The role of individual differences in cognitive training and transfer

Digital cognitive training in children with attention-deficit/hyperactivity disorder: a study protocol of a randomised controlled trial

INTRODUCTION

Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent neurodevelopmental disorders and is a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with daily functioning. Children with ADHD are developmentally vulnerable, with the disorder linked to emotional regulation difficulties, behavioural disturbances, as well as academic challenges. Emerging evidence suggests that children with ADHD may benefit from cognitive training interventions, including those focused on attention. This study aims to assess the immediate and long-term efficacy of an attention training intervention in children with ADHD.

METHODS AND ANALYSIS

This study is a preregistered, parallel, double blind, randomised controlled trial. Participants will comprise 104 children with a diagnosis of ADHD aged 5-8 years 11 months. Participants will be randomly allocated to either an adaptive, digital game-based (1) attention training programme (intervention) or (2) a numeracy programme (control). Both programmes will be delivered on a touchscreen tablet, and children will complete five 20 min sessions per week for a 5-week period at home (25 sessions in total). Assessments of the primary outcome (ie, attention and inhibitory control) and secondary outcomes (ie, selective attention, interference control, sustained attention, inhibition, behavioural attention, impairment in everyday functioning, working memory and executive functioning) will occur at preintervention, immediately postintervention and at 3-month follow-up. Multivariate linear regression will be employed to examine primary and secondary outcomes. The data analyst will be blinded to group membership.

ETHICS AND DISSEMINATION

Ethics approval has been obtained from the Monash University HREC (20495). Results will be disseminated through peer-reviewed journals, conference presentations, media outlets, the internet and various community/stakeholder activities.

TRIAL REGISTRATION NUMBER

ACTRN12620000964910, UTN U1111-1250-2620.

Working Memory Training Coupled With Transcranial Direct Current Stimulation in Older Adults: A Randomized Controlled Experiment

Background

Transcranial direct current stimulation (tDCS) has been employed to boost working memory training (WMT) effects. Nevertheless, there is limited evidence on the efficacy of this combination in older adults. The present study is aimed to assess the delayed transfer effects of tDCS coupled with WMT in older adults in a 15-day follow-up. We explored if general cognitive ability, age, and educational level predicted the effects.

Methods

In this single-center, double-blind randomized sham-controlled experiment, 54 older adults were randomized into three groups: anodal-tDCS (atDCS)+WMT, sham-tDCS (stDCS)+WMT, and double-sham. Five sessions of tDCS (2 mA) were applied over the left dorsolateral prefrontal cortex (DLPFC). Far transfer was measured by Raven’s Advanced Progressive Matrices (RAPM), while the near transfer effects were assessed through Digit Span. A frequentist linear mixed model (LMM) was complemented by a Bayesian approach in data analysis.

Results

Working memory training improved dual n-back performance in both groups submitted to this intervention but only the group that received atDCS+WMT displayed a significant improvement from pretest to follow-up in transfer measures of reasoning (RAPM) and short-term memory (forward Digit Span). Near transfer improvements predicted gains in far transfer, demonstrating that the far transfer is due to an improvement in the trained construct of working memory. Age, formal education, and vocabulary score seem to predict the gains in reasoning. However, Bayesian results do not provide substantial evidence to support this claim.

Conclusion

This study will help to consolidate the incipient but auspicious field of cognitive training coupled with tDCS in healthy older adults. Our findings demonstrated that atDCS may potentialize WMT by promoting transfer effects in short-term memory and reasoning in older adults, which are observed especially at follow-up.

What Is Targeted When We Train Working Memory? Evidence From a Meta-Analysis of the Neural Correlates of Working Memory Training Using Activation Likelihood Estimation

Working memory (WM) is the system responsible for maintaining and manipulating information, in the face of ongoing distraction. In turn, WM span is perceived to be an individual-differences construct reflecting the limited capacity of this system. Recently, however, there has been some evidence to suggest that WM capacity can increase through training, raising the possibility that training can functionally alter the neural structures supporting WM. To address the hypothesis that the neural substrates underlying WM are targeted by training, we conducted a meta-analysis of functional magnetic resonance imaging (fMRI) studies of WM training using Activation Likelihood Estimation (ALE). Our results demonstrate that WM training is associated exclusively with decreases in blood oxygenation level-dependent (BOLD) responses in clusters within the fronto-parietal system that underlie WM, including the bilateral inferior parietal lobule (BA 39/40), middle (BA 9) and superior (BA 6) frontal gyri, and medial frontal gyrus bordering on the cingulate gyrus (BA 8/32). We discuss the various psychological and physiological mechanisms that could be responsible for the observed reductions in the BOLD signal in relation to WM training, and consider their implications for the construct of WM span as a limited resource.

Brief Strategy Training in Aging: Near Transfer Effects and Mediation of Gains by Improved Self-Regulation

A common approach to cognitive intervention for adults is memory strategy training, but limited work of this type has examined intervention effects in relation to self-regulation (e.g., strategy usage, memory beliefs) and few have established near transfer (training-related performance gain on untrained tasks related to the target task). The present research, Everyday Memory Clinic—Revised (EMC-R), examined whether relatively brief face-name association training, offering elements focused on self-regulation, can improve name recall, enhance memory self-regulation, and lead to near transfer. Participants were 122 healthy, well-educated middle-aged and older adults (51–90 years old) randomly assigned to a strategy training program (SO), a comparable program with a theoretical self-regulatory boost (SB), or a waitlist control group. Compared to the waitlist group, both groups of trainees demonstrated higher pretest-posttest improvements in name recall (target task), memory self-efficacy, and effective strategy use, as well as the near transfer of gains to nontrained associative tasks, a rare finding in strategy training research. Furthermore, changes in memory self-efficacy and strategy use fully mediated the effect of training on name recall. This innovative approach for brief memory intervention offers a model for successful training that can be easily disseminated via community centers and lifelong learning programs.

On the Role of English as a Foreign Language Learners' Individual Differences in Their Use of Grammar Learning Strategies

As the use of strategies facilitates the tedious process of language learning, a multitude of studies have been conducted on language learning strategies and their educational consequences. Nonetheless, grammar learning strategies (GLSs) have not been widely studied. Moreover, no review study has been carried out to illustrate the role of individual differences in the use of GLSs. To address the existing gaps, the present review study intends to explain the role of English as a foreign language (EFL) learners’ individual differences (i.e., desire to learn a second language, motivation, and willingness to communicate) in their employment of GLSs. The favorable impact of individual difference variables on grammar learning strategy use was proved using the theoretical and empirical evidence. Future research directions and pedagogical implications are also discussed.

