Oct. 5, 2026

Episode 475: New Tools and Strategies for Managing MS-Related Cognitive Changes with Dr. Elizabeth Gromisch

Show Notes
Transcript

Whether it's walking into a room and blanking on why you're there, struggling to pull up a word that's right on the tip of your tongue, or losing track of daily tasks, cognitive fatigue and brain fog can turn simple routines into exhausting hurdles.

What makes cognitive changes particularly challenging is their invisibility. They don't show up on a routine check-in like mobility issues do. Family members might misread them as distraction. Employers might see them as disengagement. And all too often, clinicians don't have immediate, actionable tools to offer beyond standard advice.

Dr. Elizabeth Gromisch

This week, we're talking with Dr. Elizabeth Gromisch, a research neuropsychologist at the Mandell Center for Comprehensive Multiple Sclerosis Care and Neuroscience Research at Mount Sinai Rehabilitation Hospital in Hartford, Connecticut. Dr. Gromisch's work focuses on moving beyond the diagnostic label to give people real, evidence-based compensatory tools.

We're discussing the science of prospective memory—remembering to perform planned actions in the future—and exploring how smart digital tools, strategic daily systems, and patient empowerment can help you take control and maintain your independence.

We have a lot to talk about! Are you ready for RealTalk MS??!

This Week: New tools and strategies for managing and even improving MS-related cognitive changes :22

We're less than 3 weeks away from MS Toronto 2026 Patient Community Day! Have you registered yet? 1:23

Dr. Elizabeth Gromisch shares a preview of new digital tools to measure and manage MS-related cogntive changes 2:19

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RealTalk MS Episode 475
Guest: Dr. Elizabeth Gromisch

Privacy Policy

WEBVTT

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It's October 6th, and we have a lot to talk about, including brand new approaches

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to managing MS-related cognitive changes.

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For so many people living with MS, cognitive symptoms can be among the most

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disruptive challenges they face.

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What makes them especially frustrating is that they're largely invisible to

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family, to colleagues, and often even to clinicians.

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And that invisibility makes finding effective strategies all the more difficult.

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My guest today is Dr. Elizabeth Gromisch, a research neuropsychologist at the

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Mandel Center for Comprehensive Multiple Sclerosis Care and Neuroscience Research

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at Mount Sinai Rehabilitation Hospital in Hartford, Connecticut.

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Her work sits right at the intersection of neuropsychology, practical technology,

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and patient empowerment, focusing on real-world tools that help people actively

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manage and even improve cognitive dysfunction.

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We'll get to my conversation with Dr. Gromischin just a moment,

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but first, a quick reminder.

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We're now just two weeks away from MS Toronto 2026, this year's joint meeting

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of the America's Committee for Treatment and Research in MS and the European

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Committee for Treatment and Research in MS.

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It's the single largest gathering of MS researchers in the world,

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and you can be a part of it.

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This year, MS Toronto 2026 Patient Community Day is happening both in person

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and online on Friday, October 23rd from 3 to 6 p.m. Eastern Time.

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It's an incredible opportunity to hear leading experts break down the latest

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research presented at the conference into clear, accessible language.

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And you'll even have the chance to submit your own questions directly to the researchers.

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Registration is open now at ectrimspatientcommunity.eu and you can find that

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link waiting for you in today's show notes.

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Whether it's struggling to recall a familiar word, juggling a busy schedule

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that starts to feel overwhelming, or remembering to take medications on time,

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cognitive changes can fundamentally alter how someone navigates daily life with MS.

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Joining me in a moment with a preview of emerging digital tools along with practical

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strategies designed to better manage MS-related cognitive issues is Dr. Elizabeth Gromisch.

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Dr. Gromish is a research neuropsychologist at the Mandell Center for

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Comprehensive Multiple Sclerosis Care and Neuroscience Research at Mount Sinai

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Rehabilitation Hospital in Hartford, Connecticut.

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Welcome back to the podcast, Dr. Gromisch.

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Thank you for having me.

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Your work sits at the intersection of neuropsychology, technology,

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and patient empowerment.

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What first drew you to focus on the cognitive and psychological dimensions of multiple sclerosis?

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So I had a longstanding interest in cognition, actually, because my mother had

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a rare form of brain cancer.

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So I saw firsthand how different neurological conditions can take away our ability

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to remember information or pay attention. So that really led me down the road of neuropsychology.

