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Ferizaj D, Stamm O, Perotti L, Martin EM, Ophey A, Rekers S, Scharfenberg D, Oelgeschläger T, Barcatta K, Seiler S, Funk J, Benoy C, Finke C, Kalbe E, Finke K, Heimann-Steinert A. Effectiveness of a mobile application for independent computerized cognitive training in patients with mild cognitive impairment: study protocol for the NeNaE Study, a randomized controlled trial. Trials 2024; 25:444. [PMID: 38961472 PMCID: PMC11223296 DOI: 10.1186/s13063-024-08277-5] [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: 08/15/2023] [Accepted: 06/19/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Mild cognitive impairment (MCI) involves cognitive decline beyond typical age-related changes, but without significant daily activity disruption. It can encompass various cognitive domains as the causes of MCI are diverse. MCI as well as frequent comorbid neuropsychiatric conditions like depression and anxiety affect individuals' quality of life. Early interventions are essential, and computerized cognitive training (cCT) is an established treatment method. This paper presents the protocol for the NeuroNation MED Effectiveness Study, evaluating the self-administered mobile cCT intervention ("NeuroNation MED") in individuals with MCI to assess training effects on cognitive domains, health competence, neuropsychiatric symptoms, psychological well-being, and the general application usability. METHODS This study protocol presents a single-blinded multicenter randomized controlled trial that will be carried out in six study centers in Germany and Luxembourg. We included adults with MCI (existing F06.7 ICD-10-GM diagnosis and TICS ≥ 21 and ≤ 32). The intervention group will use a mobile, multi-domain cCT ("NeuroNation MED") for 12 weeks. Meanwhile, the wait list control group will receive standard medical care or no care. The eligibility of volunteers will be determined through a telephone screening. After completion of the baseline examination, patients will be randomly assigned to one of the experimental conditions in a 2:1 ratio. In total, 286 participants will be included in this study. The primary outcome is the change of cognitive performance measured by the index score of the screening module of the Neuropsychological Assessment Battery. Secondary outcomes are changes in the Cognitive Failures Questionnaire, Hospital Anxiety and Depression Scale, Health-49, Health Literacy Questionnaire, among others. All of the primary and secondary outcomes will be assessed at baseline and after the 12-week post-allocation period. Furthermore, the intervention group will undergo an assessment of the System Usability Scale, and the training data of the NeuroNation MED application will be analyzed. DISCUSSION This study aims to assess the effectiveness of a mobile self-administered cCT in enhancing cognitive abilities among individuals diagnosed with MCI. Should the findings confirm the effectiveness of the NeuroNation MED app, it may confer possible benefits for the care management of patients with MCI, owing to the accessibility, cost-effectiveness, and home-based setting it provides. Specifically, the cCT program could provide patients with personalized cognitive training, educational resources, and relaxation techniques, enabling participants to independently engage in cognitive training sessions at home without further supervision. TRIAL REGISTRATION German Clinical Trials Register DRKS00025133. Registered on November 5, 2021.
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Affiliation(s)
- Drin Ferizaj
- Department of Geriatrics and Medical Gerontology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany.
| | - Oskar Stamm
- Department of Geriatrics and Medical Gerontology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Luis Perotti
- Department of Geriatrics and Medical Gerontology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Eva Maria Martin
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Anja Ophey
- Department of Medical Psychology | Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Sophia Rekers
- Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Daniel Scharfenberg
- Department of Medical Psychology | Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Tobias Oelgeschläger
- Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Katharina Barcatta
- Centre Hospitalier Neuro-Psychiatrique Luxembourg (CHNP), Zentrum Für Psychotherapie, Ettelbruck, Luxembourg
| | - Sigrid Seiler
- Neuropsychological University Outpatient Clinic of the LMU Munich, Munich, Germany
| | - Johanna Funk
- Neuropsychological University Outpatient Clinic of the LMU Munich, Munich, Germany
| | - Charles Benoy
- Centre Hospitalier Neuro-Psychiatrique Luxembourg (CHNP), Zentrum Für Psychotherapie, Ettelbruck, Luxembourg
| | - Carsten Finke
- Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Elke Kalbe
- Department of Medical Psychology | Neuropsychology & Gender Studies, Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Kathrin Finke
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Anika Heimann-Steinert
- Department of Geriatrics and Medical Gerontology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
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Rekers S, Heine J, Thöne-Otto AIT, Finke C. Neuropsychiatric symptoms and metamemory across the life span: psychometric properties of the German Multifactorial Memory Questionnaire (MMQ). J Neurol 2024; 271:4551-4565. [PMID: 38717611 PMCID: PMC11233313 DOI: 10.1007/s00415-024-12402-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/18/2024] [Accepted: 04/22/2024] [Indexed: 07/10/2024]
Abstract
OBJECTIVE We assessed the psychometric properties, established normative data for the German Multifactorial Memory Questionnaire (MMQ), and analyzed its association with neuropsychiatric factors across the life span to provide a validated metamemory assessment for a German-speaking population. METHODS The three MMQ scales (memory satisfaction, self-rated ability, and strategy application) were translated into German, considering cultural, linguistic, and conceptual aspects. To validate the MMQ and assess associations with neuropsychiatric factors, the Complainer Profile Identification, Geriatric Depression Scale, Beck Anxiety Inventory, Pittsburgh Sleep Quality Index, and Short-Form-Health Survey were applied in an online study in 336 healthy participants with follow-up after 8 months. RESULTS Psychometric evaluation of the German MMQ showed normal distribution of all scales and good to excellent validity, internal consistency, and retest reliability. We provide percentiles and normative data for z-score conversion. Importantly, even subclinically elevated scores in depressiveness and anxiety were associated with decreased memory satisfaction and self-rated ability. Furthermore, although the influence of age on the German MMQ scales was minimal, effects of neuropsychiatric factors such as sleep quality, anxiety, and depressiveness on MMQ Satisfaction and Ability varied across the life span. CONCLUSIONS Our study provides a validated German translation of the MMQ with normative data and reliability measures, including reliable change scores. We show the impact of neuropsychiatric factors on the MMQ scales across the life span and emphasize the relevance of a multifactorial approach to metamemory as a measure of individualized everyday functionality and the importance of including neuropsychiatric factors into both research and clinical assessments of metamemory.
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Affiliation(s)
- Sophia Rekers
- Department of Neurology, Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.
| | - Josephine Heine
- Department of Neurology, Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Angelika I T Thöne-Otto
- Clinic for Cognitive Neurology, University of Leipzig, Max-Planck-Institute of Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Carsten Finke
- Department of Neurology, Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
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Xiang C, Zhang Y. Comparison of Cognitive Intervention Strategies for Individuals With Alzheimer's Disease: A Systematic Review and Network Meta-analysis. Neuropsychol Rev 2024; 34:402-416. [PMID: 36929474 PMCID: PMC11166762 DOI: 10.1007/s11065-023-09584-5] [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: 03/10/2022] [Accepted: 12/22/2022] [Indexed: 03/18/2023]
Abstract
Accumulating evidence has shown the effectiveness of cognitive interventions, which can be divided into cognitive training (CT), cognitive stimulation (CS), cognitive rehabilitation (CR), and combined interventions (i.e., cognitive interventions combined with other non-pharmacological interventions such as physical exercise), in individuals with Alzheimer's disease (AD). However, the effectiveness of cognitive interventions varies greatly among studies and more comprehensive studies are required. We aimed to evaluate whether the current evidence shows that cognitive interventions are effective at improving cognition, neuropsychiatric symptoms, depression, quality of life, and basic activities of daily living among individuals with possible or probable AD. Randomized controlled trials of all types of cognitive intervention were identified for inclusion in pairwise and network meta-analyses. There was a moderate and statistically significant post-intervention improvement in global cognition among individuals with AD for all types of cognitive intervention compared to control interventions (39 studies, g = 0.43, 95% CI: 0.28 to 0.58, p < 0.01; Q = 102.27, df = 38, p < 0.01; I2 = 61.97%, τ2 = 0.13). Regarding the specific types of cognitive intervention, combined interventions had the highest surface under the cumulative ranking curve (SUCRA) value (90.7%), followed by CT (67.8%), CS (53.4%), and lastly CR (28.9%). Significant effects of cognitive interventions were also found for working memory, verbal memory, verbal fluency, confrontation naming, attention, neuropsychiatric symptoms, basic activities of daily living, and quality of life.
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Affiliation(s)
- Chunchen Xiang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yumei Zhang
- Department of Rehabilitation Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
- Center of Stroke, Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing Institute for Brain Disorders, Beijing, China.
- China National Clinical Research Center for Neurological Diseases, Beijing, China.
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Jellinger KA. Cognitive impairment in multiple sclerosis: from phenomenology to neurobiological mechanisms. J Neural Transm (Vienna) 2024:10.1007/s00702-024-02786-y. [PMID: 38761183 DOI: 10.1007/s00702-024-02786-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/08/2024] [Indexed: 05/20/2024]
Abstract
Multiple sclerosis (MS) is an autoimmune-mediated disease of the central nervous system characterized by inflammation, demyelination and chronic progressive neurodegeneration. Among its broad and unpredictable range of clinical symptoms, cognitive impairment (CI) is a common and disabling feature greatly affecting the patients' quality of life. Its prevalence is 20% up to 88% with a wide variety depending on the phenotype of MS, with highest frequency and severity in primary progressive MS. Involving different cognitive domains, CI is often associated with depression and other neuropsychiatric symptoms, but usually not correlated with motor and other deficits, suggesting different pathophysiological mechanisms. While no specific neuropathological data for CI in MS are available, modern research has provided evidence that it arises from the disease-specific brain alterations. Multimodal neuroimaging, besides structural changes of cortical and deep subcortical gray and white matter, exhibited dysfunction of fronto-parietal, thalamo-hippocampal, default mode and cognition-related networks, disruption of inter-network connections and involvement of the γ-aminobutyric acid (GABA) system. This provided a conceptual framework to explain how aberrant pathophysiological processes, including oxidative stress, mitochondrial dysfunction, autoimmune reactions and disruption of essential signaling pathways predict/cause specific disorders of cognition. CI in MS is related to multi-regional patterns of cerebral disturbances, although its complex pathogenic mechanisms await further elucidation. This article, based on systematic analysis of PubMed, Google Scholar and Cochrane Library, reviews current epidemiological, clinical, neuroimaging and pathogenetic evidence that could aid early identification of CI in MS and inform about new therapeutic targets and strategies.
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Affiliation(s)
- Kurt A Jellinger
- Institute of Clinical Neurobiology, Alberichgasse 5/13, Vienna, A-1150, Austria.
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Bampa G, Moraitou D, Metallidou P, Masoura E, Papantoniou G, Sofologi M, Kougioumtzis GA, Tsolaki M. The Efficacy of a Metacognitive Training Program in Amnestic Mild Cognitive Impairment: A 6-Month Follow-Up Clinical Study. Healthcare (Basel) 2024; 12:1019. [PMID: 38786429 PMCID: PMC11121656 DOI: 10.3390/healthcare12101019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/23/2024] [Accepted: 04/30/2024] [Indexed: 05/25/2024] Open
Abstract
This study was conducted in response to the increasing prevalence of Alzheimer's disease (AD) dementia and the significant risk faced by individuals with amnestic mild cognitive impairment with multiple-domain deficits (aMCI-md). Given the promising effects of MTPs, the primary aim of this study was to further explore their impact by assessing the maintenance of their benefits. Thus, 45 participants were randomly allocated in two groups: the Experimental group (n = 22), which received the metacognitive training program (MTP), and the Control group (n = 23) that received the cognitive exercises program (CEP). The training programs-the MTP and the CEP-included 10 individual sessions of a one-hour duration and took place once per week. To test the efficacy of the MTP, cognitive and metacognitive outcomes were compared between two groups-Experimental (EG) and Control (CG)-at four distinct time points: before-after-3 months-6 months after intervention. Based on this study's findings, the positive effects of the MTP were evident over a six-month period. Specifically, already three months post-training, the CG began to show a decline in training-related gains. In contrast, the EG's performance consistently improved, highlighting the superior efficacy of the MTP. Gains attributed to the MTP were detected in cognitive measures: cognitive flexibility and immediate visual recall, as well as in metacognitive measures: metacognitive control, improved metacognitive beliefs of attention, and an increased use of cognitive strategies. In conclusion, the results demonstrated the sustained effects of the MTP in cognitive and metacognitive measures over a period of six months, providing novel insight into the application and efficacy of the MTP in individuals with MCI.
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Affiliation(s)
- Grigoria Bampa
- Laboratory of Psychology, Department of Cognition, Brain and Behavior, School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.M.); (P.M.); (E.M.)
- Laboratory of Neurodegenerative Diseases, Center of Interdisciplinary Research and Innovation (CIRI–AUTH), Balcan Center, Buildings A & B, 10th km Thessaloniki-Thermi, 54124 Thessaloniki, Greece;
| | - Despina Moraitou
- Laboratory of Psychology, Department of Cognition, Brain and Behavior, School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.M.); (P.M.); (E.M.)
- Laboratory of Neurodegenerative Diseases, Center of Interdisciplinary Research and Innovation (CIRI–AUTH), Balcan Center, Buildings A & B, 10th km Thessaloniki-Thermi, 54124 Thessaloniki, Greece;
| | - Panagiota Metallidou
- Laboratory of Psychology, Department of Cognition, Brain and Behavior, School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.M.); (P.M.); (E.M.)
| | - Elvira Masoura
- Laboratory of Psychology, Department of Cognition, Brain and Behavior, School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.M.); (P.M.); (E.M.)
| | - Georgia Papantoniou
- Laboratory of Psychology, Department of Early Childhood Education, School of Education, University of Ioannina, 45110 Ioannina, Greece; (G.P.); (M.S.)
- Institute of Humanities and Social Sciences, University Research Centre of Ioannina (URCI), 45110 Ioannina, Greece
| | - Maria Sofologi
- Laboratory of Psychology, Department of Early Childhood Education, School of Education, University of Ioannina, 45110 Ioannina, Greece; (G.P.); (M.S.)
- Institute of Humanities and Social Sciences, University Research Centre of Ioannina (URCI), 45110 Ioannina, Greece
| | - Georgios A. Kougioumtzis
- Department of Turkish and Modern Asian Studies, National and Kapodistrian University of Athens, 15772 Athens, Greece;
- Department of Psychology, Neapolis University Pafos, 8042 Pafos, Cyprus
| | - Magdalini Tsolaki
- Laboratory of Neurodegenerative Diseases, Center of Interdisciplinary Research and Innovation (CIRI–AUTH), Balcan Center, Buildings A & B, 10th km Thessaloniki-Thermi, 54124 Thessaloniki, Greece;
- Greek Association of Alzheimer’s Disease and Related Disorders (GAADRD), 54643 Thessaloniki, Greece
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Wen X, Song S, Tian H, Cui H, Zhang L, Sun Y, Li M, Wang Y. Intervention of computer-assisted cognitive training combined with occupational therapy in people with mild cognitive impairment: a randomized controlled trial. Front Aging Neurosci 2024; 16:1384318. [PMID: 38832072 PMCID: PMC11146196 DOI: 10.3389/fnagi.2024.1384318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 04/22/2024] [Indexed: 06/05/2024] Open
Abstract
Objective Investigate the impact of combined computerized cognitive training and occupational therapy on individuals with mild cognitive impairment (MCI). Methods We randomly assigned 118 MCI patients into two groups: a combined intervention group (n = 37) and a control group (n = 81), the latter receiving standard nursing care. The intervention group additionally underwent 12 weeks of computerized cognitive training and occupational therapy. Blind assessors evaluated cognitive performance, anxiety, depression, and daily living activities before the intervention, post-intervention, and at a 3-month follow-up. Results Repeated-measures analysis of variance showed that the sMoCA scores, HAMA scores, and ADL scores of the experimental group at T2 (post-intervention) and T3 (3-month follow-up) were higher than those of the control group, and the difference was statistically significant (p < 0.001, p < 0.001, p = 0.026). Conclusion Computerized cognitive training combined with occupational therapy can improve patients' cognitive status, enhance their compliance with continuing care, and maintain their anxiety and self-care ability at a stable level. Clinical trial registration https://www.chictr.org.cn/index.html, identifier ChiCTR2200065014.