A Machine Learning Approach to Personalize Computerized Cognitive Training Interventions

Executive functions are a class of cognitive processes critical for purposeful goal-directed behavior. Cognitive training is the adequate stimulation of executive functions and has been extensively studied and applied for more than 20 years. However, there is still a lack of solid consensus in the scientific community about its potential to elicit consistent improvements in untrained domains. Individual differences are considered one of the most important factors of inconsistent reports on cognitive training benefits, as differences in cognitive functioning are both genetic and context-dependent, and might be affected by age and socioeconomic status. We here present a proof of concept based on the hypothesis that baseline individual differences among subjects would provide valuable information to predict the individual effectiveness of a cognitive training intervention. With a dataset from an investigation in which 73 6-year-olds trained their executive functions using an online software with a fixed protocol, freely available at www.matemarote.org.ar, we trained a support vector classifier that successfully predicted (average accuracy = 0.67, AUC = 0.707) whether a child would improve, or not, after the cognitive stimulation, using baseline individual differences as features. We also performed a permutation feature importance analysis that suggested that all features contribute equally to the model's performance. In the long term, this results might allow us to design better training strategies for those players who are less likely to benefit from the current training protocols in order to maximize the stimulation for each child.

Baseline capacities and motivation in executive control training of healthy older adults

OBJECTIVES

Normal aging involves progressive prefrontal declines and impairments in executive control. This study aimed to examine the efficacy of an executive-control training focusing on working memory and inhibition, in healthy older adults, and to explore the role of individual differences in baseline capacities and motivation in explaining training gains.

METHODS

Forty-four healthy older adults were randomly assigned to an experimental (training executive control) or active control group (training processing speed). Participants completed six online training sessions distributed across two weeks. Transfer effects to working memory (Operation Span test), response inhibition (Stop-Signal test), processing speed (Pattern Comparison) and reasoning (Raven's Advanced Progressive Matrices and Cattell Culture Fair test) were evaluated. Furthermore, we explored individual differences in baseline capacities and assessed motivation during and after the intervention.

RESULTS

The experimental group, but not the active control, showed significant transfer to response inhibition. Moreover, a general compensation effect was found: older adults with lower baseline capacities achieved higher levels of training improvement. Motivation was not related to training performance.

CONCLUSION

Our results encourage the use of executive control training to improve cognitive functions, reveal the importance of individual differences in training-related gains, and provide further support for cognitive plasticity during healthy aging.

Piano Training Enhances Executive Functions and Psychosocial Outcomes in Aging: Results of a Randomized Controlled Trial

Objectives

Preliminary evidence suggests piano training may enhance areas of executive functions and psychosocial outcomes in aging adults. However, little is known regarding specific cognitive outcomes affected and whether or not enhancements are sustainable. We conducted a randomized controlled trial to evaluate the effects of piano training on cognitive performance, psychosocial well-being, and physiological stress and immune-function, in older adults.

Methods

Older adults (N=155, 60-80 years) completed an initial three-hour assessment of standardized cognitive and psychosocial measures. Participants were randomly assigned to one of three groups: piano training, computer-assisted cognitive training, or a no treatment control group. Training groups completed a 16-week program with two group training sessions per week for 90 minutes each session. All participants completed a standard battery of executive functions (working memory, processing speed, verbal fluency), psychosocial measures (musical and general self-efficacy, mood), and physiological measures (cortisol and immune-function) at pretesting, posttesting, and at a three-month follow-up time point.

Results

Results showed that piano training and computer-assisted cognitive training enhanced working memory and processing speed as compared to controls. Piano training significantly increased verbal fluency skills in category switching, as compared to computer-assisted cognitive training and no treatment controls. Participants in piano training demonstrated enhanced general and musical self-efficacy post-training; however, no significant differences were found for physiological measures.

Discussion

Piano training resulted in a unique advantage in category switching as compared to computer-assisted cognitive training and no treatment controls. Music training programs may mitigate or prevent cognitive deficits in verbal skills.

Comparing the Transfer Effects of Three Neurocognitive Training Protocols in Children With Attention-Deficit/Hyperactivity Disorder: A Single-Case Experimental Design

The current study used behavioural and electroencephalograph measures to compare the transferability of three home-based interventions — cognitive training (CT), neurofeedback training (NFT), and CT combined with NFT — for reducing symptoms in children with attention-deficit/hyperactivity disorder (AD/HD). Following a multiple-baseline single-case experimental design, twelve children were randomised to a training condition. Each child completed a baseline phase, followed by an intervention phase. The intervention phase consisted of 20 sessions of at-home training. Tau-U analysis and standardised visual analysis were adopted to detect effects. Results showed that CT improved inhibitory function and NFT improved alpha EEG activity and working memory. The combined condition, which was a reduced ‘dose’ of CT and NFT, did not show any improvements. The three conditions did not alleviate AD/HD symptoms. While CT and NFT may have transfer effects on executive functions, considering the lack of improvement in symptoms, this study does not support CT and NFT on their own as a treatment for children with AD/HD.

Prior Prognostic Expectations as a Potential Predictor in Neurofeedback Training

The present study evaluated whether subjects’ expectations and neurofeedback training performance predict neurofeedback efficacy in cognitive training by controlling both factors as statistical variables. Twenty-two psychology students underwent neurofeedback training, employing beta/theta protocol to enhance beta1 power (13–21 Hz) and suppress theta (4–7 Hz) power. Neurofeedback efficacy was evaluated by behavioral components measured on pre-tests and post-tests employing a visual continuous performance task. The results revealed a significant interaction term between change in reaction time from pre-test to post-test and expectancy effect, indicating that participants with high prognostic expectations showed better improvement in reaction time scores. The data did not reveal that actual neurofeedback performance influenced the post-test measurements of the visual continuous performance task. No significant differences were found for reaction time variability, omission, or commission errors. Possible factors contributing to the results are discussed, and directions for future research are suggested.