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And I got into the world of MS courtesy of Dr. Fred Foley.

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I ended up joining his research lab by first month of graduate school,

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which was also the first day I decided I'm gonna be doing work on cognition,

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finding better ways that we can do screening.

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And then from there, it really has evolved to including technology from my own

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experience, living with different

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disabilities and realizing how much technology is not made for people,

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when we have fine motor difficulties, when we have cognitive difficulties or vision difficulties.

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We're going to circle back to that issue in just a moment. You know,

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cognitive changes are often among the most feared and disruptive symptoms for

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people living with MS, but they can be invisible to family members,

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employers, and even clinicians.

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How would you describe the day-to-day impact cognitive dysfunction has on illness

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intrusiveness and quality of life?

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It has such a huge impact because we use our, obviously, we use cognition in our everyday life.

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Just having a conversation right now, there's so much we have to keep track

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of. I have to think of what I'm going to say next, remember what you just asked

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me, and also make sure I'm keeping a good pace.

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So anytime there's a breakdown in any of those cognitive functionings,

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that really can disrupt everyday activities. It could be so much harder to remember

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to take your meditation, pay your bills, or get to your appointments.

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And when those start to build up over time, you could feel like your MS really

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is taking over so much of your life and really affect your quality of life.

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So that's why it's really important as clinicians, as researchers,

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we do a better job of detecting cognitive issues and getting people the support they need sooner.

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I always think of you as being a busy person. You have a lot of projects going,

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and I want to touch on a few of them.

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I know, for instance, you've been active in developing and evaluating MS-CogScreen.

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How does this tool differ from traditional assessments, and how does it balance

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clinical rigor with practicality?

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So there's a couple of things that makes it different. So I think the biggest

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one is this was co-designed with our patients.

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So we didn't just develop it and then test it with people and go from there.

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Every step of the development process, I've had my patient advisory board.

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So they gave me feedback on how the tests actually work, the content.

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And then when we got to the technology part, how it looked on the screen.

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Was it easy for them to navigate? Could they see everything correctly?

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Could they interact with it? because there are some touch components.

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Another big part is it is technology. So a lot of times paper and pencil testing

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can be out of reach for clinicians if they don't have access to a neuropsychologist.

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With the tablet, because we built this to be on an iPad, you just need one device

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and you can do everything on that device, score it, administer it.

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And the last thing that makes it different is we have more than just processing

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speed. We actually developed six different subtests and three different versions.

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And we just completed actually our pilot evaluation and found that we can get

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through this entire battery, including about an average of three questionnaires in about 14 minutes.

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And that's comparable to the BICAMS or the Brief International Cognitive Assessment of MS.

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So the reason we did all this testing is we want to see if it would be rigorous.

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Does it measure what it's supposed to? Do they have around the same level of difficulty?

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And then if we have two different evaluators, do they get the same scores every time?

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I'm happy to say I just finished all of the analyses, actually just last month,

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and showed that our numbers are as good or sometimes even better than some of

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the measures that are out there.

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I know this isn't the only digital tool you're involved in where you've chosen

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to include people living with MS as part of the initial design development phase

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of the tool. Why is that important?

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It's important because these are going to be the individuals using these programs,

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whether it's an assessment tool or a treatment app.

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They're the ones who are using it day to day. So if we don't think about what

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their needs are, how it's going to be easier for them to use if the interface

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is something they like looking at, it's easy to see,

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then they're not going to use

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that tool and we're not really going to make something that's meaningful.

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And I have always said that patients with MS, they're the experts in what their

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MS is. They know what MS is like in their daily life. And I learned so much from them.

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I have my expertise as a neuropsychologist, but I don't know what it's like

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to have MS. So that's why it's so important that every stage of development

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includes patient stakeholders.

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And it's not just, oh, how does it look? It's also the content.

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So in all of our development projects, when we've done interventions,

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we ask people, what have you used in the past?

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If we have this technique, how can I make it easier for you to add it to your daily life?

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A moment ago, I heard you talk about some of the advantages of using a digital

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tool like MS-Cog screen versus pencil and paper.

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Are there potential pitfalls that you've identified or may be on the horizon

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when you're transitioning from that traditional pencil and paper neuropsychological

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test to app or tablet-based cognitive assessments?

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Yeah, there's a couple things that we have to keep in mind, first in the development

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process, and then as we get further along for validation studies.

