Please select the eligibility criteria that correspond to the clinical trial below.
Title: Neuropsychological Management of Multiple Sclerosis: Benefits of a Computerised Semi-autonomous At-home Cognitive Rehabilitation Programme
Brief Summary: Multiple sclerosis (MS) is a central nervous system inflammatory disease that causes a chronic and progressive physical handicap. Though primarily considered as a motor disease, it may, in 40 to 65% of cases, cause cognitive function deficits, concerning mainly attention, information processing speed, executive functions and memory. The impairment of these various functions may significantly impair the patients' social, professional and family lives. As such, the presence of cognitive difficulties is more frequently associated with the onset of anxio-depressive psychiatric symptoms and with reduced quality of life to the extent that it can be estimated via psychometric scales, or by a more qualitative approach. Recent research has focused, not on demonstrating the existence of cognitive disorders in MS, but rather on attempting to reduce their daily impact through cognitive rehabilitation programmes. While encouraging, the available results are relatively discordant and further work is required to demonstrate the actual efficacy of such programmes applied to daily life and of their long-term effects.

The main objective of this work is to evaluate, in patients suffering from MS and presenting with cognitive disorders and/or with complaints, the effect of an innovative computerised, semi-autonomous at-home cognitive rehabilitation programme, following care, on quality of life. The secondary objective is to estimate the improvement, or even stabilisation over time, of patients' cognitive performance and psycho-affective sphere.

In this randomised trial, the investigators plan to include 40 patients suffering from the RR and SP forms of MS, distributed to two groups paired by age, gender and socio-cultural level, one of which will benefit from computerised management, along with at-home support from a psychologist, while the other receives only the support.

This work is expected to provide two types of benefits. Firstly, to enable patients to better understand their cognitive function via daily management and as such to improve their quality of life and self-esteem. Secondly, to eventually allow more appropriate patient management by combining the quasi-systematic use of this programme with follow-up consultations with referring practitioners (neurologists, psychologists, etc.).


Options:
A: Inclusion Criteria:

* Diagnosis of Multiple sclerosis

Exclusion Criteria:

* Diagnosis of other neurological conditions
B: Inclusion Criteria:

* MS defined according to the McDonald criteria revised in 2010
* Men and women aged between 18 and 65 years
* RR and SP forms
* Duration of progression ≤ 25 years
* EDSS ≤ 5.5
* Lack of disease activity as defined by the new Lublin criteria (2013)
* Cognitive complaint and/or cognitive disorders according to the investigator's judgement
* Impaired cognitive performance at least 1.65 SD below normative data at one test of the BCcogSEP battery
* French native language
* Owner of a laptop computer with Internet access
* Signing of the informed consent

Exclusion Criteria:

* - Other neurological, psychiatric or developmental diseases prior to the MS diagnosis
* Cranial trauma sequelae
* Chronic alcohol and/or drug consumption
* EDSS \> 6
* Relapse and/or treatment with corticosteroids within the past month
* Persons deprived of liberty, minors, adults under wardship
* Cognitive examination within the past 6 months (including in particular all or some of the tests proposed by this project)
* Presence of dementia according to DSM V criteria, or of cognitive disorders preventing the patient from undergoing cognitive tests or performing cognitive rehabilitation exercises
* Any visual or motor deficit preventing the patient from undergoing cognitive tests or performing cognitive rehabilitation exercises
C: Inclusion Criteria:

* Ages 18-70
* Definite MS Diagnosis, any subtype \[83\]
* Probable cognitive impairment as defined by a score ≤ 1 SD below the mean of normative data on the SDMT
* Concurrent medications to be kept constant over three months (as possible)
* No relapse or steroids in previous month
* Reading score on WRAT-3 of 37 or greater
* Visual, auditory and motor capacity to operate computer software, as judged by treating neurologist or study staff
* Willing to sign Agreement to Borrow Laptop

Exclusion Criteria:

* History of mental retardation, pervasive developmental disorder or other neurological condition associated with cognitive impairment
* Primary psychiatric disorder that would influence ability to participate
* Other serious uncontrolled medical condition (e.g., cancer or acute myocardial infarction)
* Alcohol or other substance use disorder
* History of computer-based training manufactured by Posit Science
* Learned English language after 12 years of age
D: Inclusion Criteria:

Key inclusion criteria for the participants' eligibility are a definite MS diagnosis (McDonald criteria). Participants fulfilling the key inclusion and the following criteria are eligible for this study

* EDSS 1.0 - 6.0
* Age 19 - 75 years

The presence of any one of the following exclusion criteria will lead to exclusion of the participant:

* Persistent infections
* Severe cardiovascular and pulmonal diseases (renal failure, hepatic dysfunction, cardiovascular disease)
* Severe cardiovascular exacerbations (RR \> 240/120, HR above the age predicted maximum of 220-Age) during training
* Immunosuppressive therapy the day of CPET
* Life style factors and / or persistent addictions (drug or alcohol abuse)
* Inability to follow the study procedures (due to psychological disorders or dementia)
* Insufficient knowledge of the project language (German)
* Women who are pregnant or breast feeding,
* Intention to become pregnant during the course of the study,
* Lack of safe contraception, defined as: Female participants of childbearing potential, not using and not willing to continue using a medically reliable method of contraception for the entire study duration, such as oral, injectable, or implantable contraceptives, or intrauterine contraceptive devices, or who are not using any other method considered sufficiently reliable by the investigator in individual cases.
* Participation in another study with investigational drug within the 30 days preceding and during the present study,
* Previous enrolment into the current study,
* Enrolment of the investigator, his / her family members, employees and other dependent persons,
* Specific exclusions for the disease under study,
* Specific concomitant therapy washout requirements prior to and/or during study participation,
* Dietary restrictions

Exclusion Criteria: Criteria in which the participant withdraws from this study may be the following:

* Inability to comply with the daily schedule
* Strong symptom exacerbations
* Withdrawal of informed consent
* Non-compliance
* Disease progression or relapse

Answer: B