Intelligence Can Be Used to Make a More Equitable Society but Only When Properly Defined and Applied

In the US, undeniable evidence shows that socioeconomic inequities explain a high proportion of individual differences in school achievement. Although not all countries show this same effect due to socioeconomic status, it is consistently found that social inequities lead to achievement gaps. These achievement gaps then manifest into trajectories that set some individuals on a path of lower incomes, poorer health and higher mortality, lower wellbeing, and other poor adult outcomes. Like James Flynn so handily reminded the scientific literature that achievement gaps are explainable by environmental factors, the inequities we see around the world are based on environments some children are exposed to. In his work, Flynn stated his belief that the suppression of scientific work on intelligence would continue to lead to social inequities. We wish to take this idea and move it forward. We believe that the scientific construct of intelligence plays a key role in helping create a more equitable society through science. We also believe that the poor perception of intelligence, rooted in historical realities, means that it will continue to be misunderstood, feared, and misused, limiting how effective it could be in helping to close gaps in achievement and in creating a more equitable society.

Effect of test anxiety on visual working memory capacity using evidence from event-related potentials

This study examined the effects of test anxiety on working memory capacity. Studies have demonstrated that individuals with trait social anxiety disorder exhibit increased visual working memory capacity and that those with trait anxiety exhibit decreased working memory capacity. Test anxiety may also induce unique effects on individuals' working memory capacity, and we thus employed the change detection task to explore such effects. Participants were divided into high- and low-test anxiety groups. We used K score and contralateral delay activity (CDA) amplitude to measure working memory capacity, focusing on processing effectiveness and efficiency. The study results revealed that deficits in the working memory capacity of individuals in the high test anxiety group manifested in the CDA amplitude rather than in the K score. The CDA amplitude of the high test anxiety group did not increase after load 3, and that of the low test anxiety group did not increase after load 4. No difference was observed in the K scores of the two groups. The study concluded that test anxiety impairs processing efficiency but not processing effectiveness.

The Mindset of Intelligence Is Not a Contributor of Placebo Effects in Working Memory Training

Whether working memory training is effective in enhancing fluid intelligence remains in dispute. Several researchers, who doubt the training benefits, consider that placebo effects may be the reason for positive training gains. One of the vital variables that may induce the placebo effect is the mindset of intelligence. In this article, we provide a test of whether the mindset of intelligence leads to placebo effects in working memory training. Participants were overtly recruited and allocated to the growth mindset group or the fixed mindset group by Theories of Intelligence Scale scores. A single, 1 h session working memory training is the cue to introduce the placebo effects. During pre/post-testing, all participants completed tasks measuring working memory capacity (near transfer) and fluid intelligence (far transfer). Our findings show no significant difference between the two groups in both tasks. Therefore, these results suggest that the placebo effect does not exist in this study, which means individuals' mindset of intelligence may not be a contributor to the placebo effect in 1 h working memory training. This research will further help to clarify the mechanism of the placebo effect in working memory training.

The effect of a mindfulness-based intervention on executive, behavioural and socio-emotional competencies in very preterm young adolescents

Very preterm (VPT) children and adolescents show executive, behavioural and socio-emotional difficulties that persists into adulthood. This study aims to assess the effectiveness of a mindfulness-based intervention (MBI) in improving these competencies in VPT young adolescents using a randomised controlled trial design. 56 young adolescents aged 10–14 years, born before 32 gestational weeks, were randomly assigned to an “intervention” or a “waiting” group and completed an 8-week MBI in a cross-over design. Executive, behavioural and socio-emotional competencies were assessed at three different time points via parent and self-reported questionnaires, neuropsychological testing and computerised tasks. The data were analysed using an intention-to-treat approach with linear regression modelling. Our findings show a beneficial effect of MBI on executive, behavioural and socio-emotional competencies in VPT young adolescents measured by parent questionnaires. Increased executive competencies were also observed on computerised task with enhanced speed of processing after MBI. Two subgroups of participants were created based on measures of prematurity, which revealed increased long-term benefits in the moderate-risk that were not observed in the high-risk subgroups of VPT young adolescents. MBI seems a valuable tool for reducing detrimental consequences of prematurity in young adolescents, especially regarding executive, behavioural and socio-emotional difficulties.

Clinical Trial Registration ClinicalTrials, NCT04638101. Registered 20 November 2020—Retrospectively registered, https://clinicaltrials.gov/show/NCT04638101.

Cogmed Training Does Not Generalize to Real-World Benefits for Adult Hearing Aid Users: Results of a Blinded, Active-Controlled Randomized Trial

Objectives:

Performance on working memory tasks is positively associated with speech-in-noise perception performance, particularly where auditory inputs are degraded. It is suggested that interventions designed to improve working memory capacity may improve domain-general working memory performance for people with hearing loss, to benefit their real-world listening. We examined whether a 5-week training program that primarily targets the storage component of working memory (Cogmed RM, adaptive) could improve cognition, speech-in-noise perception and self-reported hearing in a randomized controlled trial of adult hearing aid users with mild to moderate hearing loss, compared with an active control (Cogmed RM, nonadaptive) group of adults from the same population.

Design:

A preregistered randomized controlled trial of 57 adult hearing aid users (n = 27 experimental, n = 30 active control), recruited from a dedicated database of research volunteers, examined on-task learning and generalized improvements in measures of trained and untrained cognition, untrained speech-in-noise perception and self-reported hearing abilities, pre- to post-training. Participants and the outcome assessor were both blinded to intervention allocation. Retention of training-related improvements was examined at a 6-month follow-up assessment.

Results:

Per-protocol analyses showed improvements in trained tasks (Cogmed Index Improvement) that transferred to improvements in a trained working memory task tested outside of the training software (Backward Digit Span) and a small improvement in self-reported hearing ability (Glasgow Hearing Aid Benefit Profile, Initial Disability subscale). Both of these improvements were maintained 6-month post-training. There was no transfer of learning shown to untrained measures of cognition (working memory or attention), speech-in-noise perception, or self-reported hearing in everyday life. An assessment of individual differences showed that participants with better baseline working memory performance achieved greater learning on the trained tasks. Post-training performance for untrained outcomes was largely predicted by individuals’ pretraining performance on those measures.