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The first is always, if there's any touch involvement, is there actually a large enough touch target?

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So if someone has spine motor difficulties, can they easily interact with it?

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Or if they have issues with sensation that they don't really feel they're contacting

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the screen, is it going to read their response?

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Is everything big enough? Because that is a huge issue with blurred vision that

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can people actually read this? Or do we need to go in there and change a screen

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for every single person?

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And that starts to come an issue for cognitive screenings because we need everything

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to be standard across the board.

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So if one screen looks bigger for one person than the next, that's going to

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change the validity of the measure.

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Then when we think further down the line of things like speech recognition technology,

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that's a big thing we use. If you do text-to-speech or use things like Siri

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and Alexa, those are all using things called automated speech recognition.

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Now, a big problem is a lot of that technology is developed with voice samples

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from people who do not have any speech impairments.

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And with MS, we can see things like dysarthria.

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So when we're developing these technologies, when we're implementing them in

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the clinic, we really need to make sure that it has been trained on the voices

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that are going to be, you actually said, in day-to-day actual testing.

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So if we don't include people with dysarthria when we're training these programs,

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and then we roll it out at the clinic, then we're not going to get the actual

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valid response we're expecting.

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And then people might get really

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frustrated because the program's not recognizing what they're setting.

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Much of the research in MS Cognition focuses on processing speed and working memory.

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But you've done some substantial work on prospective memory.

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That's remembering to perform an intended action in the future.

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Why is prospective memory so critical for someone managing MS?

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So, prospective memory is that cognitive domain we use every single day.

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So, it's remembering to remember.

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It's remembering to take your medication, pay your bills, make that phone call,

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go to an appointment. it.

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And it's a very complex type of cognition because not only do you have to remember

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what you're supposed to do, you have to keep track of it the same time you're

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doing everything else in your daily life.

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And then remember not only to do the right thing, but do it at the right time.

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So a breakdown at any point in that process can cause a perspective memory failure.

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And what we've seen is when even when people don't reach the level of significant

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cognitive impairment, they can still make these perspective memory errors and

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they recognize they're making that error.

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The biggest one I've always heard when I do this type of testing is,

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I know I'm supposed to do something, but I can't remember what.

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And that causes such a huge amount of frustration.

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Now, one of the problems we have is when it comes to assessing perspective memory,

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those tests are about a half hour long.

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So when you're doing a full neuropsych that's four hours, that doesn't seem

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like, oh, you could add another half hour testing. That's not that bad.

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But our batteries are so full that that extra half hour sometimes is not feasible.

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So how do we actually deal with that? That's where those cognitive screenings come into play again.

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So if there's a way that we can screen if someone has a potential prospective

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memory issue, we then know for the full evaluation that we need to actually

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do this more detailed evaluation.

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You recently led a feasibility study on improving prospective memory through telehealth.

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I'm wondering what strategies or compensations prove to be most effective,

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and are there strategies that some of our listeners can start applying today?

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Absolutely. So the ones that we found, we looked at two different types of strategies.

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The first one was visualization, and that is when you create a mental picture

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in your mind of what you're going to do.

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So when you start, you really try to pull in all your senses and create a mental

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image of what you're going to do. and you think of what would I hear,

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what would I smell, what do I taste, what colors would I see?

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And we build up from there to help you start to use those visual imagery to

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remember what you're supposed to do.

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And then the other technique we add to that is something called implementation

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intentions or adding if-then cues.

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And the reason we do that is we can really divide perspective memory into time-based and event-based.

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So event-based is when you need to do a task surrounded by an event.

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So when the coffee pot goes off, I take my medication.

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Time-based is when it's around a time, such as in 15 minutes,

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I need to do this, or at 11.15, I need to go to my appointment.

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And that time-based one is a lot harder for people with MS.

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So when we do those if-then strategies, that helps make a more salient cue to

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when they're supposed to do something. So that coffee one comes up as an example

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a lot because that's what I train people with.

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So if I see that my coffee is the alarm goes off, then I take my medications.

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And these visual strategies have actually been found to be one of the strongest

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evidence-based cognitive strategies for MS across different types of memory.

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We recently published a systematic review where we detailed every single strategy

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that has been examined in clinical trials and different experimental trials

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to see what's the evidence behind them.

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And those visualization strategies really come across as being some of the strongest evidence.

