Optimizing detection and prediction of changes in cognitive function in multiple sclerosis with novel ambulatory assessment methods

利用新型动态评估方法优化多发性硬化症认知功能变化的检测和预测

• 批准号: 10459334
• 负责人: Nora E. Fritz
• 金额: $ 60.32万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10459334
• 关键词: Accelerometer; Address; Affect; Attention; Autoimmune Diseases; Behavioral; Brain Diseases; Caring; Central Nervous System Diseases; Characteristics; Chronic; Chronic Disease; Clinic; Cognition; Cognitive; Custom; Data; Detection; Development; Ecological momentary assessment; Employment; Environment; Episodic memory; Fatigue; Foundations; Future; Grain; Health Psychology; Impaired cognition; Independent Living; Individual; Inflammatory; Intervention; Knowledge; Life; Link; Measurement; Measures; Medical; Memory; Methods; Moods; Multiple Sclerosis; Natural History; Nature; Neurology; Neuropsychology; Outcome; Pain; Patient Self-Report; Persons; Physical Function; Physical activity; Physical therapy; Protocols documentation; Reporting; Research; Short-Term Memory; Sleep; Social Functioning; Social outcome; Spinal Diseases; Statistical Data Interpretation; Stress; Symptoms; Techniques; Technology; Testing; Time; Work; base; cognitive ability; cognitive change; cognitive function; cognitive performance; cognitive testing; design; disability; executive function; experience; follow-up; health related quality of life; improved; improved functioning; innovation; medical specialties; mobile application; neurocognitive test; neurological rehabilitation; novel; patient oriented; person centered; processing speed; prognostic value; restorative treatment; smartphone Application; social engagement; visual memory; young adult

Multiple sclerosis (MS) is a chronic disease of the central nervous system that affects approximately 1 million people in the US and is the #1 cause of non-traumatic disability in young adults. Cognitive dysfunction, including deficits in processing speed, visual memory, verbal fluency, working memory, and executive functioning, is one of the most common problems in MS. Cognitive dysfunction in MS exerts a dire impact on many aspects of health-related quality of life. Unfortunately, progress in developing preventative, compensatory and restorative interventions for cognitive dysfunction in MS is stymied by major gaps in our knowledge of its natural history, mechanisms, and impacts where it matters most – in the everyday lives of people with MS. Our understanding of cognitive function in MS is restricted by two major factors: measurement limitations and lack of scientific attention to potential contributors to and consequences of declines in cognition. This study leverages advances in technology-assisted ambulatory assessment techniques to provide a unique and multidimensional window onto the experience of cognitive dysfunction in the everyday lives of people with MS. In this study, we will use multiple complementary ambulatory assessment strategies to better understand cognitive dysfunction in MS. A customized smartphone app will be used to administer a battery of ambulatory cognitive tests that are designed specifically for serial administration in the lived environment as well as ecological momentary assessments (real-time assessment) of self-reported symptoms and functioning as a person goes about daily life. The smartphone app will be paired with accelerometer technology, which will provide objective, continuous, and unobtrusive measures of physical activity. Ambulatory assessments will be administered in a “measurement burst design,” incorporating bursts of intensive repeated assessment over two weeks, with bursts repeated longitudinally, at baseline, and 1- and 2- year follow-up. Using these innovative assessment measures and methods, we will test whether ambulatory measures of subjective and objective cognitive function are more sensitive to longitudinal changes (over 2 years) in cognitive functioning than conventional “snapshot” clinic-based assessments. We will also examine short- (days) and long-term (years) temporal associations between potentially modifiable factors - physical activity, sleep, fatigue, pain, mood, and stress – and changes in cognitive functioning. Finally, we will examine the association between cognitive functioning and other key outcomes - social and physical functioning. This work is designed to better characterize the natural history of cognitive dysfunction in MS, to identify factors that contribute to cognitive functioning in daily life, and to highlight functional domains that might be impacted by changes in cognitive function. Ultimately, this work will indicate optimal methods for assessing cognitive functioning and will guide development and testing of preventative, compensatory, and/or restorative treatments for cognitive dysfunction in MS.

多发性硬化症 (MS) 是一种中枢神经系统慢性疾病，影响约 100 万人 在美国，认知功能障碍是导致年轻人非创伤性残疾的第一大原因。 包括处理速度、视觉记忆、语言流畅性、工作记忆和执行能力方面的缺陷 功能障碍是多发性硬化症最常见的问题之一，多发性硬化症的认知功能障碍对患者产生了可怕的影响。 不幸的是，在发展预防性、 对多发性硬化症认知功能障碍的补偿性和恢复性干预措施因我们的主要差距而受到阻碍 了解其自然历史、机制和最重要的影响——在人们的日常生活中 我们对多发性硬化症认知功能的理解受到两个主要因素的限制： 测量的局限性以及对潜在影响因素和后果缺乏科学关注 这项研究利用了技术辅助动态评估的进步。 技术提供了一个独特的、多维的窗口来了解认知功能障碍的经历 多发性硬化症患者的日常生活 在本研究中，我们将使用多种互补的门诊。 定制的智能手机应用程序将帮助更好地了解多发性硬化症的认知功能障碍。 用于管理一系列专为串行设计的动态认知测试 居住环境管理及生态瞬时评估（实时评估） 智能手机应用程序将记录一个人的自我报告症状和日常生活功能。 与加速计技术相结合，将提供客观、连续且不引人注目的测量 体力活动将以“突发测量设计”的方式进行。 结合两周内的密集重复评估突发，纵向重复突发，在 利用这些创新的评估措施和方法，我们将进行基线、一年和两年的跟踪。 测试主观和客观认知功能的动态测量是否对以下因素更敏感 与传统的基于临床的“快照”相比，认知功能发生了纵向变化（超过 2 年） 我们还将检查短期（天）和长期（年）时间关联。 潜在可改变的因素——体力活动、睡眠、疲劳、疼痛、情绪和压力——以及 最后，我们将研究认知功能与其他关键功能之间的关联。 结果 - 社会和身体功能这项工作旨在更好地描述自然历史。 多发性硬化症的认知功能障碍，以确定有助于日常生活中认知功能的因素，并 最终，这项工作将强调可能受到认知功能变化影响的功能领域。 指出评估认知功能的最佳方法，并将指导开发和测试 针对多发性硬化症认知功能障碍的预防性、补偿性和/或恢复性治疗。