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NCT Number: NCT03471338

Neuropsychological Management of Multiple Sclerosis: Benefits of a Computerised Semi-autonomous At-home Cognitive Rehabilitation Programme

Multiple sclerosis (MS) is a central nervous system inflammatory disease that causes a chronic and progressive physical handicap. Though primarily considered as a motor disease, it may, in 40 to 65% of cases, cause cognitive function deficits, concerning mainly attention, information processing speed, executive functions and memory. The impairment of these various functions may significantly impair the patients' social, professional and family lives. As such, the presence of cognitive difficulties is more frequently associated with the onset of anxio-depressive psychiatric symptoms and with reduced quality of life to the extent that it can be estimated via psychometric scales, or by a more qualitative approach. Recent research has focused, not on demonstrating the existence of cognitive disorders in MS, but rather on attempting to reduce their daily impact through cognitive rehabilitation programmes. While encouraging, the available results are relatively discordant and further work is required to demonstrate the actual efficacy of such programmes applied to daily life and of their long-term effects.

The main objective of this work is to evaluate, in patients suffering from MS and presenting with cognitive disorders and/or with complaints, the effect of an innovative computerised, semi-autonomous at-home cognitive rehabilitation programme, following care, on quality of life. The secondary objective is to estimate the improvement, or even stabilisation over time, of patients' cognitive performance and psycho-affective sphere.

In this randomised trial, the investigators plan to include 40 patients suffering from the RR and SP forms of MS, distributed to two groups paired by age, gender and socio-cultural level, one of which will benefit from computerised management, along with at-home support from a psychologist, while the other receives only the support.

This work is expected to provide two types of benefits. Firstly, to enable patients to better understand their cognitive function via daily management and as such to improve their quality of life and self-esteem. Secondly, to eventually allow more appropriate patient management by combining the quasi-systematic use of this programme with follow-up consultations with referring practitioners (neurologists, psychologists, etc.).

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Key information

Conditions

Relapsing Remitting Multiple Sclerosis Autoimmune Diseases Autoimmune Diseases of the Nervous System Chronic Disease Demyelinating Autoimmune Diseases, CNS Demyelinating Diseases Disease Attributes Immune System Diseases Multiple Sclerosis Multiple Sclerosis, Chronic Progressive Multiple Sclerosis, Relapsing-Remitting Nervous System Diseases Pathologic Processes Pathological Conditions, Signs and Symptoms Secondary Progressive Multiple Sclerosis

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University Hospital of Caen

Caen, Calvados, 14000, France

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • MS defined according to the McDonald criteria revised in 2010
  • Men and women aged between 18 and 65 years
  • RR and SP forms
  • Duration of progression ≤ 25 years
  • EDSS ≤ 5.5
  • Lack of disease activity as defined by the new Lublin criteria (2013)
  • Cognitive complaint and/or cognitive disorders according to the investigator's judgement
  • Impaired cognitive performance at least 1.65 SD below normative data at one test of the BCcogSEP battery
  • French native language
  • Owner of a laptop computer with Internet access
  • Signing of the informed consent

Exclusion criteria

  • - Other neurological, psychiatric or developmental diseases prior to the MS diagnosis
  • Cranial trauma sequelae
  • Chronic alcohol and/or drug consumption
  • EDSS > 6
  • Relapse and/or treatment with corticosteroids within the past month
  • Persons deprived of liberty, minors, adults under wardship
  • Cognitive examination within the past 6 months (including in particular all or some of the tests proposed by this project)
  • Presence of dementia according to DSM V criteria, or of cognitive disorders preventing the patient from undergoing cognitive tests or performing cognitive rehabilitation exercises
  • Any visual or motor deficit preventing the patient from undergoing cognitive tests or performing cognitive rehabilitation exercises

Treatment and study plan

Cognitive Rehabilitation

Behavioral

At-site inclusion visit: assessment of patient's eligibility by cognitive complaint questionnaire and BCcogSEP, VAPS and multiple errands test conducted by neuropsychologist.

At-site baseline visit: assessment of quality of life (MUSIQOL), self-esteem (SEI), depression (MADRS), anxiety (HAMA), BICAMS: SDMT, CVLT-II, BVMTR, metacognition (MCQ-30), fatigue (EMIF-SEP), subjective sleep quality (PSQI) conducted by a neuropsychologist.

At-home neuropsychological management (9 weeks): The patient performs the program (PRESCO software) on his computer autonomously at home at a rate of 3 sessions per week. A neuropsychologist performs at-home visits and weekly phone meetings to train the patient to the software, to encourage him to do exercises and to answer any software use-related questions.

At-site follow-up visits: short and long-term retest of assessments performed in inclusion visit.

Standard Psychological care

Behavioral

At-site inclusion visit: assessment of patient's eligibility by cognitive complaint questionnaire and BCcogSEP, VAPS and multiple errands test conducted by neuropsychologist.

At-site baseline visit: assessment of quality of life (MUSIQOL), self-esteem (SEI), depression (MADRS), anxiety (HAMA), BICAMS: SDMT, CVLT-II, BVMTR, metacognition (MCQ-30), fatigue (EMIF-SEP), subjective sleep quality (PSQI) conducted by a neuropsychologist.

At-home neuropsychological management (9 weeks): A neuropsychologist performs at-home visits and weekly phone meetings consisting in discussion of the patient's cognitive disorders.

At-site follow-up visits: short and long-term retest of assessments performed in inclusion visit.