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So in terms of practicing that at home, there are some different worksheets

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out there, but one of the biggest issues with cognitive rehabilitation,

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especially when it comes to these compensatory strategies,

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it often requires having a clinician to help guide you through it and provide training.

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And that can be a limitation if you don't live near an MS center that offers

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it or have access to somebody who offers it services.

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So that's actually something that we're hoping with our app projects to make

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available to people with MS. We are adopting our self-management program,

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Managing My MS My Way, and we'll be using natural language processing to make that a reality.

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So we will be able to have something in an app where you could practice those

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different strategies and see what works for you.

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You know, I was about to ask you about Managing My MS My Way,

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so this is perfect timing. Tell us more about that program.

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So Managing My MS, My Way is a self-management program. We actually started

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developing it coming up on eight years now, since I just celebrated nine years

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here at the Mandel Center. And I started the very early work on it within the first couple months.

00:16:15.770 --> 00:16:20.590
And the idea is we wanted to take evidence-based self-management strategies

00:16:20.590 --> 00:16:25.270
like cognitive behavioral therapy and energy conservation and put it in the

00:16:25.270 --> 00:16:29.560
palm of your hand so you can access it from your phone whenever you need it.

00:16:30.340 --> 00:16:34.780
And this has, we started with the fatigue, where we have six different modules

00:16:34.780 --> 00:16:39.520
with a lot of interactive worksheets, relaxation tapes developed specifically

00:16:39.520 --> 00:16:42.420
for people with MS, and lots of education.

00:16:42.620 --> 00:16:47.200
So whenever you want to learn new strategies or need some guidance in managing

00:16:47.200 --> 00:16:51.040
your fatigue, you could do it right from your phone or your tablet.

00:16:51.040 --> 00:16:53.620
Eventually, we will also have it available on the computer.

00:16:54.470 --> 00:16:59.260
So it's been a number of years, actually, when we last spoke way back in 2022,

00:16:59.260 --> 00:17:04.170
we had just finished asking our patient stakeholders about what strategies they

00:17:04.170 --> 00:17:07.650
wanted in this app and how we can make it easier to use.

00:17:08.480 --> 00:17:14.120
And over the summer, we finished the beta testing. So we have a fully functional version of the app.

00:17:14.330 --> 00:17:17.890
We asked several of our patient stakeholders to take it home for six weeks,

00:17:18.370 --> 00:17:22.300
try to break it because we're interested in finding any bugs or anything we

00:17:22.300 --> 00:17:24.420
could change to make it easier to use.

00:17:25.370 --> 00:17:29.570
And we found, even though we only asked people, try using it once a week so

00:17:29.570 --> 00:17:31.370
we could see if these different features work,

00:17:31.990 --> 00:17:37.240
we had people using it every day or multiple times a day and then asking,

00:17:37.240 --> 00:17:41.370
when is this going to come available for me to actually use for real life?

00:17:43.130 --> 00:17:46.730
And at this point, we're just making all those adjustments and we'll be doing

00:17:46.730 --> 00:17:50.850
a feasibility study. We're actually changing it to be national so you don't

00:17:50.850 --> 00:17:54.310
have to live in Connecticut to use it, hopefully this fall.

00:17:55.020 --> 00:17:59.690
And our next steps in this line of work is we're trying to make this version

00:17:59.690 --> 00:18:01.550
to address other MS symptoms.

00:18:02.240 --> 00:18:06.550
So our next one that we recently got funding for is to make that cognition version.

00:18:07.010 --> 00:18:10.990
Well, that's exciting. And when the feasibility study goes national,

00:18:11.110 --> 00:18:14.320
if you let me know, I'll let everybody listening to us know,

00:18:14.320 --> 00:18:17.520
and hopefully we can help populate that study for you.

00:18:18.170 --> 00:18:22.710
Fantastic. Yeah, we realize that there are people out there that want to use

00:18:22.710 --> 00:18:26.460
this kind of program, but coming to see me in Hartford might be a little difficult.

00:18:26.930 --> 00:18:32.820
So we have adjusted the study of materials, so you do not need to drive here.

00:18:33.140 --> 00:18:34.930
If you want to, you can always come see me.

00:18:35.320 --> 00:18:41.650
But you'll be able to do everything using RedCap and meeting with us one time on Microsoft Teams.

00:18:42.330 --> 00:18:43.300
That sounds great.

00:18:44.120 --> 00:18:48.530
Your research has shown that self-management behaviors aren't just about knowledge.

