Intellectual Enrichment to Build Cognitive Reserve in MS

Cognitive problems are a primary concern for people with multiple sclerosis. In many cases,
people with MS report these issues to be more debilitating than the motor symptoms that are
targeted by most treatment strategies. For people with MS, impaired memory and thinking
skills can interfere with the ability to function efficiently in multiple professional and
personal roles. Finding ways to decrease, slow, or reverse declines in memory and thinking
skills is a vitally important research priority. We now know that engaging in intellectually
enriching activities helps protect against the negative impact of MS disease-related
declines in memory and thinking. Such activities contribute to something called 'cognitive
reserve,' which serves as a protection against disease-related declines in memory and
thinking. Thus far, no one has created a treatment that aims to provide a concentrated
'dose' of intellectual enrichment to build cognitive reserve. The present intervention aims
to do precisely this. Here, we have developed a program of enriching activities that are
delivered via a personal iPad. This allows for a 12-week 'treatment' that is entirely
home-based, while also providing close personal contact between participants and our study
personnel, who will communicate daily via emails. Week by week, participants choose from a
menu of intellectually enriching activities such that their treatment is dynamic and
customizable to fit their interests. The intervention is designed to be fun, as we hope the
activities will be incorporated into people's lives beyond the period of the study itself.
Given what we already know about the striking benefits of cognitive reserve to protect
against disease-related declines in cognitive functioning, we expect to show that treatment
with a daily, intense, intellectually enriching schedule of activities results in improved
thinking and memory for people with MS. We will also investigate the positive impact of our
treatment on the brains of people with MS through brain scans. We expect to see evidence for
a shift toward more efficient processing in the brain, changes that translate to improved
memory and thinking skills.