Visual-Attentional Load Unveils Slowed Processing Speed in Multiple Sclerosis Patients: A Pilot Study with a Tablet-Based Videogame

Abstract

Slowing in information processing speed (IPS) is the key cognitive deficit in multiple sclerosis (MS). Testing IPS in different cognitive load conditions by using computerized tools might reveal initial IPS slowness underestimated by classic paper-and-pencil tests. To investigate the extent to which IPS can be affected by increased task demands, we developed three tasks based on the manipulation of the visual-attentional load, delivered with a home-made, tablet-based videogame. Fifty-one patients with MS (pwMS), classified as having no cognitive impairment in classic paper-and-pencil tests, and 20 healthy controls (HC) underwent the videogame tasks; reaction times (RTs) and accuracy were recorded. A significant reduced performance of pwMS as compared with HC was found on the videogame tasks, with pwMS being on average slower and less accurate than HC. Furthermore, pwMS showed a significantly more pronounced decrement in accuracy as a function of the visual-attentional load, suggesting a higher susceptibility to increased task demands. Significant correlations among the Symbol Digit Modalities Test (SDMT) and the videogame mean RTs and accuracy were found, providing evidence for the concurrent validity of the videogame as a valid tool to test IPS in pwMS. The high potential that might derive from the adoption of computerized assessment tools in clinical practice should be taken into consideration and investigated further.

Cognitive Decline Detection for Alzheimer’s Disease Patients Through an Activity of Daily Living (ADL)

“…The results highlighted a strong positive and significant association with respect to the MEC-35 scale (Spearman rho=0.71) according to Cohen [24]. This results aligns with other works, like the study of Pitteri et al [14], who also found significant correlations between the SDMT and the accuracy response of their task, thus verifying its validity as a diagnostic tool. Similarly, Kalafatis et al [16] demonstrated a convergent validity with the MOCA test (Pearson r = 0.58) and the ACE test (Pearson r = 0.62), respectively.…”

“…Other studies have used classical tests as the basis for the design of new proposals to be compared. Pitteri et al [14] presented a video game that sought to identify whether there was a cognitive impairment in the information processing speed (IPS). The results revealed that those patients with multiple sclerosis (MP) showed a lower performance compared to healthy ones.…”

Video game therapy on mobility and dual tasking in multiple sclerosis: study protocol for a randomised controlled trial

“…23 The evidence of interactive video game therapeutic exercises for improving balance and motor functions in PwMS were inconclusive, even if few studies showed a possible positive effect on balance and cognitive functions such as processing speed. [24][25][26][27] Furthermore, patients' motivation seems to be capable of being increased during active video game rehabilitation, allowing patients to exercise more consistently. 22 All previous studies did not investigate the effects on motor and cognitive functions simultaneously, particularly when compared with conventional instrumental balance training.…”