Conclusions:

Despite significant on-task learning, generalized improvements of working memory training in this trial were limited to (a) improvements for a trained working memory task tested outside of the training software and (b) a small improvement in self-reported hearing ability for those in the experimental group, compared with active controls. We found no evidence to suggest that training which primarily targets storage aspects of working memory can result in domain-general improvements that benefit everyday communication for adult hearing aid users. These findings are consistent with a significant body of evidence showing that Cogmed training only improves performance for tasks that resemble Cogmed training. Future research should focus on the benefits of interventions that enhance cognition in the context in which it is employed within everyday communication, such as training that targets dynamic aspects of cognitive control important for successful speech-in-noise perception.

Multisensory Facilitation of Working Memory Training

Research suggests that memorization of multisensory stimuli benefits performance compared to memorization of unisensory stimuli; however, little is known about multisensory facilitation in the context of working memory (WM) training and transfer. To investigate this, 240 adults were randomly assigned to an N-back training task that consisted of visual-only stimuli, alternating visual and auditory blocks, or audio-visual (multisensory) stimuli, or to a passive control group. Participants in the active groups completed 13 sessions of N-back training (6.7 hours in total) and all groups completed a battery of WM tasks: untrained N-back tasks, Corsi Blocks, Sequencing, and Symmetry Span. The Multisensory group showed similar training N-level gain compared to the Visual Only group, and both of these groups outperformed the Alternating group on the training task. As expected, all three active groups significantly improved on untrained visual N-back tasks compared to the Control group. In contrast, the Multisensory group showed significantly greater gains on the Symmetry Span task and to a certain extent on the Sequencing task compared to other groups. These results tentatively suggest that incorporating multisensory objects in a WM training protocol can benefit performance on the training task and potentially facilitate transfer to complex WM span tasks.

Working memory training does not improve executive functioning or fluid intelligence

Several studies have reported that cognitive training can lead to improvements of complex mental skills such as intelligence. However, attempts to replicate these findings have not been very successful with many studies reporting lack of transferable effects on cognitive processes unrelated to the training task. On the contrary, transfer effects on cognitive processes closely related to the training task have been more commonly reported. In this study, we investigated the effects of a frequently used working-memory training programme on fluid intelligence and specific executive functions (updating, inhibition, switching, the focus of attention, and sustained attention). We remedied common issues with previous training studies by using an active control group, using more than one instrument to assess each function, and including a larger sample size. The experimental group showed significant improvement in the training task, indicating strong practice effects. However, no evidence of training-specific transfer was found in any of the variables investigated, and we could not find any of the previous improvements reported. Participants in both the training and control groups showed post-training improvements in most of the outcome variables, suggesting that practice effects can be found even when a task is only performed twice. We conclude by discussing possible explanations for the differences between our results and those reported in prior studies and recommend that any claims of improvement should be supported by studies capable of replicating them.

Rethinking cognitive training: The moderating roles of emotional vulnerability and perceived cognitive impact of training in high worriers

Trait worry is a hallmark feature of anxiety and depression, interfering with attentional control and impairing cognitive performance. Previous research has shown the adaptive dual n-back training is effective in improving attentional control and reducing emotional vulnerability, but not for everyone. The current randomised controlled trial explored the role of baseline emotional vulnerability and perceived cognitive impact in training-related cognitive and emotional improvements in 60 high worriers randomly assigned to 10 sessions of the adaptive dual n-back training or non-adaptive 1-back training. Pre-training, post-training and one-month follow-up measures of cognitive performance were assessed using an emotional Flanker task, a cued task-switching task, and the MaRs-IB task. Self-report questionnaires assessed worry, anxiety, depression, somatisation, and self-efficacy, as well as participants' perceived cognitive impact of the training. Participants with higher levels of baseline emotional vulnerability presented the largest improvements in non-verbal reasoning and emotional vulnerability one month after the training, as well as the greatest perceived cognitive impact. Perceived cognitive impact was predicted by working memory improvement on the adaptive n-back training at high baseline levels of anxiety. These results suggest that the adaptive n-back training presents the greatest emotional and cognitive benefits for individuals experiencing severe levels of emotional vulnerability.

Gamified Attention Training in the Primary School Classroom: A Cluster-Randomized Controlled Trial

Objective: This randomized controlled trial evaluated the efficacy of attention training delivered in class on cognitive attention processes, inattention, hyperactivity, working memory, and numeracy in primary school children. Method: Eight classes (n = 98 children; 5-9 years) were cluster randomized to gamified attention training, a placebo program, or a no-contact control condition. Assessments were conducted at baseline, immediately after the 5-week intervention (posttraining), and 6 months later (follow-up). Results: Posttraining, attention training was associated with reduced inattention and hyperactivity within the classroom compared with controls, and reduced hyperactivity at home compared with the no-contact control. At follow-up, reduced hyperactivity within the classroom compared with the no-contact control persisted. No effects of training on cognitive attention processes, working memory, and numeracy were observed posttraining. Conclusion: Classroom-based attention training has select benefits in reducing inattention and hyperactivity, but may not promote gains in cognitive or academic skills in primary school children.

Emerging neurodevelopmental perspectives on mathematical learning

Strong foundational skills in mathematical problem solving, acquired in early childhood, are critical not only for success in the science, technology, engineering, and mathematical (STEM) fields but also for quantitative reasoning in everyday life. The acquisition of mathematical skills relies on protracted interactive specialization of functional brain networks across development. Using a systems neuroscience approach, this review synthesizes emerging perspectives on neurodevelopmental pathways of mathematical learning, highlighting the functional brain architecture that supports these processes and sources of heterogeneity in mathematical skill acquisition. We identify the core neural building blocks of numerical cognition, anchored in the posterior parietal and ventral temporal-occipital cortices, and describe how memory and cognitive control systems, anchored in the medial temporal lobe and prefrontal cortex, help scaffold mathematical skill development. We highlight how interactive specialization of functional circuits influences mathematical learning across different stages of development. Functional and structural brain integrity and plasticity associated with math learning can be examined using an individual differences approach to better understand sources of heterogeneity in learning, including cognitive, affective, motivational, and sociocultural factors. Our review emphasizes the dynamic role of neurodevelopmental processes in mathematical learning and cognitive development more generally.

Cognitive training with modern board and card games in healthy older adults: two randomized controlled trials

OBJECTIVES

The aim of this study was to assess the effectiveness of a cognitive intervention based on modern board and card games.

