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Chen JW, Du WQ, Zhu K. Network meta-analysis of the effects of different cognitive trainings on the cognitive function of patients with mild cognitive impairment. J Psychiatr Res 2024; 174:26-45. [PMID: 38608550 DOI: 10.1016/j.jpsychires.2024.03.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 03/07/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE Examining the relationship between the responses of a number of different cognitive trainings on cognitive functioning in middle-aged and elderly patients with mild cognitive impairment. METHODS Randomized controlled experimental studies published publicly from the time of inception to October 30, 2023 were searched through Web of Science, PubMed, Embase, and Cochrane library databases. Traditional and network meta-analyses were performed using Stata 17.0 software. RESULTS Fifty papers on 4 types of cognitive training were included. Traditional meta-analysis showed that virtual reality training (SMD = 0.53, 95%CI: [0.36,0.70], P = 0.00), neuropsychological training (SMD = 0.44, 95%CI: [0.18,0.70], P = 0.00), cognitive strategy training (SMD = 0.26, 95%CI: [0.16,0.36], P = 0.00), and cognitive behavioral therapy (SMD = 0.25, 95%CI: [0.08,0.41], P = 0.00) all had significant improvement effects on the cognitive function of middle-aged and elderly patients with mild cognitive impairment. Network meta-analysis revealed neuropsychological training as the best cognitive training, and subgroup analysis of cognitive function subdimensions showed that neuropsychological training had the best effects on working memory, lobal cognitive function, memory, and cognitive flexibility improvement. Meanwhile, virtual reality training had the best effects on processing speed, verbal ability, overall executive function, spatial cognitive ability, and attention improvement. CONCLUSION Cognitive training can significantly improve the cognitive function of middle-aged and elderly patients with mild cognitive impairment, and neuropsychological training is the best intervention, most effective in interventions lasting more than 8 weeks.
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Affiliation(s)
- Ji-Wei Chen
- School of Physical Education, Shanghai University of Sport, Shanghai, China.
| | - Wen-Qian Du
- School of Physical Education, Shanghai University of Sport, Shanghai, China.
| | - Kun Zhu
- School of Physical Education, Shanghai University of Sport, Shanghai, China.
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Moret B, Kolasinska AB, Nucci M, Campana G, Zini F, Gaspari M, Stablum F. Cognitive benefits of the attentional vs exergame training in older adults. Aging Ment Health 2024; 28:531-541. [PMID: 37395120 DOI: 10.1080/13607863.2023.2228220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/19/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVE The present study aimed at comparing the effectiveness of an Attentional Computerized Cognitive Training and a commercial Exergame Training. METHODS Eighty-four healthy older adults took part in the study. They were randomly assigned to one of the following conditions: Attentional Computerized Cognitive Training (ATT-CCT), Exergame Training (EXERG-T), or passive Control Group (CG). Participants assigned to the experimental groups underwent 8 laboratory-based sessions-lasting approximately 45 min each-of the respective training activity. A battery of cognitive tests was assessed before, after, and 3 months following the intervention phase. RESULTS The results showed that just the ATT-CCT improved participants' performance, specifically within attention, processing speed, verbal learning and memory. While both intervention groups revealed improved memory self-perception and decreased self-reported absent-mindedness, only the benefits following the ATT-CCT proved to be stable over time. CONCLUSIONS The results suggested that our ATT-CCT may be an effective tool for enhancing cognitive abilities in older healthy adults.
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Affiliation(s)
- Beatrice Moret
- Department of General Psychology, University of Padova, Padova, Italy
| | | | - Massimo Nucci
- Department of General Psychology, University of Padova, Padova, Italy
- Human Inspired Technology Research Centre, University of Padova, Padova, Italy
| | - Gianluca Campana
- Department of General Psychology, University of Padova, Padova, Italy
- Human Inspired Technology Research Centre, University of Padova, Padova, Italy
| | - Floriano Zini
- Faculty of Computer Science, Free University of Bozen-Bolzano, Bolzano, Italy
| | - Mauro Gaspari
- Department of Computer Science and Engineering, University of Bologna, Bologna, Italy
| | - Franca Stablum
- Department of General Psychology, University of Padova, Padova, Italy
- Human Inspired Technology Research Centre, University of Padova, Padova, Italy
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Li Z, He H, Chen Y, Guan Q. Effects of engagement, persistence and adherence on cognitive training outcomes in older adults with and without cognitive impairment: a systematic review and meta-analysis of randomised controlled trials. Age Ageing 2024; 53:afad247. [PMID: 38266127 DOI: 10.1093/ageing/afad247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Limited understanding exists regarding the influences of engagement, persistence and adherence on the efficacy of cognitive training for age-related cognitive decline and neurodegenerative cognitive impairment. METHODS This study conducted a meta-analysis of randomised controlled trials (RCTs). We systematically searched MEDLINE, PubMed, Web of Science, Embase and CINAHL databases from 1 January 2012 to 13 June 2023, and included RCTs assessing the effects of cognitive training in older adults, both with and without cognitive impairment. Hedges' g with a 95% confidence interval (CI) was used to synthesise cognitive training effect sizes on various neuropsychological tests. Subgroup analyses were conducted based on variables including engagement, persistence, adherence and cognitive conditions of normal cognition, mild cognitive impairment (MCI) or neurodegenerative dementia. RESULTS This meta-analysis included 55 RCTs with 4,455 participants with cognitive conditions spanning normal cognition, MCI and neurodegenerative dementia. The mean age of participants was 73.9 (range: 65.7-84.5) years. Overall, cognitive training showed a significant cross-domain effect (Hedges' g = 0.286, 95% CI: 0.224-0.348). Training effects are significant when engagement or persistence rates exceed 60% or when adherence rates exceed 80%. Higher levels of persistence are required to achieve significant training effects in memory, visuospatial ability and reasoning than in executive function and attention and language. Higher persistence is also required for older adults with normal cognition to achieve significant training gains compared to those with cognitive impairment. CONCLUSIONS This systematic review highlights the critical roles of engagement, persistence and adherence in augmenting the efficacy of cognitive training.