Primary outcomes

  1. Efficacy of cognitive rehabilitation on quality of life at short term.

    Time frame: 10 weeks

    Quality of life will be assessed by measuring the change of the scores of MUSIQOL (MUltiple Sclerosis International Quality Of Life) questionnaire between baseline and short-term visits. Efficacy will be assessed by comparing theses scores between groups A and B.

  2. Efficacy of cognitive rehabilitation on quality of life at long term.

    Time frame: 34 weeks

    Quality of life will be assessed by measuring the change of the scores of MUSIQOL (MUltiple Sclerosis International Quality Of Life) questionnaire between baseline and long-term visits. Efficacy will be assessed by comparing theses scores between groups A and B.

Secondary outcomes

  1. Efficacy of cognitive rehabilitation on self-esteem at short term.

    Time frame: 10 weeks

    Self-esteem will be assessed by measuring the change of the scores of the SEI (Self Esteem Inventory) scale between baseline and short-term. Efficacy will be assessed by comparing theses scores between groups A and B.

  2. Efficacy of cognitive rehabilitation on self-esteem long term.

    Time frame: 34 weeks

    Self-esteem will be assessed by measuring the change of the scores of the SEI (Self Esteem Inventory) scale between baseline and long-term visits. Efficacy will be assessed by comparing theses scores between groups A and B.

  3. Efficacy of cognitive rehabilitation on depression at short term.

    Time frame: 10 weeks

    Depression will be assessed by measuring the change of the scores of MADRS (Montgomery and Asberg Depression Rating Scale) questionnaire between baseline and short-term visits. Efficacy will be assessed by comparing theses scores between groups A and B.

  4. Efficacy of cognitive rehabilitation on depression at long term.

    Time frame: 34 weeks

    Depression will be assessed by measuring the change of the scores of MADRS (Montgomery and Asberg Depression Rating Scale) questionnaire between baseline and long-term visits. Efficacy will be assessed by comparing theses scores between groups A and B.

  5. Efficacy of cognitive rehabilitation on cognition at short term.

    Time frame: 10 weeks

    Cognition will be assessed by measuring the change of the scores of the BICAMS (Brief International Assessment for Multiple Sclerosis) battery between baseline and short-term visits. Efficacy will be assessed by comparing theses scores between groups A and B.

  6. Efficacy of cognitive rehabilitation on cognition at long term.

    Time frame: 34 weeks

    Cognition will be assessed by measuring the change of the scores of the BICAMS (Brief International Assessment for Multiple Sclerosis) battery between baseline and long-term visits. Efficacy will be assessed by comparing theses scores between groups A and B.

  7. Efficacy of cognitive rehabilitation on metacognition at short term.

    Time frame: 10 weeks

    Metacognition will be assessed by measuring the change of the scores of the MCQ-30 (Metacognitions Questionnaire-30) scale between baseline and long-term visits. Efficacy will be assessed by comparing theses scores between groups A and B.

  8. Efficacy of cognitive rehabilitation on metacognition at long term.

    Time frame: 34 weeks

    Metacognition will be assessed by measuring the change of the scores of the MCQ-30 (Metacognitions Questionnaire-30) scale between baseline and long-term visits. Efficacy will be assessed by comparing theses scores between groups A and B.

  9. Efficacy of cognitive rehabilitation on fatigue at short term

    Time frame: 10 weeks

    Fatigue will be assessed by measuring the change of the scores of the EMIF-SEP (Echelle Modifiée d'Impact de la Fatigue dans la Sclérose En Plaques) scale between baseline and short-term visits. Efficacy will be assessed by comparing theses scores between groups A and B.

  10. Efficacy of cognitive rehabilitation on fatigue at long term

    Time frame: 34 weeks

    Fatigue will be assessed by measuring the change of the scores of the EMIF-SEP (Echelle Modifiée d'Impact de la Fatigue dans la Sclérose En Plaques) scale between baseline and long-term visits. Efficacy will be assessed by comparing theses scores between groups A and B.

  11. Efficacy of cognitive rehabilitation on sleep at short term

    Time frame: 10 weeks

    Sleep will be assessed by measuring the change of the scores of the PSQI (Pittsburgh Sleep Quality Index) questionnaire between baseline and short-term visits. Efficacy will be assessed by comparing theses scores between groups A and B.

  12. Efficacy of cognitive rehabilitation on sleep at long term

    Time frame: 34 weeks

    Sleep will be assessed by measuring the change of the scores of the PSQI (Pittsburgh Sleep Quality Index) questionnaire between baseline and long-term visits. Efficacy will be assessed by comparing theses scores between groups A and B.

  13. Efficacy of cognitive rehabilitation on anxiety at short term.

    Time frame: 10 weeks

    Anxiety will be assessed by measuring the change of the scores of HAMA (HAMilton Anxiety) scale between baseline and short-term visits. Efficacy will be assessed by comparing theses scores between groups A and B.

  14. Efficacy of cognitive rehabilitation on anxiety at long term.

    Time frame: 34 weeks

    Anxiety will be assessed by measuring the change of the scores of HAMA (HAMilton Anxiety) scale between baseline and long-term visits. Efficacy will be assessed by comparing theses scores between groups A and B.

Sponsors and collaborators

Lead sponsor

University Hospital, Caen

Other

Registry information

Acronym: SEPIA

Important dates

Study start
2017
Primary completion
2023
Study completion
2024
First posted
Mar 20, 2018
Registry last updated
Jul 25, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

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This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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