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Affiliation(s)
- Xin Wen
- The First Hospital of Jilin University, Changchun, Jilin, China
| | - Shangrong Song
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Hui Tian
- The First Hospital of Jilin University, Changchun, Jilin, China
| | - Hang Cui
- The First Hospital of Jilin University, Changchun, Jilin, China
| | - Lijuan Zhang
- The First Hospital of Jilin University, Changchun, Jilin, China
| | - Yajie Sun
- The First Hospital of Jilin University, Changchun, Jilin, China
| | - Mingyue Li
- The First Hospital of Jilin University, Changchun, Jilin, China
| | - Yonghong Wang
- The First Hospital of Jilin University, Changchun, Jilin, China
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Young KWD, Kwok CYT, Ng YNP, Ng SM, Chen QRJ. Multicomponent Intervention on Improving the Cognitive Ability of Older Adults with Mild Cognitive Impairment: A Pilot Randomized Controlled Trial. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2024; 67:492-514. [PMID: 38590208 DOI: 10.1080/01634372.2024.2338066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 03/15/2024] [Indexed: 04/10/2024]
Abstract
This pilot randomized controlled trial aimed to evaluate the feasibility and potential outcomes of an innovative 16-session multicomponent intervention model to improve cognitive abilities in older adults with mild cognitive impairment (MCI) by promoting healthy lifestyle, cognitive skills, tai chi and mindfulness practices. This study was a multicentre, randomized controlled, two-arm, parallel-group, unblinded trial in Hong Kong. 57 Chinese older adults with MCI recruited from three local elderly centers were randomly assigned to either the control or intervention group. The study results support the feasibility and efficacy of the multicomponent intervention, and recommend future larger-scale randomized control trials.
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Affiliation(s)
- Kim-Wan Daniel Young
- Department of Social and Behavioral Sciences, City University of Hong Kong, Hong Kong, China
| | - Chi-Yui Timothy Kwok
- Department of Medicine/Geriatric Medicine, Chinese University of Hong Kong, Hong Kong, China
| | - Yat-Nam Petrus Ng
- Department of Social Work, Hong Kong Baptist University, Hong Kong, China
| | - Siu-Man Ng
- Department of Social Work & Social Administration, University of Hong Kong, Hong Kong, China
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Wang SM, Kang DW, Um YH, Kim S, Lee S, Lee CU, Lim HK. Effects of Serious Games in Older Adults With Mild Cognitive Impairment. Psychiatry Investig 2024; 21:449-456. [PMID: 38810993 PMCID: PMC11136576 DOI: 10.30773/pi.2023.0308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 01/21/2024] [Accepted: 02/28/2024] [Indexed: 05/31/2024] Open
Abstract
OBJECTIVE The rising prevalence of mild cognitive impairment (MCI) has spurred interest in innovative cognitive rehabilitation approaches, including serious games. This review summarizes randomized clinical trials (RCTs) exploring the impact of serious games on MCI patients. METHODS We conducted a comprehensive data search using key terms such as "gamification," "digital therapy," "cognition," "mild cognitive impairment," and "Alzheimer's disease." We exclusively considered published RCTs, excluding animal studies and basic research. RESULTS We identified eight RCTs. Four RCTs examined the effects of serious games using cognitive training for MCI patients. Notably, one study found that non-specific training (Nintendo Wii) significantly enhanced cognitive function and quality of life compared to cognition-specific computer training (CoTras). Among the remaining three RCTs, one specifically demonstrated that personalized serious game-based cognitive training yielded superior cognitive outcomes and reduced depressive symptoms. One RCT focused on serious games incorporating physical exercise, highlighting the effectiveness of kinetic-based exergaming in enhancing overall cognition. Three RCT focused on combined cognitive training and physical exercise. A double-blind RCT revealed that progressive resistance training or standalone physical exercise outperformed the combined approach in improving executive function and global cognition. Two additional RCTs reported positive outcomes, including improvements in cognitive function and electroencephalogram patterns associated with game-based interventions. CONCLUSION Serious games, whether focusing on cognitive training, physical exercise, or a combination of both, have potential to improve cognitive and functional outcomes in individuals with MCI. Further research and standardization of protocols are needed to better understand the full potential of serious games in MCI.
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Affiliation(s)
- Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sunghwan Kim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Soyoung Lee
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Mamayson RF, Lacanaria MGC. Effects of Cognitively Stimulating Activities on the Cognitive Functioning of Older People with Mild Cognitive Impairment: A Meta-analysis. ACTA MEDICA PHILIPPINA 2024; 58:14-23. [PMID: 38846164 PMCID: PMC11151131 DOI: 10.47895/amp.vi0.7162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
Background The number of individuals with mild cognitive impairment (MCI), or those people without dementia who are experiencing age-related cognitive decline, has increased in recent years. Conveniently, several interventions to delay cognitive decline exist, where cognitively stimulating activities (CSA) have been receiving too much attention. However, its beneficial effects have not been well established among older people with MCI due to conflicting findings. Objectives This study aimed to assess and summarize the available evidence on the effects of CSA on the overall cognitive functioning of older people with MCI. Specifically, it sought to answer the PICO question, "In older people with MCI, does engagement in cognitively stimulating activities improve cognitive function?" Methods A systematic review and meta-analysis of randomized controlled trials examining the effects of CSA on older people with MCI were conducted. Three studies met the inclusion criteria from the 1,328 records from BioMed Central, CINAHL, Cochrane Library, Health Source: Nursing/Academic Edition, MEDLINE, and PubMed databases and 156 articles from WorldCat, DSpace Saint Louis University, and Google Scholar databases and catalogs. Effect size values were inspected using the random-effects model. Data were summarized as standardized mean difference (SMD) with corresponding 95% confidence intervals in the forest plot. Results This meta-analysis which compared studies that employed similar methodologies, found that CSA has a significant, large effect in improving cognitive functioning among older people with MCI, evidenced by an SMD of 0.798 (95% CI = 0.510-1.085, p = 0.001). While its superiority over other interventions that improve cognitive function was not observed in this study, it was still found that using CSA was helpful in terms of its cost-effectiveness. Also, heterogeneity across studies was non-significant (Cochran's Q = 0.151, df = 2, p = 0.927, I2 = 0.00%). These results mean that clinical heterogeneity was absent even though a diverse range of CSA was employed. Additionally, methodological diversity was not present since there were no variations in the study design and minimal variability in the risk of bias assessment. Conclusion Overall, it is acknowledged that CSA are effective and practical, inexpensive, non-pharmacologic cognitive training approaches to delay cognitive decline among older people with MCI. However, interpreting this study's significant, large effect, and non-significant heterogeneity warrants caution.
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Ren S, Pan F, Jin J. The effect of cognitive rehabilitation on daily functioning of patients with Alzheimer's disease: a systematic review and meta-analysis of clinical trials. Front Neurol 2024; 15:1371298. [PMID: 38628699 PMCID: PMC11019015 DOI: 10.3389/fneur.2024.1371298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/19/2024] [Indexed: 04/19/2024] Open
Abstract
Background Alzheimer's disease (AD) is the most prevalent type of dementia and represents 60-80% of dementia cases. AD affects over 32 million people globally, and 8.1% of affected females and 5.4% of affected males were older than 65 years. Cognitive rehabilitation focuses on helping patients develop individualized strategies to obtain or maintain optimal functioning. As of now, there is no complete and systematic meta-analysis on the effects of cognitive rehabilitation on cognitive functioning in AD patients. Objectives To provide the most recent and extensive pooled analysis and evidence and explore the influence of cognitive rehabilitation on overall cognitive functioning in patients with AD. Methods We searched articles through several databases such as PubMed, Cochrane Library, Embase, and Web of Science, from the inception to June 2023. Studies on cognitive stimulation, cognitive training, and cognitive interventions, and non-English articles were excluded. The outcome measures encompassed the effects of cognitive rehabilitation on the overall cognitive functioning of people with AD (e.g., verbal fluency, behavioral memory, neuropsychiatric status and occupational performance levels). Results A total of 14 clinical trials were included in this analysis. The meta-analysis showed that cognitive rehabilitation significantly improved quality of life (WMD: 2.87; 95% CI: 0.79, 4.95; p = 0.007) and occupational performance levels (WMD: 1.53; 95% CI: 0.43, 2.63; p = 0.007) in patients with AD. However, it did not show a significant effect on other domains of specific cognitive functions in patients with AD. Conclusion Cognitive rehabilitation exhibited a moderate to large impact on both quality of life and occupational performance levels in people with AD. Future studies are required to explore the potential of various cognitive interventions across specific domains, so as to provide more insights into the management of AD. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42023444390.
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Dowell-Esquivel C, Czaja SJ, Kallestrup P, Depp CA, Saber JN, Harvey PD. Computerized Cognitive and Skills Training in Older People With Mild Cognitive Impairment: Using Ecological Momentary Assessment to Index Treatment-Related Changes in Real-World Performance of Technology-Dependent Functional Tasks. Am J Geriatr Psychiatry 2024; 32:446-459. [PMID: 37953132 PMCID: PMC10950539 DOI: 10.1016/j.jagp.2023.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVES Cognitive and functional skills training improves skills and cognitive test performance, but the true test of efficacy is real-world transfer. We trained participants with mild cognitive impairment (MCI) or normal cognition (NC) for up to 12 weeks on six technology-related skills using remote computerized functional skills assessment and training (FUNSAT) software. Using ecological momentary assessment (EMA), we measured real-world performance of the technology-related skills over 6 months and related EMA-identified changes in performance to training gains. DESIGN Randomized clinical trial with post-training follow-up. SETTING A total of 14 Community centers in New York City and Miami. PARTICIPANTS Older adults with normal cognition (n = 72) or well-defined MCI (n = 92), ranging in age from 60 to 90, primarily female, and racially and ethnically diverse. INTERVENTION Computerized cognitive and skills training. MEASUREMENTS EMA surveys measuring trained and untrained functional skills 3 or more days per week for 6 months and training gains from baseline to end of training. RESULTS Training gains in completion times across all 6 tasks were significant (p <0.001) for both samples, with effect sizes more than 1.0 SD for all tasks. EMA surveys detected increases in performance for both trained (p <0.03) and untrained (p <0.001) technology-related skills for both samples. Training gains in completion times predicted increases in performance of both trained and untrained technology-related skills (all p <0.001). CONCLUSIONS Computerized training produces increases in real-world performance of important technology-related skills. These gains continued after the end of training, with greater gains in MCI participants.
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Affiliation(s)
| | - Sara J Czaja
- Weil Cornell School of Medicine (SJC), New York, NY; i-Function, Inc. (SJC, PK, PDH) Miami, FL
| | | | | | | | - Philip D Harvey
- University of Miami Miller School of Medicine (CDE, PDH), Miami, FL; i-Function, Inc. (SJC, PK, PDH) Miami, FL.
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12
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Li KY, Pickett KA, Fu HW, Chen RS. Proprioceptive and olfactory deficits in individuals with Parkinson disease and mild cognitive impairment. Acta Neurol Belg 2024; 124:419-430. [PMID: 37962784 DOI: 10.1007/s13760-023-02420-w] [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: 01/18/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Individuals with neurodegenerative diseases such as Parkinson disease (PD) and Alzheimer's (AD) disease often present with perceptual impairments at an early clinical stage. Therefore, early identification and quantification of these impairments could facilitate diagnosis and early intervention. OBJECTIVES This study aimed to compare proprioceptive and olfactory sensitivities in individuals diagnosed with PD and mild cognitive impairment (MCI). METHODS Proprioception in the forearm and olfactory function were measured in neurotypical older adults, individuals with PD, and individuals with MCI. Position and passive motion senses were assessed using a passive motion apparatus. The traditional Chinese version of the University of Pennsylvania smell identification test (UPSIT-TC) and the smell threshold test (STT) were used to identify and discriminate smell, respectively. RESULTS Position sense threshold between the groups differed significantly (p < 0.001), with the PD (p < 0.001) and MCI (p = 0.004) groups showing significantly higher than the control group. The control group had significantly higher mean UPSIT-TC scores than the PD (p < 0.001) and MCI (p = 0.006) groups. The control group had a significantly lower mean STT threshold than the PD and MCI groups (p < 0.001 and p = 0.008, respectively). UPSIT-TC scores significantly correlated with disease progression in PD (r = - 0.50, p = 0.008) and MCI (r = 0.44, p = 0.04). CONCLUSIONS Proprioceptive and olfactory sensitivities were reduced in individuals with PD and MCI, and these deficits were related to disease severity. These findings support previous findings indicating that perceptual loss may be a potential biomarker for diagnosing and monitoring disease progression in individuals with neurodegenerative diseases.
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Affiliation(s)
- Kuan-Yi Li
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Tao-Yuan, Taiwan
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
- Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Kristen A Pickett
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, USA
- Occupational Therapy Program, University of Wisconsin-Madison, Madison, WI, USA
| | - Hsuan-Wei Fu
- Department of Rehabilitation, Kuang Tien General Hospital, Taichung, Taiwan
| | - Rou-Shayn Chen
- Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
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Kong Y, Guo QH, Zhou L, He L, Zeng Y, Du X, Dong JZ, Jiang C, Wang JG, Ma CS. Digital computerised cognitive training for preventing cognitive decline among hypertensive patients: a study protocol for a multicentre randomised controlled trial (DELIGHT trial). BMJ Open 2024; 14:e079305. [PMID: 38423771 PMCID: PMC10910859 DOI: 10.1136/bmjopen-2023-079305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/26/2024] [Indexed: 03/02/2024] Open
Abstract
INTRODUCTION Mild cognitive impairment (MCI) is an important intervenable stage for the prevention of dementia. Hypertension is associated with impaired cognition, and when combined with MCI, it may lead to a poor prognosis. Digital computerised cognitive training (CCT) has recently become a potential instrument for improving cognition, but evidence for its efficacy remains limited. This study aims to evaluate the efficacy of a digital adaptive CCT intervention in older patients with hypertension and MCI. METHODS AND ANALYSIS The multicentre, double-blinded, randomised, actively -controlled clinical trial will recruit 200 older (≥60 years) patients with hypertension and MCI from 11 hospitals across China. Participants will be randomly assigned in a 1:1 ratio to the intervention group (multidomain adaptative CCT) and active control group (non-adaptive cognitive training) for 12-week cognitive training for 30 min/day and 5 days/week. Those who have completed their 12-week training in the intervention group will be rerandomised into the continuation and discontinuation training groups. All participants will be followed up to 24 weeks. Neuropsychological assessments and structural and functional 7.0 T MRI will be obtained at baseline and at 12-week and 24-week follow-up. The primary outcome is the possible improvement of global cognitive function at 12 weeks, as measured by the Basic Cognitive Aptitude Tests. Secondary and exploratory endpoints include the major cognitive domain function improvement, self-efficacy, mental health, quality of life and MRI measurements of the brain. ETHICS AND DISSEMINATION The trial has been approved by the institutional review board of Beijing Anzhen Hospital and thereafter by all other participating centres. Trial findings will be disseminated in peer-reviewed journals and conference presentations. TRIAL REGISTRATION NUMBER NCT05704270.
