Enhancing Cognitive Rehabilitation in Multiple Sclerosis via P300 Brain-Computer Interfaces: A Proof of Concept

Background: Multiple sclerosis (MS) affects mainly young and middle aged adults and cognitive impairment significantly impacts their quality of life. This study explores the effects of a cognitive rehabilitation therapy using a P300-based brain-computer interface (BCI) in people with MS (pwMS). Methods: The therapy consisted of 16 cognitive rehabilitation sessions using a P300-based BCI. In each session, three different tasks were rehearsed, designed to stimulate different cognitive functions. As outcomes of the study, the cognitive functions were evaluated via the brief international cognitive assessment for MS (BICAMS) component scales before and after the intervention. The quality of life was evaluated using the MS international quality of life (MUSIQoL) questionnaire. The amplitude and latency of the P300 were obtained from the EEG signal recorded during the first and last sessions. Results: Three pwMS completed the cognitive rehabilitation therapy. A general improvement was seen in the BICAMS and MUSIQoL. In particular, all the subjects achieved an increase higher than 10% in the component scale symbol digit modalities test (SDMT) and this difference is clinically meaningful. Concerning the characteristics of the P300, the mean latency of the group decreased 50.89 ms and the mean amplitude showed no change between the two moments. These results may reflect changes at cortical level after the intervention. Conclusions: These findings suggest that the therapy described could positively affect cognitive function and that the P300 may be considered as an objective indicator of cognitive performance which complements the evaluation of the effects of P300-based BCI therapies.