Gray matter responsiveness to adaptive working memory training: a surface-based morphometry study

Working Memory Training Effects on White Matter Integrity in Young and Older Adults

OBJECTIVES

Working memory is essential for daily life skills like reading comprehension, reasoning, and problem-solving. Healthy aging of the brain goes along with working memory decline that can affect older people's independence in everyday life. Interventions in the form of cognitive training are a promising tool for delaying age-related working memory decline, yet the underlying structural plasticity of white matter is hardly studied.

METHODS

We conducted a longitudinal diffusion tensor imaging study to investigate the effects of an intensive four-week adaptive working memory training on white matter integrity quantified by global and tract-wise mean diffusivity. We compared diffusivity measures of fiber tracts that are associated with working memory of 32 young and 20 older participants that were randomly assigned to a working memory training group or an active control group.

RESULTS

The behavioral analysis showed an increase in working memory performance after the four-week adaptive working memory training. The neuroanatomical analysis revealed a decrease in mean diffusivity in the working memory training group after the training intervention in the right inferior longitudinal fasciculus for the older adults. There was also a decrease in mean diffusivity in the working memory training group in the right superior longitudinal fasciculus for the older and young participants after the intervention.

CONCLUSION

This study shows that older people can benefit from working memory training by improving their working memory performance that is also reflected in terms of improved white matter integrity in the superior longitudinal fasciculus and the inferior longitudinal fasciculus, where the first is an essential component of the frontoparietal network known to be essential in working memory.

Cortical and subcortical responsiveness to intensive adaptive working memory training: An MRI surface-based analysis

Working memory training (WMT) has been shown to have effects on cognitive performance, the precise effects and the underlying neurobiological mechanisms are, however, still a matter of debate. In particular, the impact of WMT on gray matter morphology is still rather unclear. In the present study, 59 healthy middle‐aged participants (age range 50–65 years) were pseudo‐randomly single‐blinded allocated to an 8‐week adaptive WMT or an 8‐week nonadaptive intervention. Before and after the intervention, high resolution magnetic resonance imaging (MRI) was performed and cognitive test performance was assessed in all participants. Vertex‐wise cortical volume, thickness, surface area, and cortical folding was calculated. Seven subcortical volumes of interest and global mean cortical thickness were also measured. Comparisons of symmetrized percent change (SPC) between groups were conducted to identify group by time interactions. Greater increases in cortical gyrification in bilateral parietal regions, including superior parietal cortex and inferior parietal lobule as well as precuneus, greater increases in cortical volume and thickness in bilateral primary motor cortex, and changes in surface area in bilateral occipital cortex (medial and lateral occipital cortex) were detected in WMT group after training compared to active controls. Structural training‐induced changes in WM‐related regions, especially parietal regions, might provide a better brain processing environment for higher WM load.

Executive Function Training in Childhood Obesity: Food Choice, Quality of Life, and Brain Connectivity (TOuCH): A Randomized Control Trial Protocol

Background: Individuals with obesity are known to present cognitive deficits, especially in executive functions. Executive functions play an important role in health and success throughout the whole life and have been related to food decision-making and to the ability to maintain energy balance. It is possible to improve executive functions through targeted training. This would involve brain plasticity changes that could be studied through connectivity MRI. The general hypothesis of this study is that executive functions training in children with obesity can improve food choices and produce cognitive and neuroimaging changes (structural and functional connectivity), as well as improve emotional state and quality of life. Methods: Randomized controlled double-blind trial with 12-month follow-up. Thirty children with obesity will be randomly allocated into "executive training" (Cognifit with adaptive difficulty + Cogmed) or "control task" group (Cognifit without adaptive difficulty). Both groups will attend 30-45 min of individual gamified training (Cogmed and/or Cognifit systems) by iPad, five times per week during 6 weeks. Cogmed and Cognifit software are commercially available from Pearson and Cognifit, respectively. Participants will receive an iPad with both apps installed for a 6-week use. Participants will also receive counseling diet information via presentations sent to the iPad and will wear a Fitbit Flex 2 tracker to monitor daily activity and sleep patterns. Main outcomes will be cognitive, emotional, food decision, and quality-of-life measures, as well as neuroimaging measures. Participants are evaluated at baseline (T0), after treatment (T1), and 12 months since baseline (T2). Discussion: Longitudinal study with active control group and 3 time points: baseline, immediately after treatment, and 1 year after baseline. Threefold treatment: executive function training, psychoeducation, and feedback on activity/sleep tracking. We will evaluate the transfer effects of the intervention, including emotional and functional outcomes, as well as the effects on neural plasticity by connectivity MRI. Trial registration: This project has been registered in ClinicalTrials.gov (trial registration number NCT03615274), August 3, 2018.

