Multiple Sclerose Centrum
Noord Nederland

6. Develop therapeutic interventions to improve fatigue and social cognition in MS.

MS has many symptoms including cognitive decline and fatigue. We have found that patients with MS, in addition to more usual cognitive symptoms such as memory loss, may also experience problems in socalled social cognition. This leads for instance to the inability to recognize emotions in others which can damage relations with significant others. The goal is to develop a therapeutic intervention to improve social cognition in patients with MS. Fatigue is one of the most frequent reported and debilitating symptoms of MS. Mechanisms underlying fatigue remain poorly understood. Associations between fatigue and performance decline (fatigability) are investigated to understand these mechanisms and improve therapy against increased sense of fatigue.


Fatigue and fatigability in persons with multiple sclerosis

Investigators – Roeland Prak and Inge Zijdewind

Project: Fatigue is one of the most commonly reported symptoms by persons with MS. Fatigue has a negative impact on quality of life, social functioning and employability, and general health and wellbeing. It remains unclear why fatigue is such a prominent symptom in MS. Additionally, the association between measures of fatigue and fatigability are still under debate. In general, fatigability is defined as a decline in performance during a specific task and can be measured using motor or cognitive tasks. Our studies on fatigue aim to understand the mechanisms that are responsible for fatigue, and to study the associations between fatigue and fatigability. An improved understanding of fatigue is crucial to develop effective therapies for fatigue.

Supported by a MD/PhD fellowship and Biogen

: Improving cognitive performance in MS by transcranial alternating current brain stimulation (tACS); proof of concept

Investigators – Branislava Ćurčić-Blake, André Aleman, Jan Meilof, Thea Heersema, Jon   Laman, Inge  Zijdewind, Remco Renken, Christoph Herrmann, Joke M. Spikman, Ysbrand   van der Werf, Nena Lejko

Project: Mild to severe cognitive impairment in MS is widespread (45-70 %) and highly detrimental to quality of life. Minimizing cognitive decline, will thus be of great benefit. Cognitive decline is  associated with the deterioration of brain connections involved in cognitive processing. To increases cognitive performance and processing speed in people with MS we use of transcranial alternating current stimulation (tACS), a novel technique which modulates activity oscillations in the brain.

The practical application of tACS to people with MS and the optimal way to deliver the activation is addressed first. This clinical pilot study is complementary to cognitive training and the first step towards a large multicenter trial, focused on clinical efficacy.

Supported by the Dutch MS Research Foundation

Improving visual rehabilitation for persons with MS

Investigators – Fleur van der Feen, Joost Heutinck

Project: Many persons with MS (pwMS) suffer from visual complaints and impairments. Apart from the obvious visual loss due to optic neuritis, knowledge on the spectrum of visual complaints in MS is limited. Current visual rehabilitation protocols lack evidence based recommendations. In the Netherlands, VISIO is the national organisation for visual revalidation for all diseases including MS. A new online questionnaire will be developed and validated to reliably survey visual complaints in pwMS. To this end, a large group of pwMS with and without visual complaints will complete the questionnaire. A selected group will be invited for a comprehensive analysis of visual functions at VISIO. Using the new questionnaire as guidance, MS specific rehabilitation protocols will be developed.

After the completion of this project a validated questionnaire will be available to pwMS and their doctors to reliably survey visual complaints. MS specific protocols for visual revalidation tailored to individual needs of pwMS can then be applied, thus significantly reducing the burden of visual impairments for pwMS.

Supported by Foundation Novum/VISIO