Evaluation of the effect of digital game on attention and psychosocial factors in Multiple Sclerosis: Randomized study with test-retest control group

Introduction: Multiple sclerosis (MS), is a chronic, progressive and demyelinating central nervous disease. Cognitive dysfunction is seen in attention, information processing, executive functions, memory and visual-spatial capabilities in MS patients. In this study, the effect of digital game on attention and psychosocial factors in MS patients in time were investigated. Aim and Hypothesis: The aim of this study is comparing and evaluating of the effect of digital game application on attention and psychosocial factors in multiple sclerosis patients. Method: Information on the psychosocial characteristics of MS patients with Demographic Data Form, Expanded Disability Status Scale (EDSS) was used to evaluate disability levels. MusiQoL for quality of life measurement (International MS Life Quality Inventory) and Beck Depression Inventory (BDI) were used respectively, for depression level. All participants' cognitive assessment have been evaluated with Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) battery, which includes the Symbol Digit Modalities Test (SDMT), the California Verbal Learning Test-II (CVLT-II) and the Brief Visuospatial Memory Test-Revised (BVMT-R). Trail Making Test Form A-B, Stroop Test and Wechsler Memory Scale 3- Digit Span were used to measurement of attention functions in pre-test and after 2 months of rehabilitation with final test. Game instructions were introduced patients after first interview and private accounts were created to login into application. One session was planned 30 minutes for 4 games in DEU MS Polyclinic, one session was planned as home assignment at home. Only 23 diagnosed MS patients included in application and total 41 diagnosed MS patients, 27 healthy individuals included in the research. Findings: There was a statistically significant difference between the study groups and the Pre and Post Test Beck Depression Scale scores. When the pre-test and final test scores were examined within themselves, the mean score obtained from the control MS group was higher than the mean MS group score. Post-test SDMT performances of the application group no significant relationship was found between the control groups. Correct score for CVLT-II increased after rehabilitation for the treatment group, decreased the repeat score, and also showed a significant difference in the repeat score with the control groups. BVMT-R performance of the treatment gorup made a significant difference between the post-test and pre-test scores. There was a significant difference in posttest measurement compared to control groups. Stroop test time difference, correction and error scores showed a significant difference in the post-test measurements with the Control MS group. Stroop time difference and number of corrections were found to be significant for the treatment group as a result of posttest pre-test comparison. The total score for the treatment group showed a significant increase in the posttest pretest comparison in Digit Span. For Treatment gorup, Trail Making Test B duration was found a significant difference between the pre-test group and the control MS group. Result: Most of the cognitive test scores of the Treatment MS group showed significant difference compared with the control groups. Brainquire application's category of attention was found related with the neurocognitive tests which used in the research, and it was argued that the results reflected. However, the correlations between psychosocial factors and neurocognitive tests were not found high. Key words: Multiple sclerosis, cognitive functions, digital game application, depression