00:18:48.840 --> 00:18:53.500
They involve personality, psychosocial health, and physical functioning.

00:18:54.180 --> 00:18:57.810
When you're designing mobile health or mHealth interventions,

00:18:58.240 --> 00:19:02.450
how do you go about tailoring these programs to fit these different patient profiles?

00:19:03.170 --> 00:19:08.340
The big thing we try to do is really make it the program for people to really

00:19:08.340 --> 00:19:09.730
pick and choose what works for them.

00:19:09.910 --> 00:19:14.520
So when we're putting everything together, we're trying to basically cover everything

00:19:14.520 --> 00:19:18.920
under the sun that we can feasibly make available on technology.

00:19:19.510 --> 00:19:25.640
And then we really put it back on the individual. And we say about finding what

00:19:25.640 --> 00:19:28.020
works for you and normalizing.

00:19:28.210 --> 00:19:32.000
If one of these strategies doesn't work for you, you don't like it,

00:19:32.430 --> 00:19:34.270
you don't have to keep using it.

00:19:34.710 --> 00:19:37.340
And that can be a source of frustration for people otherwise,

00:19:37.340 --> 00:19:41.040
when they're told, well, you have to do this strategy, you have to do this activity.

00:19:41.600 --> 00:19:43.720
We really put the power back to the patient.

00:19:44.430 --> 00:19:50.220
When we're designing on the tech aspect, we really are trying to make sure that it is.

00:19:51.730 --> 00:19:57.580
Regardless of who you are, where you are, or what kind of difficulties you have.

00:19:58.350 --> 00:20:03.420
So big things that we did, we took a lot of this very complex information.

00:20:03.950 --> 00:20:07.280
Everything is written in the sixth grade reading level. So you do not have to

00:20:07.280 --> 00:20:12.260
have a lot of experience learning about advanced psychological techniques before you start using it.

00:20:12.880 --> 00:20:16.700
We want things to be as much point and click as possible.

00:20:17.270 --> 00:20:21.780
Having things like speech-to-text available and easy to use,

00:20:22.480 --> 00:20:25.860
and also at baseline, making it a very big font.

00:20:26.300 --> 00:20:34.860
So if you ever look at the normal, I'll find it's a size 12 to 14 font,

00:20:34.860 --> 00:20:36.510
which can be hard for you.

00:20:36.510 --> 00:20:41.810
Our base is size 18, which is the second to largest setting if you were to activate

00:20:41.810 --> 00:20:43.660
that on your phone for every other page.

00:20:44.360 --> 00:20:49.300
Missed appointments and treatment drop-offs are major concerns in chronic illness management.

00:20:49.870 --> 00:20:54.080
What has your research revealed about the root factors behind clinical attendance

00:20:54.080 --> 00:20:58.380
behaviors, and how do you think health systems can better support patients?

00:20:59.160 --> 00:21:02.420
So a big one, going back to what we started talking about, is cognition.

00:21:02.420 --> 00:21:07.180
So that perspective memory is a huge factor, because if people can't remember

00:21:07.180 --> 00:21:10.690
they have an appointment, they're not going to be able to come in.

00:21:11.580 --> 00:21:15.870
So, in order to address that, we need to make sure that we're providing additional

00:21:15.870 --> 00:21:18.610
supports for people who have memory difficulties.

00:21:19.130 --> 00:21:24.210
So, things like offering reminders. We have seen over the years that offering

00:21:24.210 --> 00:21:27.850
telehealth appointments really can make quite a difference for people.

00:21:27.850 --> 00:21:33.870
So, if they can't come into the clinic or maybe they had a last-minute change,

00:21:34.740 --> 00:21:38.360
offering a telehealth appointment can make all the difference for people.

00:21:39.180 --> 00:21:43.760
Things like mood can also affect appointment attendance. So if someone is depressed,

00:21:43.760 --> 00:21:48.980
it's a lot harder to make that activation behavior and then come into the appointment.

00:21:49.510 --> 00:21:55.170
So being aware of the different factors that can affect attendance and really

00:21:55.170 --> 00:21:58.750
having a supportive relationship between patient and provider.

00:21:59.250 --> 00:22:02.710
So if patients feel supported, that's going to make a huge difference and they're

00:22:02.710 --> 00:22:07.240
more likely to interact with their provider than feeling they're being judged

00:22:07.240 --> 00:22:09.590
when they missed an appointment. or they missed a medication.