Shifting Minds: A Quantitative Reappraisal of Cognitive-Intervention Research

Recent popular areas of research in psychology suggest that behavioral interventions can have profound effects on our cognitive abilities. In particular, the study of brain training, video gaming, mindset, and stereotype threat all include claims that low-cost, noninvasive manipulations of the environment can greatly affect individual performance. Here, I provide a quantitative reappraisal of this literature, focusing on recent meta-analytic findings. Specifically, I show that effect-size distributions in the four aforementioned areas are best modeled by multiple rather than single latent distributions, suggesting important discrepancies in the effect sizes reported. I further demonstrate that these multimodal characteristics are not typical within the broader field of psychology, using 107 meta-analyses published in three top-tier journals as a comparison. The effect-size distributions observed in cognitive-intervention research therefore appear to be uncommon, and their characteristics are largely unexplained by current theoretical frameworks of cognitive improvement. Before the source of these discrepancies is better understood, the current study calls for constructive skepticism in evaluating claims of cognitive improvement after behavioral interventions and for caution when this line of research influences large-scale policies.

Parallel Changes in Cognitive Function and Gray Matter Volume After Multi-Component Training of Cognitive Control (MTCC) in Adolescents

Adolescence is a unique period in which higher cognition develops to adult-level, while plasticity of neuron and behavior is at one of its peak. Notably, cognitive training studies for adolescents has been sparse and neural correlates of the training effects yet to be established. This study investigated the effects of multi-component training of cognitive control (MTCC) in order to examine whether the training enhanced adolescents' cognitive control ability and if the effects were generalizable to other cognitive domains. Cognitive control refers to the ability to adjust a series of thoughts and behaviors in correspondence to an internal goal, and involves inhibition, working memory, shifting, and dual tasking as subcomponents. The participants were middle school students (aged 11-14) and randomly assigned to either a training group or an active control group. The training group performed 30 min of MTCC per day for 6 weeks. To identify the training effects, we examined the cognitive performance, regional gray matter, and their relationship. The training group showed modest improvement in a visuospatial fluid intelligence test (Block Design) after MTCC, which was not significant after correcting for multiple comparisons. In addition, the training effect on the gray matter volume (time × group interaction) was observed in the right inferior cortex (rIFC). While the control group showed a typical reduction in the rIFC volume, the training group showed a relative increase in the homologous region. The relative change in rIFC volume was associated with the change in Stroop performance. These results imply that MTCC may affect brain structure relevant to inhibitory control process.

Most evidence for the compensation account of cognitive training is unreliable

Cognitive training and brain stimulation studies have suggested that human cognition, primarily working memory and attention control processes, can be enhanced. Some authors claim that gains (i.e., post-test minus pretest scores) from such interventions are unevenly distributed among people. The magnification account (expressed by the evangelical “who has will more be given”) predicts that the largest gains will be shown by the most cognitively efficient people, who will also be most effective in exploiting interventions. In contrast, the compensation account (“who has will less be given”) predicts that such people already perform at ceiling, so interventions will yield the largest gains in the least cognitively efficient people. Evidence for this latter account comes from reported negative correlations between the pretest and the training/stimulation gain. In this paper, with the use of mathematical derivations and simulation methods, we show that such correlations are pure statistical artifacts caused by the widely known methodological error called “regression to the mean”. Unfortunately, more advanced methods, such as alternative measures, linear models, and control groups do not guarantee correct assessment of the compensation effect either. The only correct method is to use direct modeling of correlations between latent true measures and gain. As to date no training/stimulation study has correctly used this method to provide evidence in favor of the compensation account, we must conclude that most (if not all) of the evidence should be considered inconclusive.

