Symposium 10: Information Processing Speed: Applications to Cognitive Rehabilitation after Multiple Sclerosis, Stroke, and Long COVID

Summary abstract

Objective. Slowed information processing is a common feature of several neurological disorders, including stroke, multiple sclerosis (MS), traumatic brain injury, and some manifestations of long COVID. These disorders affect and disable large numbers of adults. Slowed information processing is important to address because this basic cognitive capacity underlies several critical cognitive functions, including working memory and other aspects of executive function. K. Ball's laboratory has developed an intervention for improving information processing speed, known as Speed of Processing Training (SOPT), which has robust evidence of preventing cognitive decline in older adults without frank neuropathology. Application of SOPT to individuals with neurological disorders, however, has received little study. This symposium will feature discussion of the development and testing in older adults of SOPT by its founder Ball followed by presentation of trials of the first applications of SOPT to rehabilitation of cognitive impairment after MS (J. DeLuca), stroke (E. Taub), and long COVID (G. Uswatte). Notably, the studies presented by Taub and Uswatte feature SOPT in combination with a package of behavior change strategies designed to transfer gains from the treatment setting to everyday life. These strategies were adapted from the "Transfer Package" that the laboratory of Taub and Uswatte developed to enhance the real-world effects of physical rehabilitation for adults with stroke and which has evidence of producing structural remodeling of the brain.

Methods, Results, and Conclusions. Ball will describe the basic, vision science findings that underlie SOPT. Then, she will share results from a multi-site, randomized controlled trial (RCT; N = 2832) showing that, compared to a no-contact control group and a group that received memory training, speed of processing training significantly slows cognitive decline in older adults. Strikingly, 10-year and longer follow-up indicate that this training prevents motor vehicle accidents and the development of dementia. DeLuca will present data from a RCT (N = 84) in adults with MS showing that persistent improvements in information processing speed take place after SOPT. Taub will share findings from a case series in adults with stroke testing Constraint-Induced (CI) Cognitive Therapy- a combination of SOPT with a form of the Transfer Package of CI Movement Therapy adapted for cognitive rehabilitation. Participants in this case series showed large increases in information processing speed and large improvements in performing instrumental activities of daily living (IADL) outside the treatment setting. Uswatte will share data from a pilot RCT (N = 9) of CI Cognitive Therapy in adults with persistent brain fog due to long COVID; preliminary findings show a large advantage for the experimental group in reduction of brain fog and improvement in IADL function outside the treatment setting.

Presenters and Format. Panel members are leaders in their fields who can present effectively to a wide range of audiences. Each talk will have a 20-minute slot divided into 15 minutes for speaking and 5 minutes for answering questions. Ten minutes will be reserved for questions that remain at the end about any of the four talks and to accommodate any delays that may occur.