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Affiliation(s)
- Yu Kong
- Department of Cardiology, Beijing AnZhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, Office of Beijing Cardiovascular Diseases Prevention, Chaoyang Qu, Beijing, China
- Heart Health Research Center, Beijing, China
| | - Qian Hui Guo
- Department of Cardiovascular Medicine, State Key Laboratory of Medical Geonomics, Shanghai Key Laboratory of Hypertension, Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, National Research Centre for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Le Zhou
- Department of Cardiology, Beijing AnZhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, Office of Beijing Cardiovascular Diseases Prevention, Chaoyang Qu, Beijing, China
| | - Liu He
- Department of Cardiology, Beijing AnZhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, Office of Beijing Cardiovascular Diseases Prevention, Chaoyang Qu, Beijing, China
- Heart Health Research Center, Beijing, China
| | - Yong Zeng
- Department of Cardiology, Beijing AnZhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, Office of Beijing Cardiovascular Diseases Prevention, Chaoyang Qu, Beijing, China
| | - Xin Du
- Department of Cardiology, Beijing AnZhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, Office of Beijing Cardiovascular Diseases Prevention, Chaoyang Qu, Beijing, China
- Heart Health Research Center, Beijing, China
- University of New South Wales, Sydney, New South Wales, Australia
| | - Jian Zeng Dong
- Department of Cardiology, Beijing AnZhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, Office of Beijing Cardiovascular Diseases Prevention, Chaoyang Qu, Beijing, China
| | - Chao Jiang
- Department of Cardiology, Beijing AnZhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, Office of Beijing Cardiovascular Diseases Prevention, Chaoyang Qu, Beijing, China
| | - Ji Guang Wang
- Department of Cardiovascular Medicine, State Key Laboratory of Medical Geonomics, Shanghai Key Laboratory of Hypertension, Centre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, National Research Centre for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Chang Sheng Ma
- Department of Cardiology, Beijing AnZhen Hospital, Capital Medical University, National Clinical Research Centre for Cardiovascular Diseases, Office of Beijing Cardiovascular Diseases Prevention, Chaoyang Qu, Beijing, China
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14
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Harvey PD, Dowell-Esquivel C, Macchiarelli JE, Martinez A, Kallestrup P, Czaja SJ. Early prediction of mastery of a computerized functional skills training program in participants with mild cognitive impairment. Int Psychogeriatr 2024:1-12. [PMID: 38380470 DOI: 10.1017/s1041610224000115] [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] [Indexed: 02/22/2024]
Abstract
BACKGROUND Cognition in MCI has responded poorly to pharmacological interventions, leading to use of computerized training. Combining computerized cognitive training (CCT) and functional skills training software (FUNSAT) produced improvements in 6 functional skills in MCI, with effect sizes >0.75. However, 4% of HC and 35% of MCI participants failed to master all 6 tasks. We address early identification of characteristics that identify participants who do not graduate, to improve later interventions. METHODS NC participants (n = 72) received FUNSAT and MCI (n = 92) participants received FUNSAT alone or combined FUNSAT and CCT on a fully remote basis. Participants trained twice a week for up to 12 weeks. Participants "graduated" each task when they made one or fewer errors on all 3-6 subtasks per task. Tasks were no longer trained after graduation. RESULTS Between-group comparisons of graduation status on baseline completion time and errors found that failure to graduate was associated with more baseline errors on all tasks but no longer completion times. A discriminant analysis found that errors on the first task (Ticket purchase) uniquely separated the groups, F = 41.40, p < .001, correctly classifying 94% of graduators. An ROC analysis found an AUC of .83. MOCA scores did not increase classification accuracy. CONCLUSIONS More baseline errors, but not completion times, predicted failure to master all FUNSAT tasks. Accuracy of identification of eventual mastery was exceptional. Detection of risk to fail to master training tasks is possible in the first 15 minutes of the baseline assessment. This information can guide future enhancements of computerized training.
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Affiliation(s)
- Philip D Harvey
- University of Miami Miller School of Medicine, Miami, FL, USA
- I-Function, Inc, Miami, FL, USA
| | | | | | | | | | - Sara J Czaja
- I-Function, Inc, Miami, FL, USA
- Weill-Cornell Medical Center, New York, NY, USA
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15
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Lau CI, Liu MN, Cheng FY, Wang HC, Walsh V, Liao YY. Can transcranial direct current stimulation combined with interactive computerized cognitive training boost cognition and gait performance in older adults with mild cognitive impairment? a randomized controlled trial. J Neuroeng Rehabil 2024; 21:26. [PMID: 38365761 PMCID: PMC10874043 DOI: 10.1186/s12984-024-01313-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/24/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Older adults with Mild Cognitive Impairment (MCI) are often subject to cognitive and gait deficits. Interactive Computerized Cognitive Training (ICCT) may improve cognitive function; however, the effect of such training on gait performance is limited. Transcranial Direct Current Stimulation (tDCS) improves cognition and gait performance. It remains unclear whether combining tDCS with ICCT produces an enhanced synergistic effect on cognition and complex gait performance relative to ICCT alone. This study aimed to compare the effects of tDCS combined with ICCT on cognition and gait performance in older adults with MCI. METHOD Twenty-one older adults with MCI were randomly assigned to groups receiving either anodal tDCS and ICCT ( tDCS + ICCT ) or sham tDCS and ICCT ( sham + ICCT ). Participants played Nintendo Switch cognitive games for 40 min per session, simultaneously receiving either anodal or sham tDCS over the left dorsolateral prefrontal cortex for the first 20 min. Cognitive and gait assessments were performed before and after 15 training sessions. RESULTS The global cognition, executive function, and working-memory scores improved in both groups, but there were no significant interaction effects on cognitive outcomes. Additionally, the group × time interactions indicated that tDCS + ICCT significantly enhanced dual-task gait performance in terms of gait speed (p = 0.045), variability (p = 0.016), and dual-task cost (p = 0.039) compared to sham + ICCT. CONCLUSION The combined effect of tDCS and ICCT on cognition was not superior to that of ICCT alone; however, it had a significant impact on dual-task gait performance. Administering tDCS as an adjunct to ICCT may thus provide additional benefits for older adults with MCI. TRIAL REGISTRATION This trial was registered at http://www. CLINICALTRIALS in.th/ (TCTR 20,220,328,009).
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Affiliation(s)
- Chi Ieong Lau
- Dementia Center, Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- Applied Cognitive Neuroscience Group, Institute of Cognitive Neuroscience, University College London, London, UK
- Institute of Biophotonics, National Yang Ming Chiao Tung University, Taipei, Taiwan
- College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Mu-N Liu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Fang-Yu Cheng
- Institute of Long-Term Care, MacKay Medical College, New Taipei, Taiwan
| | - Han-Cheng Wang
- Dementia Center, Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Vincent Walsh
- Applied Cognitive Neuroscience Group, Institute of Cognitive Neuroscience, University College London, London, UK
| | - Ying-Yi Liao
- Department of Gerontological Health Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
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16
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Verhülsdonk S, Folkerts AK, Hasenberg C, Bohn C, Christl J, Kalbe E, Krieger T. Cognitive training for older prisoners: a qualitative analysis of prisoners' and staff members' perceptions. Front Aging Neurosci 2024; 15:1332136. [PMID: 38259639 PMCID: PMC10800784 DOI: 10.3389/fnagi.2023.1332136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 12/22/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Correctional institutions are challenged by increasing numbers of older prisoners. Existing literature highlights the vulnerability of this group that is reflected by various somatic and mental health issues including cognitive dysfunctions. Although cognitive training studies in various target groups of older people have been conducted, there is lack of data regarding cognitive training in older prisoners. A structured cognitive group training program ("NEUROvitalis Prison") with 12 weekly sessions was offered to male prisoners in Germany. Methods Post intervention an exploratory qualitative study was conducted. Prisoners (N = 18) and staff (N = 4) perspectives were explored by conducting face-to-face semi-structured interviews. Audiotaped data were fully transcribed and deductive-inductive content analyses applied. Results Both the prisoners and the staff perceived the cognitive training as very positive and stimulating. Moreover, the importance of the training was pronounced in terms of an increase in self-esteem and understanding of cognition and aging in the prisoners. Discussion Our data indicate that cognitive training may be a feasible and valuable intervention for older prisoners that will be appreciated by both inmates and staff. The qualitative data provide substantial insight into the experiences with the applied cognitive training program. Moreover, valuable modifications for future conduct can be derived.
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Affiliation(s)
- Sandra Verhülsdonk
- Department of Psychiatry and Psychotherapy, LVR-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Medical Psychology, Neuropsychology and Gender Studies, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ann-Kristin Folkerts
- Medical Psychology, Neuropsychology and Gender Studies, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Caroline Hasenberg
- Medical Psychology, Neuropsychology and Gender Studies, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Claire Bohn
- Department of Psychiatry and Psychotherapy, LVR-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Julia Christl
- Department of Psychiatry and Psychotherapy, LVR-Klinikum Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Elke Kalbe
- Medical Psychology, Neuropsychology and Gender Studies, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Theresia Krieger
- Medical Psychology, Neuropsychology and Gender Studies, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Chan ATC, Ip RTF, Tran JYS, Chan JYC, Tsoi KKF. Computerized cognitive training for memory functions in mild cognitive impairment or dementia: a systematic review and meta-analysis. NPJ Digit Med 2024; 7:1. [PMID: 38172429 PMCID: PMC10764827 DOI: 10.1038/s41746-023-00987-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024] Open
Abstract
Dementia is a common medical condition in the ageing population, and cognitive intervention is a non-pharmacologic strategy to improve cognitive functions. This meta-analysis evaluated the benefits of computerized cognitive training (CCT) on memory functions in individuals with MCI or dementia. The study was registered prospectively with PROSPERO under CRD42022363715 and received no funding. The search was conducted on MEDLINE, Embase, and PsycINFO on Sept 19, 2022, and Google Scholar on May 9, 2023, to identify randomized controlled trials that examined the effects of CCT on memory outcomes in individuals with MCI or dementia. Mean differences and standard deviations of neuropsychological assessment scores were extracted to derive standardized mean differences. Our search identified 10,678 studies, of which 35 studies were included. Among 1489 participants with MCI, CCT showed improvements in verbal memory (SMD (95%CI) = 0.55 (0.35-0.74)), visual memory (0.36 (0.12-0.60)), and working memory (0.37 (0.10-0.64)). Supervised CCT showed improvements in verbal memory (0.72 (0.45-0.98)), visual memory (0.51 (0.22-0.79)), and working memory (0.33 (0.01-0.66)). Unsupervised CCT showed improvement in verbal memory (0.21 (0.04-0.38)) only. Among 371 participants with dementia, CCT showed improvement in verbal memory (0.64 (0.02-1.27)) only. Inconsistency due to heterogeneity (as indicated by I2 values) is observed, which reduces our confidence in MCI outcomes to a moderate level and dementia outcomes to a low level. The results suggest that CCT is efficacious on various memory domains in individuals with MCI. Although the supervised approach showed greater effects, the unsupervised approach can improve verbal memory while allowing users to receive CCT at home without engaging as many healthcare resources.
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Affiliation(s)
- Aaron T C Chan
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Roy T F Ip
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Joshua Y S Tran
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Joyce Y C Chan
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Kelvin K F Tsoi
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
- Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Hong Kong, China.
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18
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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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Altieri M, Sergi MR, Tommasi M, Santangelo G, Saggino A. The efficacy of telephone-delivered cognitive behavioral therapy in people with chronic illnesses and mental diseases: A meta-analysis. J Clin Psychol 2024; 80:223-254. [PMID: 37428900 DOI: 10.1002/jclp.23563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 03/20/2023] [Accepted: 06/10/2023] [Indexed: 07/12/2023]
Abstract
COVID-19 pandemic led to an increase of remote treatments, such as telephone-delivery cognitive behavioral therapy (T-CBT). To our knowledge, no meta-analyses studied the effect of T-CBT in chronic and/or mental illnesses on multiple psychological outcomes. Therefore, our study aims to evaluating the efficacy of T-CBT compared to other interventions (treatment as usual, TAU, or face-to-face CBT). Each effect size (ES) was calculated in Hedges' g and pooled together to produce a mean ES for each outcome (depression, anxiety, mental and physical QoL, worry, coping, and sleep disturbances). The meta-analysis included 33 studies with a randomized controlled trial design. A large ES was found when comparing the efficacy of T-CBT against TAU on depression (g = 0.84, p < 0.001), whereas a moderate ES was found on anxiety (g = 0.57; p < 0.001), and a small effect on mental quality of life (g = 0.33, p < 0.001), sleep disturbances (g = 0.37, p = 0.042), coping (g = 0.20, p = 0.016) and worry (g = 0.43, p = 0.001). The meta-analysis comparing the efficacy of T-CBT and CBT on depression revealed a not significant pooled ES (g = 0.06, p = 0.466). The results provided evidence that T-CBT could be to be more effective than TAU conditions in multiple psychological outcomes, and as efficient as face-to-face CBT in treating depression.
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Affiliation(s)
- Manuela Altieri
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Maria R Sergi
- Department of Medicine and Aging Sciences, University of Chieti, Chieti, Italy
| | - Marco Tommasi
- Department of Medicine and Aging Sciences, University of Chieti, Chieti, Italy
| | - Gabriella Santangelo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Aristide Saggino
- Department of Medicine and Aging Sciences, University of Chieti, Chieti, Italy
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20
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Jiao YC, Chang J, Liu C, Zhou SY, Ji Y, Meng Y. Factors influencing the help-seeking behavior in patients with mild cognitive impairment: a qualitative study. BMC Health Serv Res 2023; 23:1345. [PMID: 38042819 PMCID: PMC10693691 DOI: 10.1186/s12913-023-10281-5] [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: 04/09/2023] [Accepted: 11/06/2023] [Indexed: 12/04/2023] Open
Abstract
BACKGROUND The early diagnosis and intervention of mild cognitive impairment (MCI) patients is expected to delay the progression of AD. Delayed treatment will lead to MCI patients missing the best intervention expectation. At present, the medical help-seeking behavior of this group is not optimistic. This study aimed to explore influencing factors of help-seeking behavior among patients with MCI in China based on the help-seeking behavior model. METHODS Twenty-two patients with MCI were recruited to participate in semi-structured interviews via purposeful sampling with a qualitative, descriptive design. Data were analyzed by qualitative content analysis. RESULTS The study revealed the main influencing factors of help-seeking behavior among MCI patients in China included perceived disease threat, symptom attribution, disease knowledge, use of cognitive compensation strategies, sense of foreseeable burden, social support, economic condition, and accessibility of medical service. CONCLUSIONS The help-seeking behavior of patients with MCI is affected by multiple factors. There are some key factors in different stages of the help-seeking process. Healthcare providers can utilize these factors to design targeted interventions for promoting early help-seeking of patients with MCI.
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Affiliation(s)
- Yu-Chen Jiao
- School of Nursing, Nanjing Medical University, Nanjing, China
- Department of Radiotherapy, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Jing Chang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Chang Liu
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Shi-Yu Zhou
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Yan Ji
- School of Nursing, Nanjing Medical University, Nanjing, China.
| | - Yao Meng
- School of Nursing, Nanjing Medical University, Nanjing, China.