Exploration of gray matter correlates of cognitive training benefit in adolescents with chronic traumatic brain injury

Sustaining a traumatic brain injury (TBI) during adolescence has a profound effect on brain development and can result in persistent executive functioning deficits in daily life. Cognitive recovery from pediatric-TBI relies on the potential of neuroplasticity, which can be fostered by restorative training-programs. However the structural mechanisms underlying cognitive recovery in the immature brain are poorly understood. This study investigated gray matter plasticity following 2 months of cognitive training in young patients with TBI. Sixteen adolescents in the chronic stage of moderate-severe-TBI (9 male, mean age = 15y8m ± 1y7m) were enrolled in a cognitive computerized training program for 8 weeks (5 times/week, 40 min/session). Pre-and post-intervention, and 6 months after completion of the training, participants underwent a comprehensive neurocognitive test-battery and anatomical Magnetic Resonance Imaging scans. We selected 9 cortical-subcortical Regions-Of-Interest associated with Executive Functioning (EF-ROIs) and 3 control regions from the Desikan-Killiany atlas. Baseline analyses showed significant decreased gray matter density in the superior frontal gyri p = 0.033, superior parietal gyri p = 0.015 and thalamus p = 0.006 in adolescents with TBI compared to age and gender matched controls. Linear mixed model analyses of longitudinal volumetric data of the EF-ROI revealed no strong evidence of training-related changes in the group with TBI. However, compared to the change over time in the control regions between post-intervention and 6 months follow-up, the change in the EF-ROIs showed a significant difference. Exploratory analyses revealed a negative correlation between the change on the Digit Symbol Substitution test and the change in volume of the putamen (r = -0.596, p = 0.015). This preliminary study contributes to the insights of training-related plasticity mechanisms after pediatric-TBI.

Avaliação do Programa de Treinamento para Memória de Trabalho em Idosos

RESUMO Objetivo Verificar os benefícios do Treinamento de Memória de Trabalho em DVD para idosos. Método Participaram do estudo 16 voluntários com idade superior a 60 anos (média etária de 67,43 anos) sem queixas de perda auditiva, problemas neurológicos ou psiquiátricos, avaliados inicialmente com o MEEM e posteriormente com a avaliação específica para memória de trabalho. Em seguida, os quatro participantes que não tinham disponibilidade para comparecer à Universidade formaram o grupo controle e os doze restantes foram incluídos no grupo experimental. O grupo experimental foi exposto aos três DVDs que compõem o primeiro conjunto de exercícios e reavaliado com o teste específico para memória de trabalho em intervalos regulares. O grupo controle também foi submetido às reavaliações nos mesmos períodos do grupo experimental. Resultados Enquanto o grupo controle não apresentou qualquer alteração nas avaliações, o desempenho no teste de memória do grupo experimental melhorou significativamente após a apresentação dos DVDs. Além disso, o grupo experimental relatou os benefícios do treinamento para suas atividades cotidianas. Conclusão O estudo demonstra os benefícios do Treinamento de Memória de Trabalho em DVD para idosos, que se revela uma ferramenta promissora para novos estudos longitudinais com populações maiores.

Cognitive Training Does Not Enhance General Cognition

Due to potential theoretical and societal implications, cognitive training has been one of the most influential topics in psychology and neuroscience. The assumption behind cognitive training is that one's general cognitive ability can be enhanced by practicing cognitive tasks or intellectually demanding activities. The hundreds of studies published so far have provided mixed findings and systematic reviews have reached inconsistent conclusions. To resolve these discrepancies, we carried out several meta-analytic reviews. The results are highly consistent across all the reviewed domains: minimal effect on domain-general cognitive skills. Crucially, the observed between-study variability is accounted for by design quality and statistical artefacts. The cognitive-training program of research has showed no appreciable benefits, and other more plausible practices to enhance cognitive performance should be pursued.