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Affiliation(s)
- Zhen Li
- School of Psychology, Shenzhen University, Shenzhen 518060, China
| | - Hao He
- School of Psychology, Shenzhen University, Shenzhen 518060, China
- Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen 518055, China
| | - Yiqi Chen
- School of Psychology, Shenzhen University, Shenzhen 518060, China
- Department of Psychology, University of Mannheim, Mannheim 68131, Germany
| | - Qing Guan
- School of Psychology, Shenzhen University, Shenzhen 518060, China
- Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen 518055, China
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Poskotinova L, Khasanova N, Kharak A, Krivonogova O, Krivonogova E. Parameters of Auditory Evoked Related Potentials P300 in Disorders of Different Cognitive Function Domains (Visuospatial/Executive and Memory) in Elderly Hypertensive Persons. Diagnostics (Basel) 2023; 13:diagnostics13091598. [PMID: 37174989 PMCID: PMC10178622 DOI: 10.3390/diagnostics13091598] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
The neurophysiological correlates of certain types of cognitive impairment in relation to the spatial pattern of auditory cognitive evoked-related potentials (ERPs) in hypertensive persons remain unclear. The aim of this study was to determine the parameters of ERPs (N200, P300) in impaired different domains (visuospatial/executive and memory) of cognitive function in arterial hypertension, including cardiovascular ischemic events. A total of 46 patients (65-84 years) were observed. The clinical diagnosis of vascular dementia, the Montreal Cognitive Assessment Scale (MoCA test) and the spatial pattern of ERPs (N200, P300) were the parameters used to identify three groups: the Control Group without cognitive impairment (n = 13), the group with a leading memory disturbance (Memory Group, n = 20) and the group with a leading visuospatial/executive disturbance (VS/E Group, n = 13). In persons belonging to the Memory Group, N2 latency was prolonged in the central (C3 C4) and right parietal (P4) brain parts; latency of the motor component (P300) may remain similar to that of the ControlGroup. In persons belonging to theVS/E Group, maximal prolonged recognition time (N2), especially in the left central (C3), frontal-midline (Fz), right parietal (P3) and temporal (P4) brain parts, was observed; P300 latency in the central-midline (Cz) and left anterior-temporal (F7) brain parts among all the groups was revealed.
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Affiliation(s)
- Liliya Poskotinova
- N. Laverov Federal Center for Integrated Arctic Research of the Ural Branch of the Russian Academy of Sciences, 163020 Arkhangelsk, Russia
| | - Nina Khasanova
- Department of Family Medicine and Internal Medicine, Northern State Medical University, 163069 Arkhangelsk, Russia
| | - Anna Kharak
- Department of Family Medicine and Internal Medicine, Northern State Medical University, 163069 Arkhangelsk, Russia
| | - Olga Krivonogova
- N. Laverov Federal Center for Integrated Arctic Research of the Ural Branch of the Russian Academy of Sciences, 163020 Arkhangelsk, Russia
| | - Elena Krivonogova
- N. Laverov Federal Center for Integrated Arctic Research of the Ural Branch of the Russian Academy of Sciences, 163020 Arkhangelsk, Russia
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Tanaka M, Kakuma T, Asada T. Utility of paced breathing tablet guidance apparatus with real-time feedback on autonomic function for individuals with mild cognitive impairment: a pilot study. Psychogeriatrics 2023; 23:434-441. [PMID: 36878855 DOI: 10.1111/psyg.12950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 01/25/2023] [Accepted: 02/16/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND Mild cognitive impairment (MCI) individuals also show significant parasympathetic deficits, while autonomic nervous system (ANS) flexibility can strengthen cognitive and brain function. Paced (or slow) breathing has significant effects on the ANS and is associated with relaxation and well-being. However, paced breathing requires considerable time and practice, a significant barrier to its widespread adoption. Feedback systems appear promising to make practice more time-efficient. A tablet guidance system providing real-time feedback on autonomic function was developed for MCI individuals and tested for efficacy. METHODS In this single-blind study, 14 outpatients with MCI practised with the device for 5 min twice a day for 2 weeks. The active group received feedback (FB+), whereas the placebo group (FB-) did not. Coefficient of variation of R-R intervals as the outcome indicator was measured immediately after the first intervention (T1 ), the end of the 2-week intervention (T2 ), and 2 weeks later (T3 ). RESULTS The mean outcome of the FB- group remained unchanged during the study period, whereas the outcome value of the FB+ group increased and retained the intervention effect for an additional 2 weeks. CONCLUSIONS Results indicate this FB system-integrated apparatus may be useful for MCI patients for effectively learning paced breathing.
