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While physical symptoms caused by Multiple Sclerosis (MS) are most widely recognized, cognitive impairments can also impact the lives of those with MS. According to the Multiple Sclerosis Society of Canada, it is approximated 50% of MS patients experience cognitive impairments that affect their ability to process new information, recall past experiences and focus on tasks.1 However, just as physical therapy can be beneficial for treating physical symptoms, the MS Society notes cognitive functions affected by MS may also be managed and potentially improved by training the brain.

Through challenging puzzles and activities, also known as brain games, patients can work to retrain their minds to process information by strengthening neural connections. Brain Games may include word games, number puzzles, or memory testing activities forcing patients to recall previously displayed information. A study in Neurorehabilitation and Neural Repair proposes all of these activities stimulate the brain and strengthen the neural connections potentially affected by MS, working in the same manner as physical exercise to strengthen muscles in the body.2

There is now a greater academic focus on the effects of brain games for improving cognitive function. While more studies are needed to understand how to design effective MS brain games that encapsulate all strategies utilized in cognitive training studies, research has indicated a benefit to including brain games into the daily routine of those with MS.3

More of the potential benefits of brain games and why they may help mitigate the cognitive symptoms of MS are summarized below based on current research.

Self-Managed Form of Treatment

One of the greatest potential benefits of brain games for MS patients is they can be accessed anytime and through any medium. This can include puzzle books encouraging users to draw out their answers or colouring books requiring dexterity and focus. Patients may also prefer mobile apps and video games they can play through their smartphones, which often include memory games with varying levels of difficulty.

This flexibility in the method of delivery for brain training means patients can engage in brain games multiple times a day and from any location. Specifically, research completed by the American Society of Neurorehabilitation commended home-based forms of cognitive rehabilitation through video games and virtual puzzles, as there was little need for a physician to be present to administer the activity.4 Ultimately, this is may be incredibly beneficial for patients with limited access to healthcare.

By offering patients a cost effective and highly convenient form of treatment through brain games, patients are more likely to frequently engage in these activities, potentially leading to improvements in cognitive functions.

“There is now a greater focus in research on the effects of brain games for improving cognitive function with results indicating patients can slow down the progression of cognitive impairments and strengthen memory capacity with frequent brain training.”

Repetition Fosters Improvement

Along with the convenience of brain games, these activities are highly repetitive in nature and often encourage the user to use the same cognitive skill over and over, through increasing levels of difficulty. As the patient masters one skill, they move on to the next portion of the game, forcing them to challenge their cognitive abilities and continue to focus on one task at a time.

Findings from the American Psychological Association have demonstrated the benefit to this model of gameplay: when individuals are trained consistently in one cognitive skill, it can lead to improvement in other realms of cognitive abilities, such as memory and attention.5 As individuals fine-tune their strategies for problem solving and recall with one specific task, they are able to apply this knowledge to skills that weren’t specifically trained by the game.6

Over time, utilizing the skills enforced through brain games will help to slow the loss of these skills and cognitive function may remain fairly stable.7

Mimics Real-World Cognitive Demands

While brain games are designed to be enjoyable for the user, their ultimate goal is to emulate real world problem-solving and provide the user with cognitive challenges that they likely often face, such as recalling someone’s name or focusing on a single tedious task.

This is an incredibly beneficial feature to brain games, as outlined in a study published in PLoS ONE. With many similarities between the form of learning occurring in the games and the real-world task this skill would be applied to, these games encourage transfer of learning.8 It is not enough for patients to play a board game or complete a jigsaw puzzle, as these skills are not always closely related to everyday demands that would require deep concentration and memory recall.

Overall, research indicates the frequent usage of brain games may provide patients with the applicable cognitive capabilities to manage their daily tasks, so long as the games focus on intellectually challenging tasks to keep neuronal connections active.9

Promotes Neuroplasticity

It was once believed the adult brain was static and could not be restructured like a child’s brain can. However, more and more research — such as work published in Neural Plasticity — is finding that the adult brain with MS can experience rapid plasticity and functional reorganization with the help of ongoing cognitive rehabilitation.10 Specifically, neuroplasticity is defined as the brain’s ability to learn from new experiences and rearrange neural connections in response to this stimuli.11 With the help of brain games, research shows the adult brain can build new neuronal structures even when damage has occurred due to illness or injury.

In order for this restructuring to occur and prevent further degeneration in memory and concentration, patients with MS need to engage in continuous novel experiences to challenge them and encourage their brain to make new, meaningful connections. Research indicates that over time, with the help of brain games, patients may be able to learn new ways to problem solve and recall past information, allowing them to work around some of the cognitive impairments caused by MS.