00:22:10.110 --> 00:22:15.300
So that's also crucial for health systems too, is to be understanding and offer

00:22:15.300 --> 00:22:18.060
support when you can and be flexible if possible.

00:22:18.780 --> 00:22:23.490
I frequently hear that people living well with MS rely on a high level of resilience.

00:22:24.220 --> 00:22:28.930
You co-developed the Multiple Sclerosis Resiliency Scale, which is the first

00:22:28.930 --> 00:22:32.740
multidimensional measure of resilience specific to MS.

00:22:33.480 --> 00:22:38.690
Why develop an MS-specific scale rather than relying on general resilience metrics.

00:22:39.590 --> 00:22:45.320
So a lot of those general resilience metrics were designed for different psychological conditions.

00:22:45.440 --> 00:22:51.770
So it's really based on maybe a one-time event that caused trauma rather than

00:22:51.990 --> 00:22:54.800
how chronic illness can affect us over many years.

00:22:55.460 --> 00:22:58.690
I had started developing that measure actually based on my experience being

00:22:58.690 --> 00:23:03.100
a caretaker to my mother and seeing how living with multiple types of cancer

00:23:03.500 --> 00:23:06.360
really affected how she faced the world.

00:23:06.360 --> 00:23:12.780
And I saw how she bounced back, even when faced with some of the worst news you could possibly get.

00:23:13.440 --> 00:23:17.980
So it started with having conversations with her and realizing this is not really

00:23:17.980 --> 00:23:22.170
reflected in the measures out there for assessing resilience.

00:23:22.710 --> 00:23:26.550
And I saw a lot of those same things popping up with MS as well.

00:23:26.550 --> 00:23:30.720
So that really drove me to try to develop something that captures more of that

00:23:30.720 --> 00:23:36.000
wider experience, as well as the different factors that can influence resilience.

00:23:36.490 --> 00:23:41.290
Trillia is a biopsychosocial model. So there are the psychological aspects.

00:23:41.540 --> 00:23:46.550
There's also physical and there's also social. So we need to consider all those

00:23:46.550 --> 00:23:51.650
different factors and how that may affect how someone responds to all the stressors

00:23:51.650 --> 00:23:52.900
they're at-masking cause.

00:23:53.480 --> 00:23:58.110
So I guess I have a two-part question for you here. How does resilience act

00:23:58.110 --> 00:24:02.670
as a protective buffer against illness intrusiveness and cognitive decline?

00:24:03.180 --> 00:24:08.360
And do you see resilience as a fixed trait, or is it something that can be actively

00:24:08.360 --> 00:24:09.730
built and strengthened?

00:24:10.320 --> 00:24:12.970
It's definitely something that can be built and strengthened.

00:24:12.970 --> 00:24:16.310
So we look at the different aspects of resilience.

00:24:16.310 --> 00:24:21.900
So being able to view the way that you view the world, some of that optimism

00:24:21.900 --> 00:24:26.300
is a big factor, too. So we can address some of these different aspects of resilience

00:24:26.300 --> 00:24:29.610
with different interventions or building support systems.

00:24:30.520 --> 00:24:36.380
And the way that we can view resilience as a buffer is when someone has these

00:24:36.380 --> 00:24:43.420
protective factors, when they are more able to bounce back when they have stressors in their life.

00:24:43.420 --> 00:24:46.460
Doesn't mean they don't get depressed, they don't get anxious,

00:24:46.930 --> 00:24:51.440
but it's similar to different reserve metrics. It's something that kind of,

00:24:52.560 --> 00:24:55.980
lessens the blow when you're dealing with different stressors.

00:24:56.410 --> 00:25:00.060
So that way it doesn't have as much of an impact.

00:25:00.290 --> 00:25:04.300
Or you're being able to have different coping strategies that when you're faced

00:25:04.300 --> 00:25:09.960
with symptom worsening or more difficult doing activities, you're able to mentally,

00:25:09.960 --> 00:25:13.910
you can rationalize what's going on, find, okay, this is what's going on right now.

00:25:14.190 --> 00:25:16.780
And this is how I'm going to address this.

00:25:17.440 --> 00:25:21.860
You know, researchers who base their work on what the evidence shows them never

00:25:21.860 --> 00:25:26.590
enjoy this question, but I'm going to ask you to get your crystal ball out for a moment.