METHODS

We conducted two two-arm parallel-group, randomized controlled trials. The first one (pilot study) was nonblind. The second one (main study) was a double-blind design. Participants (14 in a pilot study and 35 in the main study) were healthy older adults over 65 years old who were assisting to adult care institutions. In the pilot study, participants in the experimental group (n = 6) played modern board and card games which activated cognitive processes; whereas the control group (n = 6) was in the wait-list condition. In the main study, participants in the experimental group (n = 12) also played modern board and card games; whereas the control group (n = 15) performed standardized paper-and-pencil cognitive tasks. Psychologists specialized in older-people conducted all the interventions. In both studies, intervention sessions were bi-weekly for 5 weeks. The outcomes of both studies were cognitive status and executive functioning, depressive symptomatology, and quality of life measures. All assessment and intervention sessions took place in their habitual centers.

RESULTS

In the pilot study, participants in the games intervention showed a significant improvement in semantic verbal fluency. In the main study, both interventions showed significant improvements in phonemic verbal fluency. Whilst board and card games maintained motor impulsivity control, paper-and-pencil tasks improved speed in an inhibition task.

CONCLUSIONS

Modern board and card games could be an effective cognitive intervention to maintain some cognitive functions.

Why Does Cognitive Training Yield Inconsistent Benefits? A Meta-Analysis of Individual Differences in Baseline Cognitive Abilities and Training Outcomes

Despite growing interest in improving cognitive abilities across the lifespan through training, the benefits of cognitive training are inconsistent. One powerful contributor may be that individuals arrive at interventions with different baseline levels of the cognitive skill being trained. Some evidence suggests poor performers benefit the most from cognitive training, showing compensation for their weak abilities, while other evidence suggests that high performers benefit most, experiencing a magnification of their abilities. Whether training leads to compensation or magnification effects may depend upon the specific cognitive domain being trained (such as executive function or episodic memory) and the training approach implemented (strategy or process). To clarify the association between individual differences in baseline cognitive ability and training gains as well as potential moderators, we conducted a systematic meta-analysis of the correlation between these two variables. We found evidence of a significant meta-correlation demonstrating a compensatory effect, a negative association between initial ability on a trained cognitive process and training gains. Too few papers met our search criteria across the levels of proposed moderators of cognitive domain and training approach to conduct a reliable investigation of their influence over the meta-analytic effect size. We discuss the implications of a compensatory meta-correlation, potential reasons for the paucity of qualifying papers, and important future directions for better understanding how cognitive trainings work and for whom.

Inhibitory control training reveals a common neurofunctional basis for generic executive functions and language switching in bilinguals

BACKGROUND

The neural networks underpinning language control and domain-general executive functions overlap in bilinguals, but existing evidence is mainly correlative. Here, we present the first neurofunctional evidence for a transfer effect between (domain-general) inhibitory control and language control through training. We trained Chinese-English bilinguals for 8 days using a Simon task taxing the inhibitory control system, whilst an active control group was trained with a color judgment task that does not tax the inhibitory control system. All participants performed a language-switching task before and after training. It has been suggested that the activity of the left DLPFC was associated with domain-general top-down cognitive control (Macdonald et al. Science 288: 1835-1838, 2000) and bilingual language control (Wang et al. Neuroimage 35: 862-870, 2007). In addition, the dACC was closely related to the conflict detection (Abutalebi et al. Cereb Cortex 18:1496-1505, 2008). Last, the activity of the left caudate has been linked with lexical selection (Abutalebi et al. Cereb Cortex 18:1496-1505, 2008), especially the selection of the weak language (Abutalebi et al. Cortex 49: 905-911, 2013). Therefore, we focused on these three regions of interest (ROIs) where neural changes associated with transfer were expected to occur.

RESULTS

The results showed a negative correlation between changes in activation levels in the left dorsolateral prefrontal cortex (DLPFC) and changes in the switch cost magnitude in the language-switching task in the training group but not in the control group, suggesting that the DLPFC plays a critical role in the transfer effect from domain-general executive functions to language control. However, there was no measurable effect in the anterior cingulate cortex or left caudate nucleus, suggesting that the inhibitory control training increased the neural efficiency for language production in bilinguals in terms of attention shifting and conflict resolution, but the training did not affect conflict detection and lexical selection.

CONCLUSION

These findings showed how cognitive training evidence can help establish a causational link between the neural basis of domain-general executive functions and language control in bilinguals.

Visuospatial Working Memory Capacity in the Brain After Working Memory Training in College Students With ADHD: A Randomized Controlled Trial

Objective: ADHD has been associated with persistent problems of working memory. This study investigated the efficacy of an intensive and adaptive computerized working memory treatment (CWMT) at behavioral and neural levels. Method: College students (n = 89; 40 females) with ADHD were randomized into a standard-length CWMT (45 min/session, 25 sessions, n = 29), shortened-length CWMT (15 min/session, 25 sessions, n = 32), and a waitlist group (n = 28). Both CWMT groups received treatment for 5 days a week for 5 weeks. Lab sessions before and after CWMT assessed electroencephalography (EEG) indicators of working memory, behavioral indicators of working memory performance, and ADHD symptomatology. Results: No evidence was found for neural or any other behavioral transfer effects of improvement for the CWMT treatment groups over the active control or waitlist group. Conclusion: Our study does not provide evidence for the benefits of CWMT at neural or behavioral levels.

Overlapping and dissociable brain activations for fluid intelligence and executive functions

Cognitive enhancement interventions aimed at boosting human fluid intelligence (gf) have targeted executive functions (EFs), such as updating, inhibition, and switching, in the context of transfer-inducing cognitive training. However, even though the link between EFs and gf has been demonstrated at the psychometric level, their neurofunctional overlap has not been quantitatively investigated. Identifying whether and how EFs and gf might share neural activation patterns could provide important insights into the overall hierarchical organization of human higher-order cognition, as well as suggest specific targets for interventions aimed at maximizing cognitive transfer. We present the results of a quantitative meta-analysis of the available fMRI and PET literature on EFs and gf in humans, showing the similarity between gf and (i) the overall global EF network, as well as (ii) specific maps for updating, switching, and inhibition. Results highlight a higher degree of similarity between gf and updating (80% overlap) compared with gf and inhibition (34%), and gf and switching (17%). Moreover, three brain regions activated for both gf and each of the three EFs also were identified, located in the left middle frontal gyrus, left inferior parietal lobule, and anterior cingulate cortex. Finally, resting-state functional connectivity analysis on two independent fMRI datasets showed the preferential behavioural correlation and anatomical overlap between updating and gf. These findings confirm a close link between gf and EFs, with implications for brain stimulation and cognitive training interventions.