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Wong D, Pike K, Stolwyk R, Allott K, Ponsford J, McKay A, Longley W, Bosboom P, Hodge A, Kinsella G, Mowszowski L. Delivery of Neuropsychological Interventions for Adult and Older Adult Clinical Populations: An Australian Expert Working Group Clinical Guidance Paper. Neuropsychol Rev 2023:10.1007/s11065-023-09624-0. [PMID: 38032472 DOI: 10.1007/s11065-023-09624-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 10/16/2023] [Indexed: 12/01/2023]
Abstract
Delivery of neuropsychological interventions addressing the cognitive, psychological, and behavioural consequences of brain conditions is increasingly recognised as an important, if not essential, skill set for clinical neuropsychologists. It has the potential to add substantial value and impact to our role across clinical settings. However, there are numerous approaches to neuropsychological intervention, requiring different sets of skills, and with varying levels of supporting evidence across different diagnostic groups. This clinical guidance paper provides an overview of considerations and recommendations to help guide selection, delivery, and implementation of neuropsychological interventions for adults and older adults. We aimed to provide a useful source of information and guidance for clinicians, health service managers, policy-makers, educators, and researchers regarding the value and impact of such interventions. Considerations and recommendations were developed by an expert working group of neuropsychologists in Australia, based on relevant evidence and consensus opinion in consultation with members of a national clinical neuropsychology body. While the considerations and recommendations sit within the Australian context, many have international relevance. We include (i) principles important for neuropsychological intervention delivery (e.g. being based on biopsychosocial case formulation and person-centred goals); (ii) a description of clinical competencies important for effective intervention delivery; (iii) a summary of relevant evidence in three key cohorts: acquired brain injury, psychiatric disorders, and older adults, focusing on interventions with sound evidence for improving activity and participation outcomes; (iv) an overview of considerations for sustainable implementation of neuropsychological interventions as 'core business'; and finally, (v) a call to action.
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Affiliation(s)
- Dana Wong
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
| | - Kerryn Pike
- School of Psychology and Public Health & John Richards Centre for Rural Ageing Research, La Trobe University, Melbourne, Australia
- School of Applied Psychology, Griffith University, Gold Coast, Australia
| | - Rene Stolwyk
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
| | - Kelly Allott
- , Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Jennie Ponsford
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
| | - Adam McKay
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- MERRC, Rehabilitation and Mental Health Division, Epworth HealthCare, Richmond, Australia
| | - Wendy Longley
- Rehabilitation Studies Unit, Sydney Medical School, University of Sydney, Sydney, Australia
- The Uniting War Memorial Hospital, Waverley, Sydney, Australia
| | - Pascalle Bosboom
- MindLink Psychology, West Perth, Australia
- School of Psychological Science, University of Western Australia, Crawley, Australia
| | | | - Glynda Kinsella
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Loren Mowszowski
- Faculty of Science, School of Psychology & Brain and Mind Centre, The University of Sydney, Sydney, Australia
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Smith PJ, Whitson HE, Merwin RM, O’Hayer CV, Strauman TJ. Engineering Virtuous health habits using Emotion and Neurocognition: Flexibility for Lifestyle Optimization and Weight management (EVEN FLOW). Front Aging Neurosci 2023; 15:1256430. [PMID: 38076541 PMCID: PMC10702760 DOI: 10.3389/fnagi.2023.1256430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/20/2023] [Indexed: 02/12/2024] Open
Abstract
Interventions to preserve functional independence in older adults are critically needed to optimize 'successful aging' among the large and increasing population of older adults in the United States. For most aging adults, the management of chronic diseases is the most common and impactful risk factor for loss of functional independence. Chronic disease management inherently involves the learning and adaptation of new behaviors, such as adopting or modifying physical activity habits and managing weight. Despite the importance of chronic disease management in older adults, vanishingly few individuals optimally manage their health behavior in the service of chronic disease stabilization to preserve functional independence. Contemporary conceptual models of chronic disease management and health habit theory suggest that this lack of optimal management may result from an underappreciated distinction within the health behavior literature: the behavioral domains critical for initiation of new behaviors (Initiation Phase) are largely distinct from those that facilitate their maintenance (Maintenance Phase). Psychological factors, particularly experiential acceptance and trait levels of openness are critical to engagement with new health behaviors, willingness to make difficult lifestyle changes, and the ability to tolerate aversive affective responses in the process. Cognitive factors, particularly executive function, are critical to learning new skills, using them effectively across different areas of life and contextual demands, and updating of skills to facilitate behavioral maintenance. Emerging data therefore suggests that individuals with greater executive function are better able to sustain behavior changes, which in turn protects against cognitive decline. In addition, social and structural supports of behavior change serve a critical buffering role across phases of behavior change. The present review attempts to address these gaps by proposing a novel biobehavioral intervention framework that incorporates both individual-level and social support system-level variables for the purpose of treatment tailoring. Our intervention framework triangulates on the central importance of self-regulatory functioning, proposing that both cognitive and psychological mechanisms ultimately influence an individuals' ability to engage in different aspects of self-management (individual level) in the service of maintaining independence. Importantly, the proposed linkages of cognitive and affective functioning align with emerging individual difference frameworks, suggesting that lower levels of cognitive and/or psychological flexibility represent an intermediate phenotype of risk. Individuals exhibiting self-regulatory lapses either due to the inability to regulate their emotional responses or due to the presence of executive functioning impairments are therefore the most likely to require assistance to preserve functional independence. In addition, these vulnerabilities will be more easily observable for individuals requiring greater complexity of self-management behavioral demands (e.g. complexity of medication regimen) and/or with lesser social support. Our proposed framework also intuits several distinct intervention pathways based on the profile of self-regulatory behaviors: we propose that individuals with intact affect regulation and impaired executive function will preferentially respond to 'top-down' training approaches (e.g., strategy and process work). Individuals with intact executive function and impaired affect regulation will respond to 'bottom-up' approaches (e.g., graded exposure). And individuals with impairments in both may require treatments targeting caregiving or structural supports, particularly in the context of elevated behavioral demands.
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Affiliation(s)
- Patrick J. Smith
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Heather E. Whitson
- Department of Medicine, Duke University Medical Center, Durham, NC, United States
- Department of Medicine, Durham Veterans Affairs Medical Center, Durham, NC, United States
| | - Rhonda M. Merwin
- Department of Psychiatry, Duke University Medical Center, Durham, NC, United States
| | - C. Virginia O’Hayer
- Department of Psychiatry and Human Behavior, Thomas Jefferson University, Philadelphia, PA, United States
| | - Timothy J. Strauman
- Department of Psychiatry, Duke University Medical Center, Durham, NC, United States
- Department of Psychology and Neuroscience, Duke University, Durham, NC, United States
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Lee EH, Kim GH, Park HK, Kang HJ, Park YK, Lee HA, Hong CH, Moon SY, Kang W, Oh HS, Yoon HJ, Choi SH, Jeong JH. Effects of the multidomain intervention with nutritional supplements on cognition and gut microbiome in early symptomatic Alzheimer's disease: a randomized controlled trial. Front Aging Neurosci 2023; 15:1266955. [PMID: 38020771 PMCID: PMC10652389 DOI: 10.3389/fnagi.2023.1266955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/27/2023] [Indexed: 12/01/2023] Open
Abstract
Background The SoUth Korean study to PrEvent cognitive impaiRment and protect BRAIN health through lifestyle intervention in at-risk elderly people (SUPERBRAIN) is a part of the World-Wide Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (WW-FINGERS) network. This study aimed to demonstrate the effects of the SUPERBRAIN-based multidomain intervention with nutritional supplements in amyloid positive emission tomography (PET) proven early symptomatic Alzheimer's disease patients. Methods Forty-six participants who were diagnosed with mild cognitive impairment or mild dementia and were positive in the amyloid PET study randomized into three groups: group A, the multidomain intervention with nutritional supplements; group B, nutritional supplements only; and a control group. The primary outcome was a change in the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) total scale index score after an 8-week intervention. Secondary outcomes, including gut microbiome data, were also analyzed. Results The RBANS total scale index score improved significantly in group A compared with group B (p < 0.032) and compared with the control group (p < 0.001). After intervention, beta diversity of the gut microbiome between group A and the control group increased, and patients in group A were more enriched with Bifidobacterium. Conclusion SUPERBRAIN-based multidomain intervention with nutritional supplements improves cognition and gut microbiota in patients with early symptomatic Alzheimer's disease who were amyloid-positive by PET.
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Affiliation(s)
- Eun Hye Lee
- Department of Neurology, Ewha Womans University School of Medicine, Seoul, Republic of Korea
- Department of Neurology, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea
| | - Geon Ha Kim
- Department of Neurology, Ewha Womans University School of Medicine, Seoul, Republic of Korea
- Department of Neurology, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea
| | - Hee Kyung Park
- Division of Psychiatry, Department of Mental Health Care of Older People, University College London, London, United Kingdom
| | - Hae Jin Kang
- Department of Medical Nutrition (AgeTech-Service Convergence Major), Kyung Hee University, Yongin, Republic of Korea
| | - Yoo Kyoung Park
- Department of Medical Nutrition (AgeTech-Service Convergence Major), Kyung Hee University, Yongin, Republic of Korea
| | - Hye Ah Lee
- Clinical Trial Center, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea
| | - Chang Hyung Hong
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - So Young Moon
- Department of Neurology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Woorim Kang
- CJ Bioscience Inc., Seoul, Republic of Korea
| | | | - Hai-Jeon Yoon
- Department of Nuclear Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Seong Hye Choi
- Department of Neurology, Inha University College of Medicine, Incheon, Republic of Korea
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University School of Medicine, Seoul, Republic of Korea
- Department of Neurology, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea
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Raimo S, Cropano M, Gaita M, Maggi G, Cavallo ND, Roldan-Tapia MD, Santangelo G. The Efficacy of Cognitive Training on Neuropsychological Outcomes in Mild Cognitive Impairment: A Meta-Analysis. Brain Sci 2023; 13:1510. [PMID: 38002471 PMCID: PMC10669748 DOI: 10.3390/brainsci13111510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/18/2023] [Accepted: 10/23/2023] [Indexed: 11/26/2023] Open
Abstract
Mild cognitive impairment (MCI) or mild neurocognitive disorder is an intermediate stage of cognitive impairment between normal cognitive aging and dementia. Given the absence of effective pharmacological treatments for MCI, increasing numbers of studies are attempting to understand how cognitive training (CT) could benefit MCI. This meta-analysis aims to update and assess the efficacy of CT on specific neuropsychological test performance (global cognitive functioning, short-term verbal memory, long-term verbal memory, generativity, working memory, and visuospatial abilities) in individuals diagnosed with MCI, as compared to MCI control groups. After searching electronic databases for randomized controlled trials, 31 studies were found including 2496 participants. Results showed that CT significantly improved global cognitive functioning, short-term and long-term verbal memory, generativity, working memory, and visuospatial abilities. However, no significant effects were observed for shifting, abstraction ability/concept formation, processing speed, and language. The mode of CT had a moderating effect on abstraction ability/concept formation. The findings provide specific insights into the cognitive functions influenced by CT and guide the development of tailored interventions for MCI. While CT holds promise, further research is needed to address certain cognitive deficits and assess long-term effects on dementia progression.
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Affiliation(s)
- Simona Raimo
- Department of Psychology, ‘Luigi Vanvitelli’ University of Campania, 81100 Caserta, Italy; (M.C.); (M.G.); (G.M.); (N.D.C.)
| | - Maria Cropano
- Department of Psychology, ‘Luigi Vanvitelli’ University of Campania, 81100 Caserta, Italy; (M.C.); (M.G.); (G.M.); (N.D.C.)
| | - Mariachiara Gaita
- Department of Psychology, ‘Luigi Vanvitelli’ University of Campania, 81100 Caserta, Italy; (M.C.); (M.G.); (G.M.); (N.D.C.)
| | - Gianpaolo Maggi
- Department of Psychology, ‘Luigi Vanvitelli’ University of Campania, 81100 Caserta, Italy; (M.C.); (M.G.); (G.M.); (N.D.C.)
| | - Nicola Davide Cavallo
- Department of Psychology, ‘Luigi Vanvitelli’ University of Campania, 81100 Caserta, Italy; (M.C.); (M.G.); (G.M.); (N.D.C.)
| | | | - Gabriella Santangelo
- Department of Psychology, ‘Luigi Vanvitelli’ University of Campania, 81100 Caserta, Italy; (M.C.); (M.G.); (G.M.); (N.D.C.)
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Kim SY, Park J, Choi H, Loeser M, Ryu H, Seo K. Digital Marker for Early Screening of Mild Cognitive Impairment Through Hand and Eye Movement Analysis in Virtual Reality Using Machine Learning: First Validation Study. J Med Internet Res 2023; 25:e48093. [PMID: 37862101 PMCID: PMC10625097 DOI: 10.2196/48093] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 08/07/2023] [Accepted: 09/22/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND With the global rise in Alzheimer disease (AD), early screening for mild cognitive impairment (MCI), which is a preclinical stage of AD, is of paramount importance. Although biomarkers such as cerebrospinal fluid amyloid level and magnetic resonance imaging have been studied, they have limitations, such as high cost and invasiveness. Digital markers to assess cognitive impairment by analyzing behavioral data collected from digital devices in daily life can be a new alternative. In this context, we developed a "virtual kiosk test" for early screening of MCI by analyzing behavioral data collected when using a kiosk in a virtual environment. OBJECTIVE We aimed to investigate key behavioral features collected from a virtual kiosk test that could distinguish patients with MCI from healthy controls with high statistical significance. Also, we focused on developing a machine learning model capable of early screening of MCI based on these behavioral features. METHODS A total of 51 participants comprising 20 healthy controls and 31 patients with MCI were recruited by 2 neurologists from a university hospital. The participants performed a virtual kiosk test-developed by our group-where we recorded various behavioral data such as hand and eye movements. Based on these time series data, we computed the following 4 behavioral features: hand movement speed, proportion of fixation duration, time to completion, and the number of errors. To compare these behavioral features between healthy controls and patients with MCI, independent-samples 2-tailed t tests were used. Additionally, we used these behavioral features to train and validate a machine learning model for early screening of patients with MCI from healthy controls. RESULTS In the virtual kiosk test, all 4 behavioral features showed statistically significant differences between patients with MCI and healthy controls. Compared with healthy controls, patients with MCI had slower hand movement speed (t49=3.45; P=.004), lower proportion of fixation duration (t49=2.69; P=.04), longer time to completion (t49=-3.44; P=.004), and a greater number of errors (t49=-3.77; P=.001). All 4 features were then used to train a support vector machine to distinguish between healthy controls and patients with MCI. Our machine learning model achieved 93.3% accuracy, 100% sensitivity, 83.3% specificity, 90% precision, and 94.7% F1-score. CONCLUSIONS Our research preliminarily suggests that analyzing hand and eye movements in the virtual kiosk test holds potential as a digital marker for early screening of MCI. In contrast to conventional biomarkers, this digital marker in virtual reality is advantageous as it can collect ecologically valid data at an affordable cost and in a short period (5-15 minutes), making it a suitable means for early screening of MCI. We call for further studies to confirm the reliability and validity of this approach.
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Affiliation(s)
- Se Young Kim
- Department of Applied Artificial Intelligence, Seoul National University of Science and Technology, Seoul, Republic of Korea
| | - Jinseok Park
- Department of Neurology, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Hojin Choi
- Department of Neurology, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Martin Loeser
- Department of Computer Science, Electrical Engineering and Mechatronics, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Hokyoung Ryu
- Graduate School of Technology and Innovation Management, Hanyang University, Seoul, Republic of Korea
| | - Kyoungwon Seo
- Department of Applied Artificial Intelligence, Seoul National University of Science and Technology, Seoul, Republic of Korea
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Park JY, Choi SA, Kim JJ, Park YJ, Kim CK, Cho GJ, Koh SB, Kang SH. Effect of Tablet-based Cognitive Intervention on Cognition in Patients With Mild Cognitive Impairment: A Pilot Study. Dement Neurocogn Disord 2023; 22:130-138. [PMID: 38025410 PMCID: PMC10654482 DOI: 10.12779/dnd.2023.22.4.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/17/2023] [Accepted: 09/05/2023] [Indexed: 12/01/2023] Open
Abstract
Background and Purpose Growing evidence has shown that cognitive interventions can mitigate cognitive decline in patients with mild cognitive impairment (MCI). However, most previous cognitive interventions have been group-based programs. Due to their intrinsic limitations, group-based programs are not widely used in clinical practice. Therefore, we have developed a tablet-based cognitive intervention program. This preliminary study investigated the feasibility and effects of a 12-week structured tablet-based program on cognitive function in patients with MCI. Methods We performed a single-arm study on 24 patients with MCI. The participants underwent a tablet-based cognitive intervention program 5 times a week over a 12-week period. The primary outcome was changes in cognitive function, measured using the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K). Outcomes were evaluated at baseline, within two weeks of the last program (post-intervention), and at the six-month follow-up session. Results The completion rate of the tablet-based program was 83.3% in patients with MCI. The program improved cognitive function based on the CERAD-K total score (p=0.026), which was maintained for at least three months (p=0.004). There was also an improvement in the depression scale score (p=0.002), which persisted for three months (p=0.027). Conclusions Our 12-week structured tablet-based program is feasible for patients with MCI. Furthermore, although further studies with a double-arm design are required, the program appears to be an effective strategy to prevent cognitive decline in patients with MCI.
