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| Name | Class |
|---|---|
| Akili Interactive Labs, Inc. | INDUSTRY |
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A DIGITAL THERAPEUTIC TO IMPROVE THINKING IN MULTIPLE SCLEROSIS
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.
WHERE: UCSF WEILL INSTITUTE FOR NEUROSCIENCES (675 Nelson Rising Lane, San Francisco, CA)
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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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Game 1 | Active Comparator | Tablet-based Game 1. |
|
| Game 2 | Placebo Comparator | Tablet-based Game 2. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Tablet-based Game | Device | Tablet-based game aimed at improving processing speed and attention. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in Processing Speed After 6 Weeks of Treatment With a Digital Therapeutic 'Game 1', vs. 'Game 2'. | 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. | Baseline and 6 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With at Least 4-point Increase in SDMT Above Their Baseline Value 8 Weeks After Treatment | 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. | 14 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Mood After 6 Weeks Treatment With Game 1 vs. Game 2 | 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. |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Riley Bove, MD | University of California, San Francisco | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of California San Francisco | San Francisco | California | 94158 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32584155 | Result | Bove R, Rowles W, Zhao C, Anderson A, Friedman S, Langdon D, Alexander A, Sacco S, Henry R, Gazzaley A, Feinstein A, Anguera JA. A novel in-home digital treatment to improve processing speed in people with multiple sclerosis: A pilot study. Mult Scler. 2021 Apr;27(5):778-789. doi: 10.1177/1352458520930371. Epub 2020 Jun 25. | |
| 34967751 |
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| ID | Title | Description |
|---|---|---|
| FG000 | AKL-T03 | Tablet-based game aimed at improving processing speed and attention. |
| FG001 | AKL-T09 | Control, tablet-based word-finding game |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | AKL-T03 | Tablet-based game aimed at improving processing speed and attention. |
| BG001 | AKL-T09 | Control, tablet-based word finding game |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change in Processing Speed After 6 Weeks of Treatment With a Digital Therapeutic 'Game 1', vs. 'Game 2'. | 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. | Posted | Mean | Standard Deviation | score on a scale | Baseline and 6 weeks |
|
Duration of the 6-week intervention period between Visits 1 and 2
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | AKL-T03 | Tablet-based game aimed at improving processing speed and attention. |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Riley Bove, MD MSc | University of California, San Francisco | 415.502.7209 | riley.bove@ucsf.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Aug 1, 2018 | Dec 11, 2019 | Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Aug 1, 2018 | Dec 11, 2019 | SAP_001.pdf |
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| ID | Term |
|---|---|
| D009103 | Multiple Sclerosis |
| D060825 | Cognitive Dysfunction |
| ID | Term |
|---|---|
| D020278 | Demyelinating Autoimmune Diseases, CNS |
| D020274 | Autoimmune Diseases of the Nervous System |
| D009422 | Nervous System Diseases |
| D003711 | Demyelinating Diseases |
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Study assessment administrator is blinded to what digital tool the subject has been assigned.
| Baseline and 6 weeks |
| Change in Fatigue After 6 Weeks Treatment With Game 1 vs. Game 2. | 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. | Baseline and 6 weeks |
| Change in a Digital Cognitive Battery After 6 Weeks Treatment With Game 1 vs. Game 2. | 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). | Baseline and 6 weeks |
| Change in Paper and Pencil Cognitive Testing After 6 Weeks Treatment With Game 1 vs. Game 2. | 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. | Baseline and 6 weeks |
| Hsu WY, Rowles W, Anguera JA, Anderson A, Younger JW, Friedman S, Gazzaley A, Bove R. Assessing Cognitive Function in Multiple Sclerosis With Digital Tools: Observational Study. J Med Internet Res. 2021 Dec 30;23(12):e25748. doi: 10.2196/25748. |
| 33470940 | Derived | Hsu WY, Rowles W, Anguera JA, Zhao C, Anderson A, Alexander A, Sacco S, Henry R, Gazzaley A, Bove R. Application of an Adaptive, Digital, Game-Based Approach for Cognitive Assessment in Multiple Sclerosis: Observational Study. J Med Internet Res. 2021 Jan 20;23(1):e24356. doi: 10.2196/24356. |
| BG002 | Total | Total of all reporting groups |
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
|
|
| Secondary | Number of Participants With at Least 4-point Increase in SDMT Above Their Baseline Value 8 Weeks After Treatment | 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. | 39 participants (97.5%) returned for Visit 3 | Posted | Count of Participants | Participants | 14 weeks |
|
|
|
| Other Pre-specified | Change in Mood After 6 Weeks Treatment With Game 1 vs. Game 2 | 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. | 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. | Posted | Mean | Standard Deviation | score on a scale | Baseline and 6 weeks |
|
|
|
| Other Pre-specified | Change in Fatigue After 6 Weeks Treatment With Game 1 vs. Game 2. | 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. | Missing fatigue survey data (MFIS) for 2 participants, 1 per study group. | Posted | Mean | Standard Deviation | score on a scale | Baseline and 6 weeks |
|
|
|
| Other Pre-specified | Change in a Digital Cognitive Battery After 6 Weeks Treatment With Game 1 vs. Game 2. | 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). | Match data was unavailable for some participants (n = 6, 3 per group) | Posted | Mean | Standard Deviation | number of correct responses | Baseline and 6 weeks |
|
|
|
| Other Pre-specified | Change in Paper and Pencil Cognitive Testing After 6 Weeks Treatment With Game 1 vs. Game 2. | 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. | 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. | Posted | Mean | Standard Deviation | score on a scale | Baseline and 6 weeks |
|
|
|
| 0 |
| 20 |
| 0 |
| 20 |
| 0 |
| 20 |
| EG001 | AKL-T09 | Control, tablet-based word-finding game | 0 | 20 | 0 | 20 | 0 | 20 |
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| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
| D003072 | Cognition Disorders |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
| Anxiety - State (STAI-S) |
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| Anxiety - Trait (STAI-T) |
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| CVLT-II |
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| BVMT-R |
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| PASAT |
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