Trial Outcomes & Findings for Digital Cognition in Multiple Sclerosis (NCT NCT03569618)

NCT ID: NCT03569618

Last Updated: 2020-10-26

Results Overview

Processing speed is being measured by the Symbol Digit Modalities Test (SDMT) score. SDMT measures the time to pair abstract symbols with specific numbers. The test requires visuoperceptual processing, working memory, and psychomotor speed. The score is the number of correctly coded items in 90 seconds. (max=110, min=0). Higher scores indicate improvement. Lower scores indicate worsening.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

44 participants

Primary outcome timeframe

Baseline and 6 weeks

Results posted on

2020-10-26

Participant Flow

Participant milestones

Participant milestones
Measure
AKL-T03
Tablet-based game aimed at improving processing speed and attention.
AKL-T09
Control, tablet-based word-finding game
Overall Study
STARTED
23
21
Overall Study
COMPLETED
20
20
Overall Study
NOT COMPLETED
3
1

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Digital Cognition in Multiple Sclerosis

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
AKL-T03
n=23 Participants
Tablet-based game aimed at improving processing speed and attention.
AKL-T09
n=21 Participants
Control, tablet-based word finding game
Total
n=44 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
18 Participants
n=5 Participants
19 Participants
n=7 Participants
37 Participants
n=5 Participants
Age, Categorical
>=65 years
5 Participants
n=5 Participants
2 Participants
n=7 Participants
7 Participants
n=5 Participants
Age, Continuous
52.9 years
STANDARD_DEVIATION 14.0 • n=5 Participants
49.2 years
STANDARD_DEVIATION 10.9 • n=7 Participants
51.1 years
STANDARD_DEVIATION 12.6 • n=5 Participants
Sex: Female, Male
Female
17 Participants
n=5 Participants
18 Participants
n=7 Participants
35 Participants
n=5 Participants
Sex: Female, Male
Male
6 Participants
n=5 Participants
3 Participants
n=7 Participants
9 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Asian
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
2 Participants
n=7 Participants
2 Participants
n=5 Participants
Race (NIH/OMB)
White
17 Participants
n=5 Participants
18 Participants
n=7 Participants
35 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
3 Participants
n=5 Participants
0 Participants
n=7 Participants
3 Participants
n=5 Participants
Region of Enrollment
United States
23 participants
n=5 Participants
21 participants
n=7 Participants
44 participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline and 6 weeks

Processing speed is being measured by the Symbol Digit Modalities Test (SDMT) score. SDMT measures the time to pair abstract symbols with specific numbers. The test requires visuoperceptual processing, working memory, and psychomotor speed. The score is the number of correctly coded items in 90 seconds. (max=110, min=0). Higher scores indicate improvement. Lower scores indicate worsening.

Outcome measures

Outcome measures
Measure
AKL-T03
n=20 Participants
Tablet-based game aimed at improving processing speed and attention.
AKL-T09
n=20 Participants
Control, tablet-based word-finding game
Change in Processing Speed After 6 Weeks of Treatment With a Digital Therapeutic 'Game 1', vs. 'Game 2'.
6.10 score on a scale
Standard Deviation 4.62
3.55 score on a scale
Standard Deviation 7.51

SECONDARY outcome

Timeframe: 14 weeks

Population: 39 participants (97.5%) returned for Visit 3

Number of participants showing a clinically meaningful 4+ point increase in SDMT (symbol digit modalities test) relative to baseline SDMT score. Comparison of SDMT changes 8 weeks after end of treatment with Tool 1 vs. Tool 2.

Outcome measures

Outcome measures
Measure
AKL-T03
n=20 Participants
Tablet-based game aimed at improving processing speed and attention.
AKL-T09
n=19 Participants
Control, tablet-based word-finding game
Number of Participants With at Least 4-point Increase in SDMT Above Their Baseline Value 8 Weeks After Treatment
14 Participants
7 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline and 6 weeks

Population: Missing data for 6 participants on trait anxiety (STAI-T), 3 per study group; as well as for 2 participants on depression (CES-D) and state anxiety (STAI-S) measures, 1 per study group.

Comparison of changes in mood (depression, anxiety). Depression measured using the Center for Epidemiologic Studies Depression Scale (CES-D). Possible range of scores is zero to 60, with the higher scores indicating the presence of more symptomatology. Anxiety measured using the State-Trait Anxiety Inventory - State subtest (STAI-S) and the State-Trait Anxiety Inventory - Trait subtest (STAI-T). Both have 20 questions and a score range 20-80, with higher scores indicating greater anxiety.