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Affiliation(s)
| | | | | | - Yu Jeong Park
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Chi Kyung Kim
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Geum Joon Cho
- Department of Obstetrics and Gynecology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Seong-Beom Koh
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Sung Hoon Kang
- Geumcheon Center for Dementia, Seoul, Korea
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
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Gómez-Cáceres B, Cano-López I, Aliño M, Puig-Perez S. Effectiveness of virtual reality-based neuropsychological interventions in improving cognitive functioning in patients with mild cognitive impairment: A systematic review and meta-analysis. Clin Neuropsychol 2023; 37:1337-1370. [PMID: 36416175 DOI: 10.1080/13854046.2022.2148283] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 11/11/2022] [Indexed: 11/24/2022]
Abstract
Objective: Increased prevalence of mild cognitive impairment (MCI) has led to a need for new neuropsychological intervention tools in this population. This meta-analysis aimed to learn about the efficacy of virtual reality (VR)-based neuropsychological interventions in improving cognitive functioning in patients with MCI. Method: This review followed the recommendations of the PRISMA statement, and it was registered in PROSPERO. The studies examined were collected from the PsycINFO, Web of Science, Pubmed/MEDLINE, Embase, Scopus, and Cochrane Library databases. Results: The systematic search yielded 258 articles, of which 13 randomized controlled trials were selected. VR-based neuropsychological interventions had moderate effects on global cognition (g = 0.30; 95% CI = 0.05, 0.56; p = 0.02), small effects on attention (g = 0.27; 95% CI = 0.04, 0.49; p = 0.02), and large effects on executive function (g = 0.60; 95% CI = 0.38, 0.81; p < 0.0001), but non-significant effects on working memory, episodic memory, language, or visuoconstruction. When the length of the intervention was considered, VR-based interventions of 15 or more hours had moderate effects on working memory (g = 0.55; 95% CI = 0.11, 0.99; p = 0.01), and large effects on language (g = 0.60; 95% CI = 0.01, 1.20; p = 0.05) and visuoconstruction (g = 1.13; 95% CI = 0.58, 1.67; p < 0.0001). Conclusions: Results suggest that VR-based interventions are beneficial for improving cognitive functioning in patients with MCI, and allow us to make recommendations that could have implications for clinical decision-making in this population.
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Affiliation(s)
| | - Irene Cano-López
- Faculty of Health Sciences, Valencian International University, Valencia, Spain
- VIU-NED Chair of Global Neuroscience and Social Change, Valencian International University, Valencia, Spain
- Research Group in Psychology and Quality of Life (PsiCal), Valencian International University, Valencia, Spain
| | - Marta Aliño
- Faculty of Health Sciences, Valencian International University, Valencia, Spain
- VIU-NED Chair of Global Neuroscience and Social Change, Valencian International University, Valencia, Spain
- Research Group in Psychology and Quality of Life (PsiCal), Valencian International University, Valencia, Spain
| | - Sara Puig-Perez
- Faculty of Health Sciences, Valencian International University, Valencia, Spain
- VIU-NED Chair of Global Neuroscience and Social Change, Valencian International University, Valencia, Spain
- Research Group in Psychology and Quality of Life (PsiCal), Valencian International University, Valencia, Spain
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Wu X, Zhang T, Tu Y, Deng X, Sigen A, Li Y, Jing X, Wei L, Huang N, Cheng Y, Deng L, Jia S, Li J, Jiang N, Dong B. Multidomain interventions for non-pharmacological enhancement (MINE) program in Chinese older adults with mild cognitive impairment: a multicenter randomized controlled trial protocol. BMC Neurol 2023; 23:341. [PMID: 37759178 PMCID: PMC10537159 DOI: 10.1186/s12883-023-03390-5] [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: 06/23/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Dementia is characterized by progressive neurodegeneration and therefore early intervention could have the best chance of preserving brain health. There are significant differences in health awareness, living customs, and daily behaviors among Chinese older adults compared to Europeans and Americans. Because the synergistic benefits of multidomain non-pharmacological interventions are consistent with the multifactorial pathogenicity of MCI, such interventions are more appealing, easier to adhere to, and more relevant to daily life than single-mode interventions. One of the aims of this study is to verify the effect of multidomain intervention strategies for MCI patients based on Chinese population characteristics, and the other is to establish a biobank and image database to investigate the pathogenesis and pathways of cognitive impairment. METHODS Our study was designed as a national multicenter, community-based randomized controlled trial (RCT). Twelve medical institutions in ten Chinese cities will participate in our study from 2020 to 2024, and 1080 community residents aged 50 and above will be enrolled as participants. Each sub-center will be responsible for 90 participants (30 people per community) across three communities (non-contact control group, health education group, and multidomain intervention group). The community will be the basic unit of the present study, and all participants in each community will receive the same intervention/control measure. Three working groups are set up in each sub-center to manage the three communities independently to minimize interference at the implementation level between the groups. The multidomain intervention group will receive integrated interventions including exercise, nutrition, sleep, health education and mindfulness meditation. All data generated by the research will be analyzed and processed by statistical software (such as SPSS 21.0, Python 3.0, etc.), and part of the research data will be displayed in the form of graphs and tables. DISCUSSION In order to achieve a high-quality community intervention study, it is crucial to have a well-designed experimental protocol that follows rigorous scientific methodology. In addition, effective management of quality control measures and monitoring compliance throughout the study process are essential components. This study provides a detailed discussion of stakeholder compliance, research quality control, potential harm and mitigation, auditing, and future plans in order to better address research issues. TRIAL REGISTRATION ChiCTR2000035012 (July 27, 2020).
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Affiliation(s)
- Xiaochu Wu
- National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Tianyao Zhang
- The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Yanhao Tu
- Strength and Conditioning Center, Chengdu Sport University, Chengdu, China
| | - Xueling Deng
- National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - A Sigen
- National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Yuxiao Li
- National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaofan Jing
- National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Lixuan Wei
- National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Ning Huang
- National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Ying Cheng
- National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Linghui Deng
- National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Shuli Jia
- National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Jun Li
- National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China
| | - Ning Jiang
- National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China.
| | - Birong Dong
- National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, China.
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Nousia A, Martzoukou M, Petri MC, Messinis L, Nasios G. Face-to-face vs. Telerehabilitation language and cognitive training in patients with multi-domain amnestic mild cognitive impairment. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-9. [PMID: 37734418 DOI: 10.1080/23279095.2023.2259035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
The recent coronavirus emergency raised the question of whether telerehabilitation could be as effective as conventional face-to-face intervention. The aim of the present study was to compared language and cognitive training delivered to patients from a distance, through telecommunication systems, for the same intervention conducted on a face-to-face mode in patients with multi domain amnestic MCI (md-aMCI). To this end, 30 patients diagnosed with md-aMCI took part in the present study. The participants divided into two groups; one group received conventional face-to-face training and the other group received Telerehabilitation training. Both groups received language training using paper and pencil tasks and cognitive training using the Rehacom software. The training lasted 15 weeks and was delivered twice a week, for 60 minutes per session. The conventional face-to-face mode had a significant impact on cognitive (delayed and working memory, processing speed, executive function, and attention) and language domains (naming, word recognition, and semantic fluency). The telerehabilitation method had a beneficial impact on delayed memory, naming, and semantic fluency. The results of our study provide evidence that both telerehabilitation and face-to-face language and cognitive training seem to have a positive impact in patients with md-aMCI, with face-to-face training improving more domains than telerehabilitation.
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Affiliation(s)
- Anastasia Nousia
- Department of Speech and Language Therapy, University of Peloponnese, Kalamata, Greece
| | - Maria Martzoukou
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessalonike, Greece
| | - Maria Christina Petri
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessalonike, Greece
| | - Lambros Messinis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessalonike, Greece
| | - Grigorios Nasios
- Department of Speech and Language Therapy, University of Ioannina, Greece
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Kim Y, Kim S, Yang H. Effectiveness of an enhanced simultaneous cognitive-physical dual-task training based on fairy tales (ESCARF) in older adults with mild cognitive impairment. Geriatr Nurs 2023; 53:57-65. [PMID: 37454419 DOI: 10.1016/j.gerinurse.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/18/2023]
Abstract
The aim of this study was to provide a dual-task program that included cognitive and physical training to older adults with mild cognitive impairment (MCI) and evaluate its effects. A single-group pretest-posttest design was performed using 15 older adults with MCI. A 12-week enhanced simultaneous cognitive-physical dual-task training based on fairy tales (ESCARF) program was conducted from September 2019 to December 2019. Participants were assessed using the Korean version of the Montreal Cognitive Assessment, electroencephalography (EEG), muscle strength, flexibility, agility, memory self-efficacy questionnaire, physical self-efficacy scale, and quality of life before and after 6 and 12 weeks of the intervention. The ESCARF program significantly improved cognitive function, physical function, self-efficacy, and quality of life in older adults with MCI. These findings will provide insights into the development and implementation of customized cognitive interventions to prevent or delay the onset of cognitive decline in older adults with MCI.
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Affiliation(s)
- Younkyoung Kim
- College of Nursing, Chonnam National University, 160 Baekseo-Ro, Dong-gu, Gwangju 61469, Republic of Korea
| | - Saeryun Kim
- College of Nursing, Chonnam National University, 160 Baekseo-Ro, Dong-gu, Gwangju 61469, Republic of Korea
| | - Hyunju Yang
- College of Nursing, Chonnam National University, 160 Baekseo-Ro, Dong-gu, Gwangju 61469, Republic of Korea.
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Monastero R, Baschi R. Persistent Cognitive Dysfunction in a Non-Hospitalized COVID-19 Long-Hauler Patient Responding to Cognitive Rehabilitation and Citicoline Treatment. Brain Sci 2023; 13:1275. [PMID: 37759876 PMCID: PMC10526954 DOI: 10.3390/brainsci13091275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection is characterized by severe flu-like symptoms, which can progress to life-threatening systemic inflammation and multiorgan dysfunction. The nervous system is involved in over one-third of patients, and the most common neurological manifestations concern the central nervous system, such as headache, fatigue, and brain fog. The activation of innate, humoral, and cellular immune responses, resulting in a cytokine storm and endothelial and mitochondrial dysfunctions, are the main pathophysiological mechanisms of SARS-CoV-2 infection. Citicoline is an exogenous source of choline and cytidine involved in intracellular phospholipid synthesis, which improves blood flow, brain activity, and mitochondrial dysfunction. This report will present the case of a non-hospitalized, 59-year-old female. After a mild form of SARS-CoV-2 infection, the patient developed cognitive disturbances such as forgetfulness and anomia. The multidimensional neuropsychological assessment revealed an impairment in episodic memory with borderline performance in executive and visuospatial functioning. Cognitive rehabilitation and treatment with citicoline 1000 mg/daily led to a marked improvement in symptoms after six months. Early identification of the neurological sequelae of the Coronavirus Disease 2019 (COVID-19) and timely rehabilitation interventions are required in non-hospitalized long-hauler patients with COVID-19. Long-term treatment with citicoline should be considered as potentially effective in improving cognitive functioning in subjects with Post COVID-19 Neurological Syndrome.
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Affiliation(s)
- Roberto Monastero
- Section of Neurology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, 90121 Palermo, Italy;
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Abramova O, Zorkina Y, Ushakova V, Gryadunov D, Ikonnikova A, Fedoseeva E, Emelyanova M, Ochneva A, Morozova I, Pavlov K, Syunyakov T, Andryushchenko A, Savilov V, Kurmishev M, Andreuyk D, Shport S, Gurina O, Chekhonin V, Kostyuk G, Morozova A. Alteration of Blood Immune Biomarkers in MCI Patients with Different APOE Genotypes after Cognitive Training: A 1 Year Follow-Up Cohort Study. Int J Mol Sci 2023; 24:13395. [PMID: 37686198 PMCID: PMC10488004 DOI: 10.3390/ijms241713395] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/22/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
Many studies aim to detect the early phase of dementia. One of the major ways to achieve this is to identify corresponding biomarkers, particularly immune blood biomarkers. The objective of this study was to identify such biomarkers in patients with mild cognitive impairment (MCI) in an experiment that included cognitive training. A group of patients with MCI diagnoses over the age of 65 participated in the study (n = 136). Measurements of cognitive functions (using the Mini-Mental State Examination scale and Montreal Cognitive Assessment) and determination of 27 serum biomarkers were performed twice: on the first visit and on the second visit, one year after the cognitive training. APOE genotypes were also determined. Concentrations of EGF (F = 17; p = 0.00007), Eotaxin (F = 7.17; p = 0.008), GRO (F = 13.42; p = 0.0004), IL-8 (F = 8.16; p = 0.005), MCP-1 (F = 13.46; p = 0.0001) and MDC (F = 5.93; p = 0.016) increased after the cognitive training in MCI patients. All these parameters except IL-8 demonstrated a weak correlation with other immune parameters and were poorly represented in the principal component analysis. Differences in concentrations of IP-10, FGF-2, TGFa and VEGF in patients with MCI were associated with APOE genotype. Therefore, the study identified several immune blood biomarkers that could potentially be associated with changes in cognitive function.
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Affiliation(s)
- Olga Abramova
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia; (O.A.); (Y.Z.); (V.U.); (A.O.); (I.M.)
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
| | - Yana Zorkina
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia; (O.A.); (Y.Z.); (V.U.); (A.O.); (I.M.)
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
| | - Valeriya Ushakova
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia; (O.A.); (Y.Z.); (V.U.); (A.O.); (I.M.)
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
- Biological Faculty, M.V. Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Dmitry Gryadunov
- Center for Precision Genome Editing and Genetic Technologies for Biomedicine, Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Anna Ikonnikova
- Center for Precision Genome Editing and Genetic Technologies for Biomedicine, Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Elena Fedoseeva
- Center for Precision Genome Editing and Genetic Technologies for Biomedicine, Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Marina Emelyanova
- Center for Precision Genome Editing and Genetic Technologies for Biomedicine, Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Aleksandra Ochneva
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia; (O.A.); (Y.Z.); (V.U.); (A.O.); (I.M.)
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
| | - Irina Morozova
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia; (O.A.); (Y.Z.); (V.U.); (A.O.); (I.M.)
| | - Konstantin Pavlov
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia; (O.A.); (Y.Z.); (V.U.); (A.O.); (I.M.)
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
| | - Timur Syunyakov
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia; (O.A.); (Y.Z.); (V.U.); (A.O.); (I.M.)
- International Centre for Education and Research in Neuropsychiatry (ICERN), Samara State Medical University, 443016 Samara, Russia
| | - Alisa Andryushchenko
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia; (O.A.); (Y.Z.); (V.U.); (A.O.); (I.M.)
| | - Victor Savilov
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia; (O.A.); (Y.Z.); (V.U.); (A.O.); (I.M.)
| | - Marat Kurmishev
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia; (O.A.); (Y.Z.); (V.U.); (A.O.); (I.M.)
| | - Denis Andreuyk
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia; (O.A.); (Y.Z.); (V.U.); (A.O.); (I.M.)