Comparing Web-Based and Classroom-Based Memory Training for Older Adults: The ACTIVE Memory Works™ Study

OBJECTIVES

To compare the efficacy of a web-based versus a classroom-based memory training program in enhancing cognition and everyday functioning in older adults, and program satisfaction and acceptability.

METHOD

Participants (N = 208; mean age = 71.1) were randomly assigned to a web-based or classroom-based training, or to a wait-list control condition. Cognitive and everyday functioning measures were administered at baseline, immediate, and 6 months post-training; both training groups evaluated program satisfaction and acceptability at immediate post-training. Repeated-measures analyses of variance assessed training effects on cognitive and functioning outcomes; independent-samples t tests assessed group differences in program satisfaction and acceptability.

RESULTS

Compared to controls, neither training group showed a significant improvement on measures of memory or everyday functioning as assessed by dependence or difficulty on instrumental activities of daily living over time. Training effects did not transfer to non-trained cognitive abilities. The web-based group was as satisfied with the training as the classroom-based group (p > .05).

DISCUSSION

Although no significant training effects were found, we demonstrated that a web-based platform is an acceptable and feasible mode to provide memory training to healthy older adults. Further studies are needed to investigate the potential of web-based memory training programs for improving cognition and function in cognitively healthy older adults.

Transcranial electrical stimulation improves cognitive training effects in healthy elderly adults with low cognitive performance

OBJECTIVE

To investigate the efficacy of transcranial direct (tDCS) or alternating current stimulation (tACS) in boosting cognitive training efficiency in healthy older adults. We further explored whether such improvements depend on general cognitive performance or age.

METHODS

In this randomized, sham-controlled study, 59 healthy elderly participants (mean age 71.7) were assigned to receive computer-based cognitive training (10 sessions, 50 min, twice weekly) combined with tDCS (2 mA), tACS (5 Hz), or sham stimulation over the left dorsolateral prefrontal cortex (20 minutes). Cognitive performance was assessed with the Montreal Cognitive Assessment (MoCA), and a cognitive composite score derived from a broad neuropsychological test battery before and immediately after the intervention as well as at 6 and 12 months follow-ups.

RESULTS

Performance in the cognitive composite score improved significantly in all groups but was not further modulated by neurostimulation. Additional analyses revealed that participants with a low initial MoCA score (<1SD) improved significantly more in the tDCS than in the sham group.

CONCLUSION

TDCS increased the efficacy of cognitive training, but only in participants with initially low general cognitive performance.

SIGNIFICANCE

Cognitive interventions including tDCS should address baseline performance as modulating factor of cognitive outcomes.

Reliability, sensitivity, and predictive value of fMRI during multiple object tracking as a marker of cognitive training gain in combination with tDCS in stroke survivors

Computerized cognitive training (CCT) combined with transcranial direct current stimulation (tDCS) has showed some promise in alleviating cognitive impairments in patients with brain disorders, but the robustness and possible mechanisms are unclear. In this prospective double-blind randomized clinical trial, we investigated the feasibility and effectiveness of combining CCT and tDCS, and tested the predictive value of and training-related changes in fMRI-based brain activation during attentive performance (multiple object tracking) obtained at inclusion, before initiating training, and after the three-weeks intervention in chronic stroke patients (>6 months since hospital admission). Patients were randomized to one of two groups, receiving CCT and either (a) tDCS targeting left dorsolateral prefrontal cortex (1 mA), or (b) sham tDCS, with 40s active stimulation (1 mA) before fade out of the current. Of note, 77 patients were enrolled in the study, 54 completed the cognitive training, and 48 completed all training and MRI sessions. We found significant improvement in performance across all trained tasks, but no additional gain of tDCS. fMRI-based brain activation showed high reliability, and higher cognitive performance was associated with increased tracking-related activation in the dorsal attention network and default mode network as well as anterior cingulate after compared to before the intervention. We found no significant associations between cognitive gain and brain activation measured before training or in the difference in activation after intervention. Combined, these results show significant training effects on trained cognitive tasks in stroke survivors, with no clear evidence of additional gain of concurrent tDCS.

A "Proof of Concept" Randomized Controlled Trial of a Video Game Requiring Emotional Regulation to Augment Anger Control Training

Emotional dysregulation leading to clinically significant anger and aggression is a common and substantial concern for youth and their families. While psychotropic medications and cognitive behavioral therapies can be effective, these modalities suffer from drawbacks such as significant side effects, high rates of attrition, and lack of real-world skill translation. Regulate and Gain Emotional Control (RAGE-Control) is a video game designed as an engaging augment to existing treatments. The game facilitates emotional regulation skill building through practice modulating physiological arousal while completing a challenging inhibitory task. We compared reduction in anger, aggression, oppositionality, and global severity between two treatment conditions: Anger Control Training (ACT) augmented with RAGE-Control and ACT with a sham version of the game, in a pilot double-blind randomized controlled trial. To begin to understand mechanisms of change, we examined heart rate during game play over the course of the study and explored associations between symptom changes and heart rate changes. Materials and Methods: Forty youth with clinically significant anger dyscontrol (age 10-17) were randomly assigned to 10 sessions of ACT with RAGE-Control or ACT with sham video game. Results: Both treatments similarly reduced self-reported anger. However, ACT with RAGE-Control led to larger improvements in aggression (CI: -17 to -1.0, ES: 0.55, p = 0.015); oppositionality (CI: -9.0 to -7e-6, ES: 0.48, p = 0.032); and global severity (CI: -1.0 to -5e-6, ES: 0.51, p = 0.023) relative to sham. Participants in the RAGE-Control group saw a decrease in median heart rate during game play (β = 1.2, p < 0.001). Larger pre to post decreases in heart rate were significantly associated with larger pre to post decreases in aggression and oppositional behaviors. Discussion: Augmenting ACT with RAGE-Control reduced behavioral expression of anger, but not the experience of angry feelings, as compared to ACT with a sham version of the game. Increased heart rate control, demonstrated by reduction in median heart rate during gameplay, was associated with decreased aggression and oppositional behavior. Together these findings support that augmenting traditional treatment with technology facilitating heart rate control through skill practice translates to enhancements in real-life behavioral change. Therefore, further exploration into engaging skill-focused games such as RAGE-Control is warranted. Clinical Trial Registration:ClinicalTrials.gov, identifier: NCT01551732.

