Specific RehaCom Modules Predict Processing Speed Gains in Progressive Multiple Sclerosis

Cognitive decline remains a primary driver of disability in progressive multiple sclerosis, yet clinicians lack a standardized metric for longitudinal assessment, which complicates the timing and delivery of targeted interventions [1]. In the absence of effective pharmacotherapy, non-pharmacological strategies such as computerized cognitive training have demonstrated the ability to improve immediate and delayed verbal memory and information processing speed in this population [2]. A meta-analysis of 3,091 patients further indicates that mobile health applications offer a scalable alternative to traditional therapy, yielding a small but significant effect on cognitive function (standardized mean difference = 0.28) and a moderate effect on fatigue (standardized mean difference = 0.61) [3]. However, the clinical utility of these digital tools is often hindered by high inter-patient variability and a lack of consensus regarding the most effective therapeutic components [4, 5]. To address these uncertainties, a secondary analysis of the CogEx trial (a large-scale randomized controlled trial investigating cognitive rehabilitation and aerobic exercise) provides evidence on how specific training trajectories and patient phenotypes influence long-term cognitive outcomes [6].