- Biological Faculty, M.V. Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Svetlana Shport
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
| | - Olga Gurina
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
| | - Vladimir Chekhonin
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
- Department of Medical Nanobiotechnology, Pirogov Russian National Research Medical University, 117997 Moscow, Russia
| | - Georgy Kostyuk
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia; (O.A.); (Y.Z.); (V.U.); (A.O.); (I.M.)
- Department of Psychiatry, Federal State Budgetary Educational Institution of Higher Education “Moscow State University of Food Production”, Volokolamskoye Highway 11, 125080 Moscow, Russia
| | - Anna Morozova
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia; (O.A.); (Y.Z.); (V.U.); (A.O.); (I.M.)
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
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Özge A, Ghouri R, Öksüz N, Taşdelen B. Predictive factors for Alzheimer's disease progression: a comprehensive retrospective analysis of 3,553 cases with 211 months follow-up. Front Neurol 2023; 14:1239995. [PMID: 37693748 PMCID: PMC10484751 DOI: 10.3389/fneur.2023.1239995] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/07/2023] [Indexed: 09/12/2023] Open
Abstract
Background There is conflicting data regarding the predictors of Alzheimer's Disease (AD), the most common form of dementia. The main objective of the study is to evaluate potential predictors of AD progression using a comprehensive follow-up dataset that includes functional/cognitive assessments, clinical and neuropsychiatric evaluations, and neuroimaging biomarkers such as hippocampal atrophy or white matter intensities (WMIs). Method A total of 161 AD cases were recruited from a dementia database consisting of individuals who consulted the Dementia Outpatient Clinic of the Neurology Department at Mersin University Medical Faculty between 2000 and 2022, under the supervision of the same senior author have at least 3 full evaluation follow-up visit including functional, clinical, biochemical, neuropsychological, and radiological screening. Data were exported and analyzed by experts accordingly. Results Mean follow-up duration of study sample was 71.66 ± 41.98, min 15 to max 211 months. The results showed a fast and slow progressive subgroup of our AD cases with a high sensitivity (Entropy = 0.836), with a close relationship with several cofactors and the level of disability upon admittance. Hippocampal atrophy and WMIs grading via Fazekas were found to be underestimated predictors of AD progression, and functional capacity upon admittance was also among the main stakeholders. Conclusion The study highlights the importance of evaluating multiple potential predictors for AD progression, including functional capacity upon admittance, hippocampal atrophy, and WMIs grading via Fazekas. Our findings provide insight into the complexity of AD progression and may contribute to the development of effective strategies for managing and treating AD.
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Affiliation(s)
- Aynur Özge
- Department of Neurology, School of Medicine, Mersin University, Mersin, Türkiye
| | - Reza Ghouri
- Department of Neurology, School of Medicine, Mersin University, Mersin, Türkiye
| | - Nevra Öksüz
- Department of Neurology, School of Medicine, Mersin University, Mersin, Türkiye
| | - Bahar Taşdelen
- Department of Biostatistics, School of Medicine, Mersin University, Mersin, Türkiye
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Canyazo CM, Keller G, Helou B, Arruabarrena M, Corvalán N, Carello A, Harris P, Feldman M, Fernández R, Calandri IL, Martin ME, Allegri RF, Crivelli L. Effectiveness of cognitive rehabilitation on mild cognitive impairment using teleneuropsychology. Dement Neuropsychol 2023; 17:e20220079. [PMID: 37533595 PMCID: PMC10392881 DOI: 10.1590/1980-5764-dn-2022-0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/18/2023] [Accepted: 03/05/2023] [Indexed: 08/04/2023] Open
Abstract
The COVID-19 pandemic has affected the continuity of cognitive rehabilitation worldwide. However, the use of teleneuropsychology to provide cognitive rehabilitation has contributed significantly to the continuity of the treatment. Objectives To measure the effects of cognitive telerehabilitation on cognition, neuropsychiatric symptoms, and memory strategies in a cohort of patients with mild cognitive impairment. Methods A sample of 60 patients with mild cognitive impairment according to Petersen's criteria was randomly divided into two groups: 30 treatment cases and 30 controls (waiting list group). Subjects were matched by age, sex, and Montreal Cognitive Assessment. The treatment group received ten cognitive telerehabilitation sessions of 45 minutes duration once a week. Pre-treatment (week 0) and post-treatment (week 10) measures were assessed for both groups. Different linear mixed models were estimated to test treatment effect (cognitive telerehabilitation vs. controls) on each outcome of interest over time (pre/post-intervention). Results A significant group (control/treatment) x time (pre/post) interaction revealed that the treatment group at week 10 had better scores in cognitive variables: memory (RAVLT learning trials p=0.030; RAVLT delayed recall p=0.029), phonological fluency (p=0.001), activities of daily living (FAQ p=0.001), satisfaction with memory performance (MMQ satisfaction p=0.004) and use of memory strategies (MMQ strategy p=0.000), as well as, and a significant reduction of affective symptomatology: depression (GDS p=0.000), neuropsychiatric symptoms (NPI-Q p=0.045), forgetfulness (EDO-10 p=0.000), and stress (DAS stress p=0.000). Conclusions Our study suggests that CTR is an effective intervention.
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Affiliation(s)
- Carlos Martínez Canyazo
- Hospital Fleni, Departamento de Neurología Cognitiva, Buenos Aires, Argentina
- Hospital Fleni, Servicio de Neuroinmunología, Buenos Aires, Argentina
| | - Greta Keller
- Hospital Fleni, Departamento de Neurología Cognitiva, Buenos Aires, Argentina
| | - Belen Helou
- Hospital Fleni, Departamento de Neurología Cognitiva, Buenos Aires, Argentina
| | | | - Nicolas Corvalán
- Hospital Fleni, Departamento de Neurología Cognitiva, Buenos Aires, Argentina
| | - Agostina Carello
- Hospital Fleni, Departamento de Neurología Cognitiva, Buenos Aires, Argentina
| | - Paula Harris
- Hospital Fleni, Departamento de Neurología Cognitiva, Buenos Aires, Argentina
| | - Monica Feldman
- Hospital Fleni, Departamento de Neurología Cognitiva, Buenos Aires, Argentina
| | - Rodrigo Fernández
- Universidad de Buenos Aires, Instituto de Psicología, Biología Molecular y Neurociencias, CONICET, Buenos Aires, Argentina
| | | | | | - Ricardo Francisco Allegri
- Hospital Fleni, Departamento de Neurología Cognitiva, Buenos Aires, Argentina
- Universidad de la Costa, Departamento de Ciencias de la Salud, Barranquilla, Colombia
- Instituto de Neurociencias, Fleni-CONICET, Buenos Aires, Argentina
| | - Lucía Crivelli
- Hospital Fleni, Departamento de Neurología Cognitiva, Buenos Aires, Argentina
- Instituto de Neurociencias, Fleni-CONICET, Buenos Aires, Argentina
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Chang LH, Tang YL, Chiu MJ, Wu CT, Mao HF. A Multicomponent Cognitive Intervention May Improve Self-Reported Daily Function of Adults With Subjective Cognitive Decline. Am J Occup Ther 2023; 77:7704205040. [PMID: 37589302 DOI: 10.5014/ajot.2023.050133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023] Open
Abstract
IMPORTANCE Limited evidence exists to support cognitive intervention improving the daily function of adults with subjective cognitive decline (SCD). OBJECTIVE To examine the preliminary efficacy of a group-based multicomponent cognitive intervention that integrates Lifestyle Redesign® (LR) techniques. DESIGN Single-arm two-period crossover trial; 16-wk waiting period, 16-wk intervention, and 16-wk follow-up. SETTING Memory clinic in a medical center, Taiwan. PARTICIPANTS Purposive sample of adults ages >55 yr with SCD. INTERVENTION Sixteen 1.5-hr weekly multicomponent sessions of cognitive training, cognitive rehabilitation, psychological intervention, and lifestyle intervention. OUTCOMES AND MEASURES Primary outcomes were (1) self-reported daily function, measured with the Activities of Daily Living Questionnaire (ADLQ) and Cognitive Failure Questionnaire; (2) performance-based daily function, measured with the Brief University of California San Diego Performance-Based Skills Assessment-Traditional Chinese Version; and (3) functional cognition, measured with the Contextual Memory Test (CMT) and Miami Prospective Memory Test. Secondary outcomes included cognitive functions, anxiety, and depression. RESULTS Seventeen participants completed the intervention; 4 missed the follow-up. The generalized estimating equations model showed significant changes from baseline to pretest (control) and pretest to posttest (intervention) on the ADLQ (p = .014) and CMT-delayed (p = .003). Effects remained at the 16-wk follow-up. After adjusting for the effects of covariates, the self-reported daily function of participants ages ≤ 63 yr improved more than that of other participants (p = .003). CONCLUSIONS AND RELEVANCE Multicomponent cognitive interventions integrating LR techniques may improve self-reported daily function and context-dependent memory function of adults with SCD, with efficacy sustained at follow-up. What This Article Adds: A group-based multicomponent cognitive intervention consisting of cognitive training, cognitive rehabilitation, psychoeducation, and lifestyle intervention may provide benefits for the daily function and cognitive function of adults with SCD.
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Affiliation(s)
- Ling-Hui Chang
- Ling-Hui Chang, PhD, is Associate Professor, Department of Occupational Therapy, College of Medicine, and Associate Professor, Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yuan Ling Tang
- Yuan-Ling Tang, MS, is Occupational Therapist, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Ming-Jang Chiu
- Ming-Jang Chiu, PhD, is Adjunct Professor, Department of Neurology, College of Medicine, National Taiwan University, and Distinguished Adjunct Attending Physician, Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan. At the time of this research, Chiu was Attending Neurologist, Department of Neurology, National Taiwan University Hospital; Professor, Graduate Institute of Brain and Mind Sciences; Professor, Graduate Institute of Psychology; and Professor, Graduate Institute of Biomedical Engineering and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Chien-Te Wu
- Chien-Te Wu, PhD, is Project Associate Professor, International Research Center for Neurointelligence, The University of Tokyo Institutes for Advanced Study, The University of Tokyo, Tokyo, Japan. At the time of this research, Wu was Associate Professor, School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hui-Fen Mao
- Hui-Fen Mao, MS, is Professor, School of Occupational Therapy, College of Medicine, National Taiwan University, and Occupational Therapist, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan;
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Zhao X, Ji C, Zhang C, Huang C, Zhou Y, Wang L. Transferability and sustainability of process-based multi-task adaptive cognitive training in community-dwelling older adults with mild cognitive impairment: a randomized controlled trial. BMC Psychiatry 2023; 23:418. [PMID: 37308857 PMCID: PMC10259063 DOI: 10.1186/s12888-023-04917-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 05/31/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Cognitive training shows promising effects for improving cognitive domains in individuals with mild cognitive impairment (MCI), including the crucial predictive factor of executive function (EF) for dementia prognosis. Few studies have paid sufficient emphasis on the training-induced effects of cognitive training programs, particularly with regards to targeting EF. A process-based multi-task adaptive cognitive training (P-bM-tACT) program targeting EF is required to examine direct, transfer, and sustainability effects in older adults with MCI. OBJECTIVE This study aimed to evaluate the direct effects of a P-bM-tACT program on EF, the transfer effects on untrained cognitive domains, and further explore the sustainability of training gains for older adults with MCI in the community. METHODS In a single-blind, randomized controlled trial, 92 participants with MCI were randomly assigned to either the intervention group, participating in a P-bM-tACT program (3 training sessions/week, 60 min/session for 10 weeks) or the wait-list control group, accepting a health education program on MCI (1 education session/ twice a week, 40-60 min/session for 10 weeks). The direct and transfer effects of the P-bM-tACT program were assessed at baseline, immediately after 10 weeks of training, and the 3-month follow-up. Repeated measures analysis of variance and a simple effect test were used to compare the direct and transfer effects over the 3-time points between the two groups. RESULTS The P-bM-tACT program yielded a greater benefit of direct and transfer effects in the intervention group participants than in the wait-list control group. Combined with the results of simple effect tests, the direct and transfer effects of participants in the intervention group significantly increased immediately after 10 weeks of training compared to the baseline (F = 14.702 ~ 62.905, p < 0.05), and these effects were maintained at the 3-month follow-up (F = 19.595 ~ 122.22, p < 0.05). Besides, the acceptability of the cognitive training program was established with a high adherence rate of 83.4%. CONCLUSIONS The P-bM-tACT program exerted positive direct and transfer effects on the improvement of cognitive function, and these effects were sustained for 3 months. The findings provided a viable and potential approach to improving cognitive function in older adults with MCI in the community. TRIAL REGISTRATION The trial was registered at Chinese Clinical Trials Registry on 09/01/2019 ( www.chictr.org.cn ; Number Registry: ChiCTR1900020585).
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Affiliation(s)
- Xia Zhao
- Department of Geriatric Psychiatry, Suzhou Guangji Hospital, JiangSu, China
- School of Medicine, Huzhou University, Zhejiang, China
| | - Caifang Ji
- Department of Geriatric Psychiatry, Suzhou Guangji Hospital, JiangSu, China
| | - Chen Zhang
- Department of general medicine, Community health service center of Binhu Street, Zhejiang, China
| | - Cheng Huang
- School of Medicine, Huzhou University, Zhejiang, China
| | - Yuanyuan Zhou
- School of Nursing, Jiangsu College of Nursing, JiangSu, China
| | - Lina Wang
- School of Medicine, Huzhou University, Zhejiang, China.
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Wang YY, Wang XX, Chen L, Liu Y, Li YR. A systematic review and network meta-analysis comparing various non-pharmacological treatments for older people with mild cognitive impairment. Asian J Psychiatr 2023; 86:103635. [PMID: 37270875 DOI: 10.1016/j.ajp.2023.103635] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 05/09/2023] [Accepted: 05/19/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND AND OBJECTIVE Non-pharmacological therapy appeared to alleviate Mild Cognitive Impairment (MCI) symptoms and signs, according to systematic studies. This network meta-analysis aimed to assess the impact of non-pharmacological therapies on improving cognition in individuals with MCI and identified the most effective intervention. METHODS We reviewed six databases in search of potentially relevant studies of non-pharmacological therapies such as Physical exercise (PE), Multidisciplinary intervention (MI), Musical therapy (MT), Cognitive training (CT), Cognitive stimulation (CS), Cognitive rehabilitation (CR),Art therapy (AT), general psychotherapy or interpersonal therapy (IPT), and Traditional Chinese Medicine (TCM) (such as acupuncture therapy, massage, auricular-plaster and other related systems) and others. Excluded the literature such as missing full text, missing search results, or no reporting specific values and combined with the inclusion criteria and exclusion criteria in this article, the literature ultimately included in the analysis addressed the following seven non-drug therapies PE, MI, MT, CT, CS, CR, AT. Mini-mental state evaluation paired meta-analyses were undertaken by taking weighted average mean differences with confidence intervals (CI) of 95%. The network meta-analysis was conducted to compare various therapies. RESULTS A total of 39 randomized controlled trials, including two three-arm studies, with 3157 participants were included. PE was most likely to be the most effective intervention to slow down the cognitive ability of patients (SMD = 1.34, 95%CI: 0.80, 1.89). CS and CR had no significant effect on cognitive ability. CONCLUSIONS The non-pharmacological therapy had the potential to greatly promote the cognitive ability of the adult population with MCI. PE had the best chance of being the best non-pharmacological therapy. Due to the limited sample size, substantial variability among different study designs, and the potential for bias, the results should be regarded with caution. Our findings should be confirmed by future multi-center randomized controlled, high-quality large-scale studies.
