Cognition et sclérose en plaques : développement de nouveaux outils d’évaluation « écologique » en réalité virtuelle et d'un programme spécifique de réhabilitation, caractérisation de l’humeur dépressive, évaluation de la qualité de vie et apport de l’imagerie cérébrale à l'étude de la réhabilitation.

摘要

The purpose of this work is to better understand the cognitive and brain changes associated with multiple sclerosis and the influencing factors to help improve cognitive support for people living with MS. We organized our work according to two axes. The first one was to optimize cognitive assessments. We have shown i) a decrease in quality of life (QoL) linked to cognitive impairment and its impact on the professional status and ii) interest in the use of Depressed Mood Scale self-questionnaire that we validated and whose lack of emotional control dimension was particularly associated with QoL. We also developed ecological tasks in virtual environment and showed their potential to evaluate several cognitive components or their interactions, suggesting an interest in evaluating the functional impact of cognitive impairment in daily activities of PwMS. The second, for which we presented the theoretical basis, methodology and preliminary results, was to improve cognitive care through its assessment and rehabilitation (REACTIV study in progress). We created fMRI paradigms and a specific rehabilitation program to guide brain plasticity phenomena in order to optimize the transfer of training in daily life and improve QoL. Preliminary results in multimodal imaging revealed MRI measures of two structures, the thalamus and the corpus callosum, which would be predictive of progression of certain cognitive performance during our therapies.