Is Training with the N-Back Task More Effective Than with Other Tasks? N-Back vs. Dichotic Listening vs. Simple Listening

Cognitive training most commonly uses computerized tasks that stimulate simultaneous cognitive processing in two modalities, such as a dual n-back task with visual and auditive stimuli, or on two receptive channels, such as a listening task with dichotically presented stimuli. The present study was designed to compare a dual n-back task and a dichotic listening (DL) task with an active control condition (a simple listening task) and a no-training control condition for their impact on cognitive performance, daily life memory, and mindfulness. One hundred thirty healthy adults aged 18–55 years were randomly assigned to one of the four conditions. The training consisted of twenty 15-min sessions spread across 4 weeks. The results indicated some improvement on episodic memory tasks and a trend for enhanced performance in an untrained working memory (WM) span task following cognitive training relative to the no-training control group. However, the only differential training effects were found for the DL training in increasing choice reaction performance and a trend for self-reported mindfulness. Transfer to measures of fluid intelligence and memory in daily life did not emerge. Additionally, we found links between self-efficacy and n-back training performance and between emotion regulation and training motivation. Our results contribute to the field of WM training by demonstrating that our listening tasks are comparable in effect to a dual n-back task in slightly improving memory. The possibility of improving attentional control and mindfulness through dichotic listening training is promising and deserves further consideration.

Working memory training effects across the lifespan: Evidence from human and experimental animal studies

Working memory refers to a cognitive function that provides temporary storage and manipulation of the information necessary for complex cognitive tasks. Due to its central role in general cognition, several studies have investigated the possibility that training on working memory tasks could improve not only working memory function but also increase other cognitive abilities or modulate other behaviors. This possibility is still highly controversial, with prior studies providing contradictory findings. The lack of systematic approaches and methodological shortcomings complicates this debate even more. This review highlights the impact of working memory training at different ages on humans. Finally, it demonstrates several findings about the neural substrate of training in both humans and experimental animals, including non-human primates and rodents.

Multidomain Cognitive Training Transfers to Attentional and Executive Functions in Healthy Older Adults

Healthy aging is associated with deficits in focused and sustained attention and executive functions. However, cognitive training (CT) provides a promising method to counteract these deficits. In the present randomized controlled study, we examined to what extent CT regimes can improve attention, verbal skills, and inhibition capacities. Over a period of 16 weeks, healthy older adults (65 years and older, mean: 70 years) received a trainer-guided multidomain paper-and-pencil and computerized CT. Pre- and post-training, a battery of psychometric tests was applied that measured the critical functions. This study used two control groups: a passive control and an active control group performing a relaxation training. Compared to a passive control group, the CT led to enhanced performance in the attentional endurance test and the interference list of the Stroop test, whereas no benefits in verbal and crystalized tests were found. Similar effects were found on the attentional endurance compared to the active control group. Additionally, word fluency was enhanced after CT, but the improvement in the Stroop test did not reach significance compared to the active control. The contents of CT were dissimilar to the psychometric tests showing far transfer, whereas no transfer to attentional or memory functions in the daily life assessed by the Cognitive Failures Questionnaire was found. This demonstrates specific gains of multidomain CT on cognitive functions not explicitly trained and lack of transfer to daily activities.

Working memory training restores aberrant brain activity in adult attention-deficit hyperactivity disorder

The development of treatments for attention impairments is hampered by limited knowledge about the malleability of underlying neural functions. We conducted the first randomized controlled trial to determine the modulations of brain activity associated with working memory (WM) training in adults with attention-deficit hyperactivity disorder (ADHD). At baseline, we assessed the aberrant functional brain activity in the n-back WM task by comparing 44 adults with ADHD with 18 healthy controls using fMRI. Participants with ADHD were then randomized to train on an adaptive dual n-back task or an active control task. We tested whether WM training elicits redistribution of brain activity as observed in healthy controls, and whether it might further restore aberrant activity related to ADHD. As expected, activity in areas of the default-mode (DMN), salience (SN), sensory-motor (SMN), frontoparietal (FPN), and subcortical (SCN) networks was decreased in participants with ADHD at pretest as compared with healthy controls, especially when the cognitive load was high. WM training modulated widespread FPN and SN areas, restoring some of the aberrant activity. Training effects were mainly observed as decreased brain activity during the trained task and increased activity during the untrained task, suggesting different neural mechanisms for trained and transfer tasks.

Predictors and Moderators of Treatment Outcome in Cognitive Training for Children With ADHD

Objective: To explore whether clinical variables and initial cognitive abilities predict or moderate (far) transfer treatment outcomes of cognitive training. Method: A total of 98 children (aged 8-12 years) with ADHD were randomly assigned to Cogmed Working Memory Training or a new cognitive training called "Paying Attention in Class." Outcome measures included neurocognitive assessment, parent and teacher rated questionnaires of executive functioning behavior and academic performance. Predictor/moderator variables included use of medication, comorbidity, subtype of ADHD, and initial verbal and visual working memory skills. Results: Parent and teacher ratings of executive functioning behavior were predicted and moderated by subtype of ADHD. Word reading accuracy was predicted by subtype of ADHD and comorbidity. Use of medication and initial verbal and visual spatial working memory skills only predicted and moderated near transfer measures. Conclusion: Cognitive training can be beneficial for certain subgroups of children with ADHD; individual differences should be taken into account in future trials.

N-Back Related ERPs Depend on Stimulus Type, Task Structure, Pre-processing, and Lab Factors

The N-Back, a common working memory (WM) updating task, is increasingly used in basic and applied psychological research. As such, an increasing number of electroencephalogram (EEG) studies have sought to identify the electrophysiological signatures of N-Back task performance. However, stimulus type, task structure, pre-processing methods, and differences in the laboratory environment, including the EEG recording setup employed, greatly vary across studies, which in turn may introduce inconsistencies in the obtained results. Here we address this issue by conducting nine different variations of an N-Back task manipulating stimulus type and task structure. Furthermore, we explored the effect of the pre-processing method used and differences in the laboratory environment. Results reveal significant differences in behavioral and electrophysiological signatures in response to N-Back stimulus type, task structure, pre-processing method, and laboratory environment. In conclusion, we suggest that experimental factors, analysis pipeline, and laboratory differences, which are often ignored in the literature, need to be accounted for when interpreting findings and making comparisons across studies.