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Affiliation(s)
- Yuan-Yuan Wang
- School of Public Health and Health Management, Anhui Medical College, Hefei City, Anhui Province 230061, China.
| | - Xiao-Xian Wang
- School of Public Health and Health Management, Anhui Medical College, Hefei City, Anhui Province 230061, China
| | - Lei Chen
- School of Public Health and Health Management, Anhui Medical College, Hefei City, Anhui Province 230061, China
| | - Yan Liu
- School of Public Health and Health Management, Anhui Medical College, Hefei City, Anhui Province 230061, China
| | - Ya-Ru Li
- School of Public Health and Health Management, Anhui Medical College, Hefei City, Anhui Province 230061, China
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Rute-Pérez S, Rodríguez-Domínguez C, Vélez-Coto M, Pérez-García M, Caracuel A. Effectiveness of Computerized Cognitive Training by VIRTRAEL on Memory and Executive Function in Older People: A Pilot Study. Brain Sci 2023; 13:brainsci13040684. [PMID: 37190649 DOI: 10.3390/brainsci13040684] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/15/2023] [Accepted: 04/16/2023] [Indexed: 05/17/2023] Open
Abstract
The prevalence of people over 60 years of age with cognitive impairment has increased in recent decades. As a consequence, numerous computerized cognitive trainings (CCT) have been developed. This pilot study aimed to determine the effectiveness of the CCT with VIRTRAEL in improving older adults' cognition. Fifty-five participants (x¯ = 72.7 years; SD = 6.5) underwent CCT, and twenty participants (x¯ = 76.1 years; SD = 7.6) received face-to-face cognitive stimulation with a paper-and-pencil methodology. Both trainings were conducted in nine sessions (45-60 min each). Participants completed a pre-post training neuropsychological assessment. ANCOVAs and the standardized clinical change were performed. VIRTRAEL's group showed a significant and greater improvement in verbal learning (p < 0.006) and delayed recall (p ≤ 0.001), working memory (p < 0.005), abstract (p < 0.002) and semantic reasoning (p < 0.015), and planning (p < 0.021). Additionally, more large clinical changes (d > 0.8) were found in the VIRTRAEL condition (in verbal learning and delayed free and cued recall) than in the standard group. Here we show that the CCT with VIRTRAEL is effective in improving cognitive function in older adults and is superior to the standard format. These preliminary findings indicate that CCT is a useful tool potentially applicable in the fight against cognitive symptomatology associated with aging and neurodegenerative diseases. VIRTRAEL represents a breakthrough in this field as it is inexpensive and easily accessible to any older person, regardless of whether they live far from health care resources.
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Affiliation(s)
- Sandra Rute-Pérez
- CIMCYC-Mind, Brain and Behavior Research Center, University of Granada, 18011 Granada, Spain
- Department of Developmental and Educational Psychology, Faculty of Education Sciences, University of Granada, 18011 Granada, Spain
| | - Carlos Rodríguez-Domínguez
- Department of Computer Languages and Systems, Faculty of Education, Economy and Technology of Ceuta, University of Granada, 51001 Granada, Spain
| | - María Vélez-Coto
- Department of Psychology, Catholic University of Murcia, Guadalupe, 30107 Murcia, Spain
| | - Miguel Pérez-García
- CIMCYC-Mind, Brain and Behavior Research Center, University of Granada, 18011 Granada, Spain
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Granada, 18011 Granada, Spain
| | - Alfonso Caracuel
- CIMCYC-Mind, Brain and Behavior Research Center, University of Granada, 18011 Granada, Spain
- Department of Developmental and Educational Psychology, Faculty of Education Sciences, University of Granada, 18011 Granada, Spain
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Haddad SMH, Pieruccini-Faria F, Montero-Odasso M, Bartha R. Localized White Matter Tract Integrity Measured by Diffusion Tensor Imaging Is Altered in People with Mild Cognitive Impairment and Associated with Dual-Task and Single-Task Gait Speed. J Alzheimers Dis 2023; 92:1367-1384. [PMID: 36911933 DOI: 10.3233/jad-220476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
BACKGROUND Altered white matter (WM) tract integrity may contribute to mild cognitive impairment (MCI) and gait abnormalities. OBJECTIVE The purpose of this study was to determine whether diffusion tensor imaging (DTI) metrics were altered in specific portions of WM tracts in people with MCI and to determine whether gait speed variations were associated with the specific DTI metric changes. METHODS DTI was acquired in 44 people with MCI and 40 cognitively normal elderly controls (CNCs). Fractional anisotropy (FA) and radial diffusivity (RD) were measured along 18 major brain WM tracts using probabilistic tractography. The average FA and RD along the tracts were compared between the groups using MANCOVA and post-hoc tests. The tracts with FA or RD differences between the groups were examined using an along-tract exploratory analysis to identify locations that differed between the groups. Associations between FA and RD in whole tracts and in the segments of the tracts that differed between the groups and usual/dual-task gait velocities and gross cognition were examined. RESULTS Lower FA and higher RD was observed in right cingulum-cingulate gyrus endings (rh.ccg) of the MCI group compared to the CNC group. These changes were localized to the posterior portions of the rh.ccg and correlated with gait velocities. CONCLUSION Lower FA and higher RD in the posterior portion of the rh.ccg adjacent to the posterior cingulate suggests decreased microstructural integrity in the MCI group. The correlation of these metrics with gait velocities suggests an important role for this tract in maintaining normal cognitive-motor function.
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Affiliation(s)
- Seyyed M H Haddad
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, University of Western Ontario, London, Canada
| | - Frederico Pieruccini-Faria
- Department of Medicine, Division of Geriatric Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada.,Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, Canada
| | - Manuel Montero-Odasso
- Department of Medicine, Division of Geriatric Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada.,Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Canada
| | - Robert Bartha
- Centre for Functional and Metabolic Mapping, Robarts Research Institute, University of Western Ontario, London, Canada.,Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Canada
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Mitchell JJ, Blodgett JM, Chastin SFM, Jefferis BJ, Wannamethee SG, Hamer M. Exploring the associations of daily movement behaviours and mid-life cognition: a compositional analysis of the 1970 British Cohort Study. J Epidemiol Community Health 2023; 77:189-195. [PMID: 36690475 PMCID: PMC9933163 DOI: 10.1136/jech-2022-219829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 12/08/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Movement behaviours (eg, sedentary behaviour (SB), moderate and vigorous physical activity (MVPA), light intensity physical activity (LIPA) and sleep) are linked to cognition, yet the relative importance of each component is unclear, and not yet explored with compositional methodologies. OBJECTIVE To (i) assess the associations of different components of daily movement and participant's overall cognition, memory and executive function, and (ii) understand the relative importance of each individual component for cognition. METHODS The 1970 British Cohort Study (BCS70) is a prospective birth cohort study of UK-born adults. At age 46, participants consented to wear an accelerometer device and complete tests of verbal memory and executive function. Compositional linear regression was used to examine cross-sectional associations between 24-hour movement behaviours and standardised cognition scores. Isotemporal substitution was performed to model the effect of reallocating time between components of daily movement on cognition. RESULTS The sample comprised 4481 participants (52% female). Time in MVPA relative to SB, LIPA and sleep was positively associated with cognition after adjustments for education and occupational physical activity, but additional adjustment for health status attenuated associations. SB relative to all other movements was robustly positively associated with cognition. Modelling time reallocation between components revealed an increase in cognition centile after MVPA theoretically replaced 9 min of SB (OR=1.31; 95% CI 0.09 to 2.50), 7 min of LIPA (1.27; 0.07 to 2.46) or 7 min of sleep (1.20; 0.01 to 2.39). CONCLUSIONS Relative to time spent in other behaviours, greater MVPA and SB was associated with higher cognitive scores. Loss of MVPA time, given its smaller relative amount, appears most deleterious. Efforts should be made to preserve MVPA time, or reinforce it in place of other behaviours.
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Affiliation(s)
- John J Mitchell
- Primary Care and Population Health, University College London, London, UK
| | - Joanna M Blodgett
- Institute of Sport, Exercise and Health, University College London, London, UK
| | | | - Barbara J Jefferis
- Primary Care and Population Health, University College London, London, UK
| | - S Goya Wannamethee
- Primary Care and Population Health, University College London, London, UK
| | - Mark Hamer
- Institute of Sport, Exercise and Health, University College London, London, UK
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Nousia A, Pappa E, Siokas V, Liampas I, Tsouris Z, Messinis L, Patrikelis P, Manouilidou C, Dardiotis E, Nasios G. Evaluation of the Efficacy and Feasibility of a Telerehabilitation Program Using Language and Cognitive Exercises in Multi-Domain Amnestic Mild Cognitive Impairment. Arch Clin Neuropsychol 2023; 38:224-235. [PMID: 36156732 DOI: 10.1093/arclin/acac078] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2022] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The aim of the present study was to investigate the efficacy and feasibility of a telerehabilitation program in multi-domain amnestic Mild Cognitive Impairment (md-aMCI). The study sample consisted of 30 patients with md-aMCI and aged 60-80 years. METHODS The participants were randomly divided into two groups. The Training Group (TG), which received cognitive training by using the RehaCom software as well as paper-pencil language training and the Control Group (CG) which received standard clinical care (e.g., psychotherapy or/and physiotherapy). Duration of the telerehabilitation intervention was 15 weeks (twice a week for 60 min/session). RESULTS Our results revealed that the neuropsychological performance of the TG group after the telerehabilitation intervention improved on a statistically significant level on the domains of delayed and working memory, confrontation naming, verbal fluency, and global cognition. Comparison between the TG and CG revealed a significant impact of the telerehabilitation program on the domains of memory (delay and working) and language (naming and verbal fluency) as well as global cognition performance. CONCLUSION The findings of the study are promising in that the telerehabilitation intervention appears to be a useful method in improving or stabilizing cognitive decline in md-aMCI individuals and was a particularly effective alternative approach during the period of the pandemic lockdown. Specifically, the beneficial impact of the telerehabilitation intervention on episodic memory (which is one of the first domains to show impairment in md-aMCI patients) provides us with hope and evidence that these types of interventions may be applied with similar success using face-to-face interventions.
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Affiliation(s)
- Anastasia Nousia
- Department of Speech and Language Therapy, University of Ioannina, Ioannina, Greece
| | - Evangelia Pappa
- Department of Speech and Language Therapy, University of Ioannina, Ioannina, Greece
| | - Vasileios Siokas
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, Larissa, Greece
| | - Ioannis Liampas
- Department of Neurology, Faculty of Medicine, School of Health Sciences, University Hospital of Larissa, Larissa, Greece
| | - Zisis Tsouris
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, Larissa, Greece
| | - Lambros Messinis
- Departement of Psychology, Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Greece
| | - Panayiotis Patrikelis
- Departement of Psychology, Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Greece
| | - Christina Manouilidou
- Department of Comparative and General Linguistics, University of Ljubljana, Ljubljana, Slovenia
| | - Efthimios Dardiotis
- Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, Larissa, Greece
| | - Grigorios Nasios
- Department of Speech and Language Therapy, University of Ioannina, Ioannina, Greece
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Tinello D, Tarvainen M, Zuber S, Kliegel M. Enhancing Inhibitory Control in Older Adults: A Biofeedback Study. Brain Sci 2023; 13:brainsci13020335. [PMID: 36831878 PMCID: PMC9954520 DOI: 10.3390/brainsci13020335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023] Open
Abstract
Multidomain interventions based on bio-/neurofeedback have proven useful in improving executive functions. The present study aimed to explore the potential efficacy and feasibility of an intervention that combined Heart Rate Variability Biofeedback (HRV-BF) and Near Infrared Hemoencephalography Neurofeedback (nirHEG-NF) on inhibitory control (IC) of healthy older adults. Thirty-four participants were randomly assigned to two groups: the biofeedback group (received a 10-week combined intervention of HRV-BF and nirHEG-NF) and the active control group (received a similar protocol without real-time biofeedback). Besides cognitive outcomes, the study examined pre- and post-changes in autonomic regulation and prefrontal blood oxygenation at rest and during training. Results revealed training-induced inhibitory control gains in one of the two interference tasks, whereas no effect was found on response inhibition. After the intervention, HRV increased in participants with the lowest levels of HRV at baseline. Although older adults increased blood oxygenation during training, no significant pre- and post-changes were found in blood flow oxygenation. These findings not only suggest that HRV-BF and nirHEG-NF potentially improve performance in certain subcomponents of inhibition (i.e., interference vs. response inhibition), but it may also be beneficial for parasympathetic activity in participants with low HRV and for increasing blood flow oxygenation on prefrontal areas during training.
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Affiliation(s)
- Doriana Tinello
- Faculty of Psychology and Educational Sciences, University of Geneva, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland
- LIVES, Overcoming Vulnerability, Life Course Perspective, Swiss National Centre of Competence in Research, University of Lausanne, Géopolis Building, 1015 Lausanne, Switzerland
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland
- Correspondence: ; Tel.: +41-22-937-93796
| | - Mika Tarvainen
- Department of Technical Physics, University of Eastern Finland, 70211 Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, University of Eastern Finland and Kuopio University Hospital, 70029 Kuopio, Finland
| | - Sascha Zuber
- LIVES, Overcoming Vulnerability, Life Course Perspective, Swiss National Centre of Competence in Research, University of Lausanne, Géopolis Building, 1015 Lausanne, Switzerland
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland
- Institute on Aging & Lifelong Health, University of Victoria, Victoria, BC V8W 2Y2, Canada
| | - Matthias Kliegel
- Faculty of Psychology and Educational Sciences, University of Geneva, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland
- LIVES, Overcoming Vulnerability, Life Course Perspective, Swiss National Centre of Competence in Research, University of Lausanne, Géopolis Building, 1015 Lausanne, Switzerland
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland
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43
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Bonnechère B, Klass M. Cognitive Computerized Training for Older Adults and Patients with Neurological Disorders: Do the Amount and Training Modality Count? An Umbrella Meta-Regression Analysis. Games Health J 2023; 12:100-117. [PMID: 36920851 DOI: 10.1089/g4h.2022.0120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
Numerous applications have been created to train cognition and challenge the brain, a process known as computerized cognitive training (CCT). Despite potential positive results, important questions remain unresolved: the appropriate training duration, the efficacy of CCT depending on its type (commercial or developed in-house for the rehabilitation of specific patients) and delivery mode (at-home or on-site), and the patients most likely to benefit such intervention. This study aims to perform an umbrella meta-analysis and meta-regression to determine if the type of CCT, the delivery mode, the amount of training, and participants' age at inclusion influence the improvement of the cognitive function. To do so, we performed a umbrella meta-analysis. One hundred studies were included in this analysis representing 6407 participants. Statistical improvements were found for the different conditions after the training. We do not find statistical difference between the type of intervention or the delivery mode. No dose-response relationship between the total amount of training and the improvement of cognitive functions was found. CCT is effective in improving cognitive function in patients suffering from neurological conditions and in healthy aging. There is therefore an urgent need for health care systems to recognize its therapeutic potential and to evaluate at a larger scale their integration into the clinical pipeline as preventive and rehabilitation tool.
