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Digital Cognition in Multiple Sclerosis (DigCog)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
ClinicalTrials.gov Identifier: NCT03569618
Recruitment Status : Completed
First Posted : June 26, 2018
Results First Posted : October 26, 2020
Last Update Posted : October 26, 2020
Akili Interactive Labs, Inc.
Information provided by (Responsible Party):
University of California, San Francisco

Brief Summary:


WHO: 65 participants with a confirmed diagnosis of Multiple Sclerosis (MS)

WHY: Purpose of the study is to compare the effect of 2 tablet-based brain training digital tools on important components of thinking (cognition).

WHAT: Complete a set of tests (physical and cognitive) at baseline, 6 weeks and 14 weeks, and use one of two brain training tools on an iPad in your home, for 25 minutes a day, 5 days a week, for 6 weeks.


Condition or disease Intervention/treatment Phase
Multiple Sclerosis Cognitive Decline Device: Tablet-based Game Not Applicable

Detailed Description:

The purpose of this study is to begin to test a brain training video game in people with Multiple Sclerosis (MS).

Visit 1. After informed consent, you will complete a series of questions about your functioning and mood. You will then complete a series of tests (vision, hand tapping, walking). Then, you will complete a set of thinking tests. The first set will be paper and pencil. The second set will be on a tablet or a computer. You will use your study code to sign into these tools and you won't provide any personal details for the digitized tests.

Finally, you will complete the "cognitive training tool". There are two versions of this digital, iPad based tool, which takes about 25 minutes to complete and is designed to be entertaining. You will be randomized into 1 of 2 groups: each group will play a version of the brain training game. You will not be told what group/game type you were randomized into. You will be given the tablet with the game on it to take home, and to practice this game 5 times a week for 6 weeks.

Visit 2. After the 6 weeks of at-home training, you will then come back to the research study unit to do a repeat of the initial visit (with physical and cognitive assessments). At this study visit, you will also be returning the iPad.

Visit 3. You will then return 8 weeks after Visit 2, to do a repeat of the assessments.

You will be compensated for each study visit (visit 1: $50, visit 2: $100, visit 3: $150).

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 44 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Masking Description: Study assessment administrator is blinded to what digital tool the subject has been assigned.
Primary Purpose: Treatment
Official Title: Effect of a Digital Therapeutic on Processing Speed in Adults With Multiple Sclerosis
Actual Study Start Date : April 1, 2018
Actual Primary Completion Date : November 1, 2018
Actual Study Completion Date : January 15, 2019

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Active Comparator: Game 1
Tablet-based Game 1.
Device: Tablet-based Game
Tablet-based game aimed at improving processing speed and attention.

Placebo Comparator: Game 2
Tablet-based Game 2.
Device: Tablet-based Game
Tablet-based game aimed at improving processing speed and attention.

Primary Outcome Measures :
  1. Change in Processing Speed After 6 Weeks of Treatment With a Digital Therapeutic 'Game 1', vs. 'Game 2'. [ Time Frame: 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.

Secondary Outcome Measures :
  1. Number of Participants With at Least 4-point Increase in SDMT Above Their Baseline Value 8 Weeks After Treatment [ Time Frame: 14 weeks ]
    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.

Other Outcome Measures:
  1. Change in Mood After 6 Weeks Treatment With Game 1 vs. Game 2 [ Time Frame: Baseline and 6 weeks ]
    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.

  2. Change in Fatigue After 6 Weeks Treatment With Game 1 vs. Game 2. [ Time Frame: Baseline and 6 weeks ]
    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.

  3. Change in a Digital Cognitive Battery After 6 Weeks Treatment With Game 1 vs. Game 2. [ Time Frame: Baseline and 6 weeks ]
    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).

  4. Change in Paper and Pencil Cognitive Testing After 6 Weeks Treatment With Game 1 vs. Game 2. [ Time Frame: Baseline and 6 weeks ]

    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.

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years to 71 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Adult men or women diagnosed with multiple sclerosis (MS) or clinically isolated syndrome (CIS)
  • SDMT z-score range (-2 to +1)
  • Wifi available in home
  • Able to use a tablet (iPad)
  • Able to attend 3 study visits in person.

Exclusion Criteria:

  • Clinician's assessment of visual, cognitive, or motor impairment that would preclude participation.
  • A clinical relapse within the last 30 days.
  • Steroid treatment for clinical relapse within the last 30 days.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03569618

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United States, California
University of California San Francisco
San Francisco, California, United States, 94158
Sponsors and Collaborators
University of California, San Francisco
Akili Interactive Labs, Inc.
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Principal Investigator: Riley Bove, MD University of California, San Francisco
  Study Documents (Full-Text)

Documents provided by University of California, San Francisco:
Study Protocol  [PDF] August 1, 2018
Statistical Analysis Plan  [PDF] August 1, 2018

Publications of Results:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: University of California, San Francisco
ClinicalTrials.gov Identifier: NCT03569618    
Other Study ID Numbers: 16-19891
First Posted: June 26, 2018    Key Record Dates
Results First Posted: October 26, 2020
Last Update Posted: October 26, 2020
Last Verified: October 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: Yes
Device Product Not Approved or Cleared by U.S. FDA: Yes
Product Manufactured in and Exported from the U.S.: No
Additional relevant MeSH terms:
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Multiple Sclerosis
Cognitive Dysfunction
Pathologic Processes
Demyelinating Autoimmune Diseases, CNS
Autoimmune Diseases of the Nervous System
Nervous System Diseases
Demyelinating Diseases
Autoimmune Diseases
Immune System Diseases
Cognition Disorders
Neurocognitive Disorders
Mental Disorders