkhof and {de Jong}, B.A. and M.M. Sitskoorn and J.J.G. Geurts and H.E. Hulst",
note = "Funding Information: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: M.M.S. serves on the editorial board of Frontiers in Neurology, receives research support from the Dutch MS Research Foundation and has served as a consultant for or received research support from Biogen, Celgene, Genzyme, MedDay and Merck. F.B. is a steering committee member and iDMC member for Biogen, Merck, Roche and EISAI; consultant for Roche, Biogen, Merck, IXICO, Jansen and Combinostics; has research agreements with Novartis, Merck, Biogen, GE and Roche; is the co-founder and shareholder of Queen Square Analytics LTD and is supported by the NIHR biomedical research centre at UCLH. B.A.d.J. has received speaker and consulting fees from Merck-Serono, Biogen, TEVA, Genzyme and Novartis. J.J.G.G. is an editor of Multiple Sclerosis Journal. He serves on the editorial boards of Neurology and Frontiers in Neurology and is the president of the Netherlands Organization for Health Research And Innovation. He has served as a consultant for or received research support from Biogen, Celgene, Genzyme, MedDay, Merck, Novartis and Teva. H.E.H. serves on the editorial board of Multiple Sclerosis Journal, receives research support from the Dutch MS Research Foundation and has served as a consultant for or received research support from Biogen, Celgene, Genzyme, MedDay, Merck and Novartis. The remaining authors have no conflicts to declare. Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by the Dutch MS Research foundation (grant no. 12-799 MS). Funding Information: The authors thank Heleen Geubels, Quinten van Geest, Benthe Westerik, Denise Visser, Marike van Lingen, Noor Braaksma, Matthijs Keijzer, Wietske Babeliowsky, Julia Jelgerhuis, Lieke van Dongen, Hannah de Bruin, Rosanne Heijstek and Eileen Stalman for their extensive assistance with neuropsychological testing, and MRI scanning. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by the Dutch MS Research foundation (grant no. 12-799 MS). Publisher Copyright: {\textcopyright} The Author(s), 2022.",
year = "2022",
month = nov,
day = "1",
doi = "https://doi.org/10.1177/13524585221103134",
language = "English",
volume = "28",
pages = "2124--2136",
journal = "MULTIPLE SCLEROSIS JOURNAL",
issn = "1352-4585",
publisher = "SAGE Publications Ltd",
number = "13",
}