Factors Associated With Response to Cognitive Rehabilitation in Progressive MS: Cecilia Meza, MA

WATCH TIME: 3 minutes | Captions are auto-generated and may contain errors.

"Knowing that cognitive reserve and cognitive capacity predict improvement, perhaps this type of cognitive rehabilitation should be allocated to those who have the most to gain from it."

A secondary analysis of the international CogEx trial (NCT03679468) evaluated computerized cognitive rehabilitation (CCR) in 153 individuals with progressive multiple sclerosis (MS) across 11 centers in Canada, the United States, England, Denmark, Italy, and Belgium. In the study, participants completed a 12-week intervention using RehaCom, a computerized cognitive training platform featuring 5 attention-based modules. Cognitive outcomes were assessed at baseline, week 12, and 6-month follow-up using the Brief International Cognitive Assessment for MS (BICAMS), with processing speed measured by the Symbol Digit Modalities Test (SDMT) serving as the primary endpoint.

The RehaCom intervention consisted of 5 computerized training modules focused on attention-related cognitive functions commonly affected in MS. Through progressively challenging exercises, the program targeted skills such as sustained attention, concentration, vigilance, and divided attention, with participants advancing through increasing levels of difficulty over the 12-week treatment period. Investigators assessed module progression based on the percentage of maximum difficulty attained, allowing them to examine whether improvement within specific training domains was associated with cognitive outcomes.

Findings from this secondary analysis, presented at the 2026 Consortium of Multiple Sclerosis Centers (CMSC) annual meeting, held May 27-29 in Charlotte, demonstrated that progression within several RehaCom training modules was associated with improvements in processing speed. Led by Cecilia Meza, MA, a clinical research coordinator at Sunnybrook Health Sciences Centre and St. Michael's Hospital in Toronto, the analysis also showed that baseline patient characteristics influenced treatment response and the durability of cognitive gains. During the meeting, NeurologyLive sat down with Meza to gain further insight into the findings.

In the interview, Meza explained that not all components of the CCR training program contributed equally to cognitive improvement, with attention, concentration, and divided attention exercises emerging as the strongest drivers of meaningful gains. In addition, Meza outlined the patient characteristics associated with the greatest benefit and long-term retention of cognitive improvements, including higher baseline cognitive performance, greater cognitive reserve, older age, and female sex. The conversation further examined how these results support a more personalized approach to cognitive rehabilitation and may help clinicians identify which patients are most likely to benefit from targeted cognitive training interventions.

For more CMSC coverage, click here!