00:25:27.020 --> 00:25:32.680
And as you consider the future of MS care, what emerging digital health or new

00:25:32.680 --> 00:25:37.450
psychological development excites you the most over the next five to 10 years?

00:25:38.140 --> 00:25:41.650
So there's a lot, there's definitely a lot of different things that are coming out there.

00:25:41.840 --> 00:25:48.330
I think digital tools are offering, opening whole new doors for people to access

00:25:48.330 --> 00:25:49.670
psychological treatments.

00:25:50.540 --> 00:25:55.400
I think in the world of MS, access to psychological treatments has been

00:25:55.400 --> 00:26:01.070
a barrier for so many people, whether it's having providers that are knowledgeable

00:26:01.070 --> 00:26:04.160
about MS, having any mental health providers.

00:26:04.570 --> 00:26:08.780
I know there's not a ton of us out there, even less so with neuropsychologists.

00:26:09.070 --> 00:26:14.120
So I always feel bad that I'm 100% research and And I can't see people clinically,

00:26:14.120 --> 00:26:19.830
so my research studies are a backdoor way for people to get some of this information.

00:26:20.570 --> 00:26:25.970
But now that we are having more advanced technology that can be accessible,

00:26:26.110 --> 00:26:31.030
that you can be able to access from your phone when you need it,

00:26:31.030 --> 00:26:34.130
that can connect with wearable devices like smartwatches.

00:26:34.900 --> 00:26:40.980
This is going to make it easier for people to access evidence-based interventions.

00:26:41.610 --> 00:26:46.550
It's going to make it easier for clinicians to provide screenings,

00:26:46.550 --> 00:26:51.550
provide assessments, when previously they couldn't access these kind of tools

00:26:51.550 --> 00:26:54.570
because they didn't have the right clinician in the clinic.

00:26:55.080 --> 00:26:59.310
So then patients are getting care earlier and they're getting help when they need it.

00:27:00.520 --> 00:27:05.250
And I think as we see better improvements with accessibility,

00:27:05.770 --> 00:27:10.960
when I mentioned the automated speech recognition, we've become better at understanding

00:27:10.960 --> 00:27:12.490
we need more training data.

00:27:12.810 --> 00:27:17.190
So there is a great project called the Speech Accessibility Project,

00:27:17.190 --> 00:27:22.360
where they had data from 999 people with speech impairments.

00:27:22.940 --> 00:27:28.900
And the whole idea was to get data from people with dysarthria so that speech

00:27:28.900 --> 00:27:34.530
recognition technology is more accurate to when people have impairments.

00:27:35.130 --> 00:27:39.320
And we're lucky we actually have access to that data, and we're using that for

00:27:39.320 --> 00:27:41.790
training speech recognition for MS-COG screen.

00:27:42.360 --> 00:27:45.920
So that way, it's not going to be a barrier. If someone has a speech impairment,

00:27:45.920 --> 00:27:50.610
they can still get access to these cognitive screening tools.

00:27:51.840 --> 00:27:55.430
And I think as we see more of these technologies becoming on the market,

00:27:55.540 --> 00:27:57.290
and that's also a crucial thing, too.

00:27:57.470 --> 00:28:01.900
We could do all the research we want, but if we don't make this available to

00:28:01.900 --> 00:28:06.990
the general public, then we haven't really made an impact. So I know for my

00:28:06.990 --> 00:28:11.390
own work, we're hoping over the next couple of years to move towards the commercialization stage.

00:28:11.790 --> 00:28:15.680
So you don't have to come in for a research study to access these programs.

00:28:16.220 --> 00:28:18.610
And I think that's going to make a huge difference for people.

00:28:19.250 --> 00:28:23.600
Well, Dr. Elizabeth Gromisch, I want to thank you for all the ways your research

00:28:23.600 --> 00:28:27.200
continues to improve the quality of life for people living with MS.

00:28:27.510 --> 00:28:29.480
And thanks so much for talking with me today.

00:28:30.000 --> 00:28:31.120
Thank you so much.

00:28:32.130 --> 00:28:36.750
That's going to wrap up this episode of Real Talk MS. Real Talk MS is powered

00:28:36.750 --> 00:28:38.540
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00:28:38.940 --> 00:28:43.240
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Episode 475: New Tools and Strategies for Managing MS-Related Cognitive Changes with Dr. Elizabeth Gromisch

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