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Four weeks of mindfulness training vs. adaptive cognitive training in multiple sclerosis: Effects on processing speed and working memory

Objective: The aim of this pre-registered, secondary analysis of a pilot randomized controlled trial was to compare the impact of two four-week interventions with a waitlist control condition on processing speed and working memory in people with multiple sclerosis (PwMS). Method: Sixty-one PwMS were randomized to mindfulness-based training (MBT), adaptive cognitive training (aCT), or a waitlist (WL) control group and completed the Brief Repeatable Battery of Neuropsychological Tests (BRB-N) at pre- and post-training. Performance on the BRB-N at pre-training determined cognitive status (impairment/preservation), which was assessed as a moderator of training effects. Practice time, average change in game difficulty, and rate of change in state mindfulness were assessed as correlates of cognitive gains.Results: Relative to the aCT and WL groups, participants in the MBT group demonstrated significant improvement in processing speed. A marginally significant interaction for working memory performance suggested that benefits of active intervention compared to WL may be moderated by cognitive status at baseline. Practice time in either active group and change in game difficulty in the aCT group were not significantly correlated with cognitive gains. In the MBT group, rate of change in state mindfulness during training was significantly associated with working memory improvement. Conclusions: Overall, this pilot study shows that brief mindfulness meditation training may improve processing speed in PwMS. Preliminary evidence suggests that baseline cognitive function and changes in state mindfulness may be associated with working memory gains. The results of this pilot trial invite further study of factors that may influence outcomes of cognitive rehabilitation in MS.