Enhancing Intelligence: From the Group to the Individual

Research aimed at testing whether short-term training programs can enhance intelligence is mainly concentrated on behavior. Expected positive effects are found sometimes, but the evidence is far from conclusive. It is assumed that training must evoke changes in the brain for observing genuine improvements in behavior. However, behavioral and brain data are seldom combined in the same study. Here we present one example of this latter type of research summarizing, discussing, and integrating already published results. The training program was based on the adaptive dual n-back task, and participants completed a comprehensive battery measuring fluid and crystallized ability, along with working memory and attention control, before and after training. They were also submitted to MRI scanning at baseline and post-training. Behavioral results revealed positive effects for visuospatial processing across cognitive domains. Brain imaging data were analyzed by longitudinal voxel-based morphometry, tensor-based morphometry, surface-based morphometry, and structural connectivity. The integration of these multimodal brain results provides clues about those observed in behavior. Our findings, along with previous research and current technological advances, are considered from the perspective that we now live in ideal times for (a) moving from the group to the individual and (b) developing personalized training programs.

Enhanced structural connectivity within a brain sub-network supporting working memory and engagement processes after cognitive training

The structural connectome provides relevant information about experience and training-related changes in the brain. Here, we used network-based statistics (NBS) and graph theoretical analyses to study structural changes in the brain as a function of cognitive training. Fifty-six young women were divided in two groups (experimental and control). We assessed their cognitive function before and after completing a working memory intervention using a comprehensive battery that included fluid and crystallized abilities, working memory and attention control, and we also obtained structural MRI images. We acquired and analyzed diffusion-weighted images to reconstruct the anatomical connectome and we computed standardized changes in connectivity as well as group differences across time using NBS. We also compared group differences relying on a variety of graph-theory indices (clustering, characteristic path length, global and local efficiency and strength) for the whole network as well as for the sub-network derived from NBS analyses. Finally, we calculated correlations between these graph indices and training performance as well as the behavioral changes in cognitive function. Our results revealed enhanced connectivity for the training group within one specific network comprised of nodes/regions supporting cognitive processes required by the training (working memory, interference resolution, inhibition, and task engagement). Significant group differences were also observed for strength and global efficiency indices in the sub-network detected by NBS. Therefore, the connectome approach is a valuable method for tracking the effects of cognitive training interventions across specific sub-networks. Moreover, this approach allowsfor the computation of graph theoretical network metricstoquantifythetopological architecture of the brain networkdetected. The observed structural brain changes support the behavioral results reported earlier (see Colom, Román, et al., 2013).

Brain structural changes following adaptive cognitive training assessed by Tensor-Based Morphometry (TBM)

Tensor-Based Morphometry (TBM) allows the automatic mapping of brain changes across time building 3D deformation maps. This technique has been applied for tracking brain degeneration in Alzheimer's and other neurodegenerative diseases with high sensitivity and reliability. Here we applied TBM to quantify changes in brain structure after completing a challenging adaptive cognitive training program based on the n-back task. Twenty-six young women completed twenty-four training sessions across twelve weeks and they showed, on average, large cognitive improvements. High-resolution MRI scans were obtained before and after training. The computed longitudinal deformation maps were analyzed for answering three questions: (a) Are there differential brain structural changes in the training group as compared with a matched control group? (b) Are these changes related to performance differences in the training program? (c) Are standardized changes in a set of psychological factors (fluid and crystallized intelligence, working memory, and attention control) measured before and after training, related to structural changes in the brain? Results showed (a) greater structural changes for the training group in the temporal lobe, (b) a negative correlation between these changes and performance across training sessions (the greater the structural change, the lower the cognitive performance improvements), and (c) negligible effects regarding the psychological factors measured before and after training.