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Affiliation(s)
| | - Tatsuyuki Kakuma
- Biostatistics Centre, Kurume University School of Medicine, Kurume, Japan
| | - Takashi Asada
- Tokyo Medical and Dental University, Tokyo, Japan.,Memory Clinic Ochanomizu, Tokyo, Japan
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Huynh-Le MP, Tibbs MD, Karunamuni R, Salans M, Tringale KR, Yip A, Connor M, Simon AB, Vitzthum LK, Reyes A, Macari AC, Moiseenko V, McDonald CR, Hattangadi-Gluth JA. Microstructural Injury to Corpus Callosum and Intrahemispheric White Matter Tracts Correlate With Attention and Processing Speed Decline After Brain Radiation. Int J Radiat Oncol Biol Phys 2021; 110:337-347. [PMID: 33412257 DOI: 10.1016/j.ijrobp.2020.12.046] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 11/17/2020] [Accepted: 12/28/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE The corpus callosum (CC) and intrahemispheric white matter tracts (IHWM) subserve critical aspects of attention and processing speed. We analyzed imaging biomarkers of microstructural injury within these regions and association with attention and processing speed performance before and after radiation therapy in primary brain tumor patients. METHODS AND MATERIALS In a prospective clinical trial, 44 primary brain tumor patients underwent cognitive testing and magnetic resonance imaging/diffusion-weighted imaging at baseline (pre-radiation therapy) and 3-, 6-, and 12-months post-radiation therapy. CC (subregions, total) and IHWM tracts (left/right without CC, total) were autosegmented; tumor, tumor bed, and edema were censored. Biomarkers included volume changes (cm3), mean diffusivity ([MD]; higher values indicate white matter injury), fractional anisotropy ([FA]; lower values indicate white matter injury). Reliable-change indices measured changes in attention (Weschler Adult Intelligence Scale [WAIS-IV] digits-forward; Delis-Kaplan Executive Function System Trail Making [D-KEFS-TM] visual-scanning), and processing speed (WAIS-IV coding; D-KEFS-TM number-sequencing, letter-sequencing), accounting for practice effects. Linear mixed-effects models evaluated associations between mean radiation dose and biomarkers (volume, MD, FA) and imaging biomarkers and neurocognitive performance. Statistics were corrected for multiple comparisons. RESULTS Processing speed declined at 6 months following radiation therapy (number sequencing, letter sequencing; P < .04). Seizures and antiepileptic drug therapy were associated with lower visual-scanning attention reliable-change indices at 6 months (P = .039). Higher radiation dose correlated with smaller midanterior CC volume (P = .023); lower FA in posterior CC, anterior CC, and total CC (all P < .03); and higher MD in anterior CC (P = .012). Smaller midanterior CC and left IHWM volume correlated with worse processing speed (coding, letter-sequencing, number-sequencing; all P < .03). Higher FA in right, left, and total IHWM correlated with better coding scores (all P < .01). Lower FA in total IHWM (P = .009) was associated with worse visual-scanning attention scores. Higher FA in midposterior CC (P = .029) correlated with better digits-forward attention scores. CONCLUSIONS The CC demonstrated radiation dose-dependent atrophy and WM injury. Microstructural injury within the CC and IHWM was associated with attention and processing speed decline after radiation therapy. These areas represent possible avoidance regions for preservation of attention and processing speed.
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Affiliation(s)
| | - Michelle D Tibbs
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California; Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, California
| | - Roshan Karunamuni
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California; Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, California
| | - Mia Salans
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California
| | - Kathryn R Tringale
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Anthony Yip
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California
| | - Michael Connor
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California
| | - Aaron B Simon
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California
| | - Lucas K Vitzthum
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California
| | - Anny Reyes
- Department of Psychiatry, University of California San Diego, La Jolla, California
| | - Anna Christina Macari
- Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, California; Department of Psychiatry, University of California San Diego, La Jolla, California
| | - Vitali Moiseenko
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California
| | - Carrie R McDonald
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California; Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, California; Department of Psychiatry, University of California San Diego, La Jolla, California
| | - Jona A Hattangadi-Gluth
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California; Center for Multimodal Imaging and Genetics, University of California San Diego, La Jolla, California.
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