The Effects of Gamification on Computerized Cognitive Training: Systematic Review and Meta-Analysis

Background

There has been a growing interest in the application of gamification (ie, the use of game elements) to computerized cognitive training. The introduction of targeted gamification features to such tasks may increase motivation and engagement as well as improve intervention effects. However, it is possible that game elements can also have adverse effects on cognitive training (eg, be a distraction), which can outweigh their potential motivational benefits. So far, little is known about the effectiveness of such applications.

Objective

This study aims to conduct a systematic review and meta-analysis to investigate the effect of gamification on process outcomes (eg, motivation) and on changes in the training domain (eg, cognition), as well as to explore the role of potential moderators.

Methods

We searched PsycINFO, Cumulative Index to Nursing and Allied Health Literature, ProQuest Psychology, Web of Science, Scopus, PubMed, Science Direct, Excerpta Medica dataBASE, Institute of Electrical and Electronics Engineers Xplore, Association for Computing Machinery, and a range of gray-area literature databases. The searches included papers published between 2008 and 2018. Meta-analyses were performed using a random-effects model.

Results

The systematic review identified 49 studies, of which 9 randomized controlled trials were included in the meta-analysis. The results of the review indicated that research in this context is still developing and lacks well-controlled empirical studies. Gamification in cognitive training is applied to a large range of age groups and audiences and is mostly delivered at a research site through computers. Rewards and feedback continue to dominate the gamification landscape, whereas social-oriented features (eg, competition) are underused. The meta-analyses showed that gamified training tasks were more motivating/engaging (Hedges g=0.72) and more demanding/difficult (Hedges g=–0.52) than non- or less-gamified tasks, whereas no effects on the training domain were found. Furthermore, no variables moderated the impact of gamified training tasks. However, meta-analytic findings were limited due to a small number of studies.

Conclusions

Overall, this review provides an overview of the existing research in the domain and provides evidence for the effectiveness of gamification in improving motivation/engagement in the context of cognitive training. We discuss the shortcomings in the current literature and provide recommendations for future research.

Non-verbal IQ Gains from Relational Operant Training Explain Variance in Educational Attainment: An Active-Controlled Feasibility Study

Research suggests that training relational operant patterns of behavior can lead to increases in general cognitive ability and educational outcomes. Most studies to date have been under-powered and included proxy measures of educational attainment. We attempted to extend previous findings with increased experimental control in younger children (aged 6.9–10.1 years). Participants (N = 49) were assigned to either a relational training or chess control group. Over 5 months, teachers assigned class time to complete either relational training or play chess. Those who were assigned relational training gained 8.9 non-verbal IQ (NVIQ) points, while those in the control condition recorded no gains (dppc2 = .99). Regression analyses revealed that post-training NVIQ predicted reading test scores (conducted approximately 1 month later) over and above baseline NVIQ in the experimental condition only, consistent with what we might expect in a full test of far transfer towards educational outcomes.

Investigating the Effects of Spacing on Working Memory Training Outcome: A Randomized, Controlled, Multisite Trial in Older Adults

OBJECTIVE

The majority of the population will experience some cognitive decline with age. Therefore, the development of effective interventions to mitigate age-related decline is critical for older adults' cognitive functioning and their quality of life.

METHODS

In our randomized controlled multisite trial, we target participants' working memory (WM) skills, and in addition, we focus on the intervention's optimal scheduling in order to test whether and how the distribution of training sessions might affect task learning, and ultimately, transfer. Healthy older adults completed an intervention targeting either WM or general knowledge twice per day, once per day, or once every-other-day. Before and after the intervention and 3 months after training completion, participants were tested in a variety of cognitive domains, including those representing functioning in everyday life.

RESULTS

In contrast to our hypotheses, spacing seems to affect learning only minimally. We did observe some transfer effects, especially within the targeted cognitive domain (WM and inhibition/interference), which remained stable at the 3-month follow-up.

DISCUSSION

Our findings have practical implications by showing that the variation in training schedule, at least within the range used here, does not seem to be a crucial element for training benefits.

Effects of 1 mA and 2 mA transcranial direct current stimulation on working memory performance in healthy participants

Anodal transcranial current stimulation (tDCS) to the left dorsolateral prefrontal cortex (DLPFC) has been shown to enhance working memory (WM) in neuropsychiatric patients. In healthy populations, however, tDCS obtains inconclusive results, mostly due to heterogeneous study and stimulation protocols. Here, we approached these issues by investigating effects of tDCS intensity on simultaneous WM performance with three cognitive loads by directly comparing findings of two double-blind, cross-over, sham-controlled experiments. TDCS was administrated to the left DLPFC at intensity of 1 mA (Experiment 1) or 2 mA (Experiment 2), while participants completed a verbal n-back paradigm (1-, 2-, 3-back). Analysis showed no overall effects of tDCS on WM, but a significant interaction with cognitive load. The present study suggests that cognitive load rather than tDCS intensity could be a decisive factor for effects on WM. Moreover, it emphasizes the need of thorough investigation on study parameters to develop more efficient stimulation protocols.

Quantifying the Difference between Active and Passive Control Groups in Cognitive Interventions Using two Meta-Analytical Approaches

Despite promising reports of broad cognitive benefit in studies of cognitive training, it has been argued that the reliance of many studies on no-intervention control groups (passive controls) make these reports difficult to interpret because placebo effects cannot be ruled out. Although researchers have recently been trying to incorporate more active controls, in which participants engage in an alternate intervention, previous work has been contentious as to whether this actually yields meaningfully different results. To better understand the influence of passive and active control groups on cognitive interventions, we conducted two meta-analyses to estimate their relative effect sizes. While the first one broadly surveyed the literature by compiling data from 34 meta-analyses, the second one synthesized data from 42 empirical studies that simultaneously employed both types of controls. Both analyses showed no meaningful performance difference between passive and active controls, suggesting that current active control placebo paradigms might not be appropriately designed to reliably capture these non-specific effects or that these effects are minimal in this literature.