“We can enhance neuroplasticity through exercise, balanced nutrition, avoidance of toxic agents such as excessive alcohol or tobacco, and by engaging in cognitively demanding and novel situations.”12

Learning From the Past

Ultimately, adults are a collection of all of their past experiences. The make-up of who someone is, how they process stimuli and act on information is based on everything they’ve learned in the past. This ongoing development of oneself, and one’s Cognitive Reserve, which is defined as cognitive abilities and strength developed through education, work and leisure, can be enhanced through brain games.13

Research indicates that most individuals may be able to add to their Cognitive Reserve and improve their memory and concentration. Research also indicates that games designed to engage the mind through memory and problem solving tasks are likely to bolster the Cognitive Reserve and can help protect patients from further cognitive decline.14 While brain games may not be a cure-all solution for cognitive impairment related to MS, research demonstrates that compared to no intervention, home-based brain games have the ability to improve memory and processing abilities.15

Did you know? Pairing neurostimulation with targeted therapeutic activities has also been demonstrated to encourage neuroplasticity. This is the basis of PoNS TreatmentTM, which may help MS patients manage their gait issues due to mild-to-moderate symptoms of MS. Learn more about PoNS TreatmentTM and visit the website for a free consultation.

Disclaimer: This content is provided for general informational and educational purposes only and is not a substitute for professional advice. Contact your physician prior to acting on recommendations thereof.

1 “Cognition and MS,” Multiple Sclerosis Society of Canada, (Accessed September 29, 2020), https://mssociety.ca/library/document/LrvdiAzUK01SbsCcafFt938eQhNP2IJ7/original.pdf.

2 Antonio Cerasa, Maria Celicilia Gioia, Paola Valentino, “Computer-Assisted Cognitive Rehabilitation if Attention Deficits for Multiple Sclerosis: A Randomized Trial with fMRI Correlates,” Neurorehabilitation and Neural Repair 27, no. 4 (2012): 284-295, accessed September 29, 2020, https://journals.sagepub.com/doi/full/10.1177/1545968312465194.

3 Kristen Weir, “Mind Games: Can Brian-Training Games Keep Your Mind Young,” American Psychological Association 45, No. 9 (2014): 44, accessed on September 30, 2020, https://www.apa.org/monitor/2014/10/mind-games.

4 Laura De Giglio, Francesca De Luca, Luca Prosperini, “A Low-Cost Rehabilitation With a Commercial Video Game Improves sustained Attention and Executive functions in Multiple Sclerosis: A Pilot Study,” Neurorehabilitation and Neural Repair 29, no. 5 (2014): 453-461, accessed September 29, 2020, https://journals.sagepub.com/doi/full/10.1177/1545968314554623.

5 Kristen Weir, “Mind Games: Can Brian-Training Games Keep Your Mind Young,” American Psychological Association 45, No. 9 (2014): 44, accessed on September 30, 2020, https://www.apa.org/monitor/2014/10/mind-games.

6 Kristen Weir, “Mind Games: Can Brian-Training Games Keep Your Mind Young,” American Psychological Association 45, No. 9 (2014): 44, accessed on September 30, 2020, https://www.apa.org/monitor/2014/10/mind-games.

7 Antonio Cerasa, Maria Celicilia Gioia, Paola Valentino, “Computer-Assisted Cognitive Rehabilitation if Attention Deficits for Multiple Sclerosis: A Randomized Trial with fMRI Correlates,” Neurorehabilitation and Neural Repair 27, no. 4 (2012): 284-295, accessed September 29, 2020, https://journals.sagepub.com/doi/full/10.1177/1545968312465194.

8 Adam C. Oei, Michael D. Patterson, “Enhancing Cognition with Video Games: A Multiple Game Training Study,” PLoS ONE 8, no. 3 (2013):1-16, accessed on September 29, 2020, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0058546.

9 Hallie Levine, “Best Brain-Boosting Apps for MS,” last modified February 18, 2020. https://www.healthcentral.com/slideshow/ms-brain-boosting-apps.

10 Luca Prosperini, Maria Cristina Piattella, Costanza Gianni, Patrizia Pantano, “Functional and Structural Brain Plasticity Enhanced by Motor and Cognitive Rehabilitation in Multiple Sclerosis,” Neural Plasticity 2015, (2015): 1-12, accessed on September 29, 2020, https://www.hindawi.com/journals/np/2015/481574/.

11 Cynthia L. Kryder, “Forging New Pathways in the Brain,” Momentum Magazine, The National MS Society, 2016, accessed September 29, 2020, http://momentummagazineonline.com/forging-new-pathways-brain/.

12 Cynthia L. Kryder, “Forging New Pathways in the Brain,” Momentum Magazine, The National MS Society, 2016, accessed September 29, 2020, http://momentummagazineonline.com/forging-new-pathways-brain/.

13 “Cognitive Health,” National Multiple Sclerosis Society, (Accessed September 29, 2020), https://www.nationalmssociety.org/Living-Well-With-MS/Cognitive-Health.

14 “Cognitive Health,” National Multiple Sclerosis Society, (Accessed September 29, 2020), https://www.nationalmssociety.org/Living-Well-With-MS/Cognitive-Health.

15 Laura De Giglio, Francesca De Luca, Luca Prosperini, “A Low-Cost Rehabilitation With a Commercial Video Game Improves sustained Attention and Executive functions in Multiple Sclerosis: A Pilot Study,” Neurorehabilitation and Neural Repair 29, no. 5 (2014): 453-461, accessed September 29, 2020, https://journals.sagepub.com/doi/full/10.1177/1545968314554623.