Outcome measures

Outcome measures
Measure
AKL-T03
n=19 Participants
Tablet-based game aimed at improving processing speed and attention.
AKL-T09
n=19 Participants
Control, tablet-based word-finding game
Change in Mood After 6 Weeks Treatment With Game 1 vs. Game 2
Depression (CES-D)
1.11 score on a scale
Standard Deviation 6.14
-.90 score on a scale
Standard Deviation 5.57
Change in Mood After 6 Weeks Treatment With Game 1 vs. Game 2
Anxiety - State (STAI-S)
.05 score on a scale
Standard Deviation 4.64
.21 score on a scale
Standard Deviation 8.93
Change in Mood After 6 Weeks Treatment With Game 1 vs. Game 2
Anxiety - Trait (STAI-T)
.77 score on a scale
Standard Deviation 4.10
.35 score on a scale
Standard Deviation 3.35

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline and 6 weeks

Population: Missing fatigue survey data (MFIS) for 2 participants, 1 per study group.

Fatigue is being measured by the Modified Fatigue Impact Scale (MFIS) which has participants rank 21 items on 1 to 4 (never to always) scale. The score is the sum of these subscales. (max=84, min=0) Lower scores indicate improvement. Higher scores indicate worsening.

Outcome measures

Outcome measures
Measure
AKL-T03
n=19 Participants
Tablet-based game aimed at improving processing speed and attention.
AKL-T09
n=19 Participants
Control, tablet-based word-finding game
Change in Fatigue After 6 Weeks Treatment With Game 1 vs. Game 2.
-4.79 score on a scale
Standard Deviation 6.27
-2.95 score on a scale
Standard Deviation 9.55

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline and 6 weeks

Population: Match data was unavailable for some participants (n = 6, 3 per group)

Comparison of changes in scores on Match, a tablet-based assessment of processing speed and executive function. Performance is gauged on a continuous scale using the total number of correct responses given in 2-minutes. The minimum possible score is 0 (no correct responses) with higher scores indicating better performance (no maximum possible score).

Outcome measures

Outcome measures
Measure
AKL-T03
n=17 Participants
Tablet-based game aimed at improving processing speed and attention.
AKL-T09
n=17 Participants
Control, tablet-based word-finding game
Change in a Digital Cognitive Battery After 6 Weeks Treatment With Game 1 vs. Game 2.
0.94 number of correct responses
Standard Deviation 3.54
0.35 number of correct responses
Standard Deviation 4.66

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline and 6 weeks

Population: Missing PASAT data for 3 participants, 2 in AKL-T03 and 1 in AKL-T09. Data for other measures (SDMT, BVMT-R and CVLT-II) were collected from all participants.

Comparison of changes in cognition, as assessed using the BICAMS battery (Brief International Cognitive Assessment for Multiple Sclerosis) and PASAT (Paced Auditory Serial Addition Test). The BICAMS battery is composed of 3 tests (for all, higher scores indicate better performance): (1) The Symbol Digit Modalities Test (SDMT), a measure of information processing speed where performance is gauged by the number of correct responses given in 90-seconds, with a minimum possible score of 0 and maximum of 110. (2) The California Verbal Learning Test-II (CVLT-II) is a 5-trial auditory/verbal learning test with a total min. score of 0 and max of 80. (3) The Brief Visuospatial Memory Test -- Revised (BVMT-R) is a visual and spatial memory test given in 3 trials with a total min score of 0 and max of 36. The PASAT is a test of information processing and attention with a minimum score of 0 and maximum of 60. Higher scores indicate better performance.

Outcome measures

Outcome measures
Measure
AKL-T03
n=20 Participants
Tablet-based game aimed at improving processing speed and attention.
AKL-T09
n=20 Participants
Control, tablet-based word-finding game
Change in Paper and Pencil Cognitive Testing After 6 Weeks Treatment With Game 1 vs. Game 2.
BVMT-R
0.70 score on a scale
Standard Deviation 4.47
3.25 score on a scale
Standard Deviation 5.23
Change in Paper and Pencil Cognitive Testing After 6 Weeks Treatment With Game 1 vs. Game 2.
PASAT
2.72 score on a scale
Standard Deviation 5.41
2.53 score on a scale
Standard Deviation 7.19
Change in Paper and Pencil Cognitive Testing After 6 Weeks Treatment With Game 1 vs. Game 2.
SDMT
6.10 score on a scale
Standard Deviation 4.62
3.55 score on a scale
Standard Deviation 7.51
Change in Paper and Pencil Cognitive Testing After 6 Weeks Treatment With Game 1 vs. Game 2.
CVLT-II
2.05 score on a scale
Standard Deviation 9.14
5.20 score on a scale
Standard Deviation 8.60

Adverse Events

AKL-T03

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

AKL-T09

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Riley Bove, MD MSc

University of California, San Francisco

Phone: 415.502.7209

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place