A pilot study examining functional brain activity 6 months after memory retraining in MS: the MEMREHAB trial.

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Abstract

Cognitive impairment in individuals with multiple sclerosis (MS) is now well recognized. One of the most common cognitive deficits is found in memory functioning, largely due to impaired acquisition. We examined functional brain activity 6 months after memory retraining in individuals with MS. The current report presents long term follow-up results from a randomized clinical trial on a memory rehabilitation protocol known as the modified Story Memory Technique. Behavioral memory performance and brain activity of all participants were evaluated at baseline, immediately after treatment, and 6 months after treatment. Results revealed that previously observed increases in patterns of cerebral activation during learning immediately after memory training were maintained 6 months post training.

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Neural activity that predicts subsequent memory and forgetting: a meta-analysis of 74 fMRI studies.

Hongkeun Kim (2011)

The present study performed a quantitative meta-analysis of functional MRI studies that used a subsequent memory approach. The meta-analysis considered both subsequent memory (SM; remembered>forgotten) and subsequent forgetting (SF; forgotten>remembered) effects, restricting the data used to that concerning visual information encoding in healthy young adults. The meta-analysis of SM effects indicated that they most consistently associated with five neural regions: left inferior frontal cortex (IFC), bilateral fusiform cortex, bilateral hippocampal formation, bilateral premotor cortex (PMC), and bilateral posterior parietal cortex (PPC). Direct comparisons of the SM effects between the studies using verbal versus pictorial material and item-memory versus associative-memory tasks yielded three main sets of findings. First, the left IFC exhibited greater SM effects during verbal material than pictorial material encoding, whereas the fusiform cortex exhibited greater SM effects during pictorial material rather than verbal material encoding. Second, bilateral hippocampal regions showed greater SM effects during pictorial material encoding compared to verbal material encoding. Furthermore, the left hippocampal region showed greater SM effects during pictorial-associative versus pictorial-item encoding. Third, bilateral PMC and PPC regions, which may support attention during encoding, exhibited greater SM effects during item encoding than during associative encoding. The meta-analysis of SF effects indicated they associated mostly with default-mode network regions, including the anterior and posterior midline cortex, the bilateral temporoparietal junction, and the bilateral superior frontal cortex. Recurrent activity oscillations between the task-positive and task-negative/default-mode networks may account for trial-to-trial variability in participants' encoding performances, which is a fundamental source of both SM and SF effects. Taken together, these findings clarify the neural activity that supports successful encoding, as well as the neural activity that leads to encoding failure. Copyright © 2010 Elsevier Inc. All rights reserved.

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Brain areas underlying visual mental imagery and visual perception: an fMRI study.

Giorgio Ganis, William Thompson, Stephen Kosslyn (2004)

We used functional magnetic resonance imaging (fMRI) to assess the maximal degree of shared neural processing in visual mental imagery and visual perception. Participants either visualized or saw faint drawings of simple objects, and then judged specific aspects of the drawings (which could only be evaluated properly if they used the correct stimulus). The results document that visual imagery and visual perception draw on most of the same neural machinery. However, although the vast majority of activated voxels were activated during both conditions, the spatial overlap was neither complete nor uniform; the overlap was much more pronounced in frontal and parietal regions than in temporal and occipital regions. This finding may indicate that cognitive control processes function comparably in both imagery and perception, whereas at least some sensory processes may be engaged differently by visual imagery and perception.

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An RCT to treat learning impairment in multiple sclerosis: The MEMREHAB trial.

Heather N Moore, Nancy Chiaravalloti, John DeLuca … (2013)

To examine the efficacy of the modified Story Memory Technique (mSMT), a 10-session behavioral intervention teaching context and imagery to facilitate learning, to improve learning and memory abilities in persons with multiple sclerosis (MS). This double-blind, placebo-controlled, randomized clinical trial included 86 participants with clinically definite MS, 41 in the treatment group and 45 in the placebo control group. Participants completed a baseline neuropsychological assessment, including questionnaires assessing everyday memory, a repeat assessment immediately posttreatment, and a long-term follow-up assessment 6 months after treatment. After completion of the treatment phase, persons in the treatment group were assigned to a booster session or a non-booster session group to examine the efficacy of monthly booster sessions in facilitating the treatment effect over time. The treatment group showed a significantly improved learning slope relative to the placebo group posttreatment. Similar results were noted on objective measures of everyday memory, general contentment, and family report of apathy and executive dysfunction. Long-term follow-up data showed that posttreatment improvement in the treatment group continued to be noted on the list learning and self-report measures. The provision of booster sessions demonstrated little benefit. The mSMT is effective for improving learning and memory in MS. This study provides Class I evidence that the mSMT behavioral intervention improves both objective memory and everyday memory in patients with MS over 5 weeks, with treatment effects lasting over a 6-month period.