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Affiliation(s)
- Bruno Bonnechère
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium.,Technology-Supported and Data-Driven Rehabilitation, Data Sciences Institute, Hasselt University, Diepenbeek, Belgium
| | - Malgorzata Klass
- Laboratory of Applied Biology and Neurophysiology, ULB Neuroscience Institute (UNI), Université Libre de Bruxelles (ULB), Brussels, Belgium
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44
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Burton CZ, Garnett EO, Capellari E, Chang SE, Tso IF, Hampstead BM, Taylor SF. Combined Cognitive Training and Transcranial Direct Current Stimulation in Neuropsychiatric Disorders: A Systematic Review and Meta-analysis. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:151-161. [PMID: 36653210 PMCID: PMC10823589 DOI: 10.1016/j.bpsc.2022.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/25/2022] [Accepted: 09/19/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND Treatments for cognitive dysfunction in neuropsychiatric conditions are urgently needed. Cognitive training and transcranial direct current stimulation (tDCS) hold promise, and there is growing interest in combined or multimodal treatments, though studies to date have had small samples and inconsistent results. METHODS A systematic review and meta-analysis was completed. Retained studies included cognitive training combined with active or sham tDCS in a neuropsychiatric population and reported a posttreatment cognitive outcome. Meta-analyses included effect sizes comparing cognitive training plus active tDCS and cognitive training plus sham tDCS in 5 cognitive domains. Risk of bias in included studies and across studies was explored. RESULTS Fifteen studies were included: 10 in neurodegenerative disorders and 5 in psychiatric disorders (n = 629). There were several tDCS montages, though two-thirds of studies placed the anode over the left dorsolateral prefrontal cortex. A wide variety of cognitive training types and outcome measures were reported. There was a small, statistically significant effect of combined treatment on measures of attention/working memory, as well as small and non-statistically significant effects favoring combined treatment on global cognition and language. There was no evidence of bias in individual studies but some evidence of nonreporting or small-study bias across studies. CONCLUSIONS These results may provide preliminary support for the efficacy of combined cognitive training and tDCS on measures of attention/working memory. More data are needed, particularly via studies that explicitly align the cognitive ability of interest, stimulation target, training type, and outcome measures.
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Affiliation(s)
- Cynthia Z Burton
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.
| | - Emily O Garnett
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Emily Capellari
- Taubman Health Sciences Library, University of Michigan, Ann Arbor, Michigan
| | - Soo-Eun Chang
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Ivy F Tso
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Benjamin M Hampstead
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan; Mental Health Service, U.S. Department of Veterans Affairs, VA Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - Stephan F Taylor
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
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45
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Naismith SL, Michaelian JC, Santos C, Mehrani I, Robertson J, Wallis K, Lin X, Ward SA, Martins R, Masters CL, Breakspear M, Ahern S, Fripp J, Schofield PR, Sachdev PS, Rowe CC. Tackling Dementia Together via The Australian Dementia Network (ADNeT): A Summary of Initiatives, Progress and Plans. J Alzheimers Dis 2023; 96:913-925. [PMID: 37927266 PMCID: PMC10741334 DOI: 10.3233/jad-230854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2023] [Indexed: 11/07/2023]
Abstract
In 2018, the Australian Dementia Network (ADNeT) was established to bring together Australia's leading dementia researchers, people with living experience and clinicians to transform research and clinical care in the field. To address dementia diagnosis, treatment, and care, ADNeT has established three core initiatives: the Clinical Quality Registry (CQR), Memory Clinics, and Screening for Trials. Collectively, the initiatives have developed an integrated clinical and research community, driving practice excellence in this field, leading to novel innovations in diagnostics, clinical care, professional development, quality and harmonization of healthcare, clinical trials, and translation of research into practice. Australia now has a national Registry for Mild Cognitive Impairment and dementia with 55 participating clinical sites, an extensive map of memory clinic services, national Memory and Cognition Clinic Guidelines and specialized screening for trials sites in five states. This paper provides an overview of ADNeT's achievements to date and future directions. With the increase in dementia cases expected over coming decades, and with recent advances in plasma biomarkers and amyloid lowering therapies, the nationally coordinated initiatives and partnerships ADNeT has established are critical for increased national prevention efforts, co-ordinated implementation of emerging treatments for Alzheimer's disease, innovation of early and accurate diagnosis, driving continuous improvements in clinical care and patient outcome and access to post-diagnostic support and clinical trials. For a heterogenous disorder such as dementia, which is now the second leading cause of death in Australia following cardiovascular disease, the case for adequate investment into research and development has grown even more compelling.
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Affiliation(s)
- Sharon L. Naismith
- Healthy Brain Ageing Program, School of Psychology, Charles Perkins Centre and the Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Johannes C. Michaelian
- Healthy Brain Ageing Program, School of Psychology, Charles Perkins Centre and the Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Cherry Santos
- The University of Melbourne, Melbourne, Victoria, Australia
| | - Inga Mehrani
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Joanne Robertson
- The Florey Institute, The University of Melbourne, Parkville, Victoria, Australia
| | - Kasey Wallis
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Xiaoping Lin
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Stephanie A. Ward
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Geriatric Medicine, The Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Ralph Martins
- School of Medical Sciences, Edith Cowan University, Perth, Western Australia, Australia and Department of Biomedical Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Colin L. Masters
- The Florey Institute, The University of Melbourne, Parkville, Victoria, Australia
| | - Michael Breakspear
- School of Psychology, College of Engineering, Science and the Environment, University of Newcastle, New South Wales, Australia and School of Medicine and Public Health, College of Health and Medicine, University of Newcastle, New South Wales, Australia
| | - Susannah Ahern
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jurgen Fripp
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Queensland, Australia
| | - Peter R. Schofield
- Neuroscience Research Australia, Sydney, Australia and School of Biomedical Sciences, University of New South Wales, Sydney, Australia
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Christopher C. Rowe
- The University of Melbourne, Melbourne, Victoria, Australia
- The Florey Institute, The University of Melbourne, Parkville, Victoria, Australia
- Department of Molecular Imaging and Therapy, Austin Health, The University of Melbourne, Victoria, Australia
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46
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Hanoglu L, Velioglu HA, Hanoglu T, Yulug B. Neuroimaging-Guided Transcranial Magnetic and Direct Current Stimulation in MCI: Toward an Individual, Effective and Disease-Modifying Treatment. Clin EEG Neurosci 2023; 54:82-90. [PMID: 34751037 DOI: 10.1177/15500594211052815] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The therapeutic approaches currently applied in Alzheimer's disease (AD) and similar neurodegenerative diseases are essentially based on pharmacological strategies. However, despite intensive research, the effectiveness of these treatments is limited to transient symptomatic effects, and they are still far from exhibiting a true therapeutic effect capable of altering prognosis. The lack of success of such pharmacotherapy-based protocols may be derived from the cases in the majority of trials being too advanced to benefit significantly in therapeutic terms at the clinical level. For neurodegenerative diseases, mild cognitive impairment (MCI) may be an early stage of the disease continuum, including Alzheimer's. Noninvasive brain stimulation (NIBS) techniques have been developed to modulate plasticity in the human cortex in the last few decades. NIBS techniques have made it possible to obtain unique findings concerning brain functions, and design novel approaches to treat various neurological and psychiatric conditions. In addition, its synaptic and cellular neurobiological effects, NIBS is an attractive treatment option in the early phases of neurodegenerative diseases, such as MCI, with its beneficial modifying effects on cellular neuroplasticity. However, there is still insufficient evidence about the potential positive clinical effects of NIBS on MCI. Furthermore, the huge variability of the clinical effects of NIBS limits its use. In this article, we reviewed the combined approach of NIBS with various neuroimaging and electrophysiological methods. Such methodologies may provide a new horizon to the path for personalized treatment, including a more individualized pathophysiology approach which might even define new specific targets for specific symptoms of neurodegenerations.
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Affiliation(s)
- Lutfu Hanoglu
- 218502Istanbul Medipol University School of Medicine, Istanbul, Turkey
| | - Halil Aziz Velioglu
- 218502Istanbul Medipol University, Health Sciences and Technology Research Institute (SABITA), Regenerative and Restorative Medicine Research Center (REMER), functional Imaging and Cognitive-Affective Neuroscience Lab (fINCAN), Istanbul, Turkey
| | - Taha Hanoglu
- 218502Istanbul Medipol University, Health Sciences and Technology Research Institute (SABITA), Regenerative and Restorative Medicine Research Center (REMER), functional Imaging and Cognitive-Affective Neuroscience Lab (fINCAN), Istanbul, Turkey
| | - Burak Yulug
- 450199Alanya Alaaddin Keykubat University School of Medicine, Alanya/Antalya, Turkey
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47
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Orloff NC, McGinley K, Lenz K, Mack AS, Timko CA. Adaptations of cognitive remediation therapy for adolescents with anorexia nervosa for delivery via telehealth. Int J Eat Disord 2023; 56:72-79. [PMID: 36401578 PMCID: PMC10207383 DOI: 10.1002/eat.23850] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The COVID-19 pandemic hastened a transition to treatment delivery via telehealth. While barriers still exist, the increased uptake of telehealth has the potential to increase access to mental health treatment for all diagnoses, including eating disorders. Delivery of evidence-based treatment as well as adjunctive treatments, including those that are hard to find in-person, have been modified to virtual format to increase accessibility and allow for continuity of care for adolescents with anorexia nervosa. METHOD We describe how to modify and deliver Cognitive Remediation Therapy for youth with anorexia nervosa (CRT-AN) via a telehealth platform. Preliminary and practical guidance for best practice for both group and individual delivery is established. RESULTS With minimal modifications, CRT-AN can be delivered via telehealth for both individual and group delivery. More disengagement in group delivery was noted; however, overall application of the treatment via a remote platform was observed. DISCUSSION As more treatment moves to a telehealth format, highlighting how an adjunctive treatment like CRT-AN can combined with other treatments in a telehealth format has the potential to increase research in its implementation and furthermore increase its dissemination. PUBLIC SIGNIFICANCE Cognitive Remediation Therapy for Anorexia Nervosa (CRT-AN) requires significant manipulation of materials and supplementary human guidance. Suggestions for how to modify CRT-AN for remote delivery via telehealth are provided. Modifications grew out of immediate changes made during the beginning of the COVID-19 pandemic and can be used to inform changes therapists and programs can make to continue to or begin to use CRT-AN in a remote fashion.
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Affiliation(s)
- Natalia C Orloff
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Kate McGinley
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Private Practice, Cape May Court House, Cape May County, New Jersey, USA
| | - Katrina Lenz
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Amy S Mack
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - C Alix Timko
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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48
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Sone D, Beheshti I. Neuroimaging-Based Brain Age Estimation: A Promising Personalized Biomarker in Neuropsychiatry. J Pers Med 2022; 12:jpm12111850. [PMID: 36579560 PMCID: PMC9695293 DOI: 10.3390/jpm12111850] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 11/10/2022] Open
Abstract
It is now possible to estimate an individual's brain age via brain scans and machine-learning models. This validated technique has opened up new avenues for addressing clinical questions in neurology, and, in this review, we summarize the many clinical applications of brain-age estimation in neuropsychiatry and general populations. We first provide an introduction to typical neuroimaging modalities, feature extraction methods, and machine-learning models that have been used to develop a brain-age estimation framework. We then focus on the significant findings of the brain-age estimation technique in the field of neuropsychiatry as well as the usefulness of the technique for addressing clinical questions in neuropsychiatry. These applications may contribute to more timely and targeted neuropsychiatric therapies. Last, we discuss the practical problems and challenges described in the literature and suggest some future research directions.
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Affiliation(s)
- Daichi Sone
- Department of Psychiatry, Jikei University School of Medicine, Tokyo 105-8461, Japan
- Correspondence: ; Tel.: +81-03-3433
| | - Iman Beheshti
- Department of Human Anatomy and Cell Science, University of Manitoba, Winnipeg, MB R3E 3P5, Canada
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Gómez-Soria I, Marin-Puyalto J, Peralta-Marrupe P, Latorre E, Calatayud E. Effects of multi-component non-pharmacological interventions on cognition in participants with mild cognitive impairment: A systematic review and meta-analysis. Arch Gerontol Geriatr 2022; 103:104751. [PMID: 35839574 DOI: 10.1016/j.archger.2022.104751] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 06/06/2022] [Accepted: 06/10/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND AND PURPOSE Mild cognitive impairment (MCI) describes a stage of intermediate cognitive dysfunction where the risk of conversion to dementia is elevated. Given the absence of effective pharmacological treatments for MCI, increasing numbers of studies are attempting to understand how multicomponent non-pharmacological interventions (MNPI) could benefit MCI. The purpose of this systematic review and meta-analysis were to assess the effects of two-component MNPI (simultaneous cognitive intervention based on cognitive stimulation, cognitive training and/or cognitive rehabilitation or combined cognitive and physical interventions) on global cognition and cognitive functions in older adults with MCI and to compare the degree of efficacy between the two interventions. METHODS After searching electronic databases (PubMed, Web of Science, Scopus and Cochrane Central) for randomized controlled trials and clinical trials published from 2010 to 18 January 2021, 562 studies were found. 8 studies were included in this review, with a fair to good quality according to the PEDro scale. RESULTS From a random-effects model meta-analysis, the pooled standardized MMSE mean difference between the intervention and control groups showed a significant small-to-medium effect in global cognition in MMSE score (0.249; 95% CI = [0.067, 0.431]), which seemed to be greater for combined physical and cognitive interventions. However, the meta-analyses did not show any effects regarding specific cognitive functions. CONCLUSION Our analyses support that MNPI could improve the global cognition in older adults with MCI. However, more studies are needed to analyze the potential benefits of MNPI on older adults with MCI.
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Affiliation(s)
- Isabel Gómez-Soria
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain; Institute of Health Research of Aragón (IIS Aragón), Zaragoza, Spain.
| | - Jorge Marin-Puyalto
- Department of Physiatry and Nursing, Faculty of Health and Sport Sciences, Universidad de Zaragoza, C/Pedro Cerbuna, 12, Zaragoza 50009, Spain; Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza, Spain; Instituto Agroalimentario de Arag ́on (IA2), Zaragoza, Spain.
| | - Patricia Peralta-Marrupe
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain.
| | - Eva Latorre
- Department of Biochemistry and Molecular and Cell Biology, Faculty of Sciences, Universidad de Zaragoza, Zaragoza, Spain; Institute of Health Research of Aragón (IIS Aragón), Zaragoza, Spain.
| | - Estela Calatayud
- Department of Physiatry and Nursing, Faculty of Health Sciences, Universidad de Zaragoza, Zaragoza, Spain; Institute of Health Research of Aragón (IIS Aragón), Zaragoza, Spain.
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50
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Rabi R, Chow R, Paracha S, Hasher L, Gardner S, Anderson ND, Alain C. Time of Day Effects on Inhibitory Functioning: Cognitive and Neural Evidence of Sundowning in Amnestic Mild Cognitive Impairment. J Alzheimers Dis 2022; 90:869-890. [DOI: 10.3233/jad-220580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Amnestic mild cognitive impairment (aMCI), a prodromal phase of Alzheimer’s disease (AD), is characterized by episodic memory dysfunction, but inhibitory deficits have also been commonly reported. Time of day (TOD) effects have been confirmed in 1) healthy aging on cognitive processes such as inhibitory control, and 2) on behavior in AD (termed the sundowning effect), but no such research has addressed aMCI. Objective: The present study examined the impact of TOD on the behavioral and electrophysiological correlates of inhibition in 54 individuals with aMCI and 52 healthy controls (HCs), all of morning chronotype. Methods: Participants were randomly assigned to complete two inhibition tasks (Go-NoGo and Flanker) during their optimal (morning) or non-optimal (evening) TOD, while electroencephalography was recorded. Results: Both tasks elicited changes in N2 and P3 event-related potential (ERP) components, which commonly index inhibitory functioning. Analyses showed that the Go-NoGo difference in P3 amplitude was reduced in individuals with aMCI relative to HCs. Compared to HCs, the Flanker difference in P3 amplitude was also reduced and coincided with more errors in the aMCI group. Notably, these behavioral and ERP differences were exaggerated in the non-optimal TOD relative to the optimal TOD. Conclusion: Findings confirm the presence of inhibition deficits in aMCI and provide novel evidence of sundowning effects on inhibitory control in aMCI. Results reinforce the need to consider the influences of TOD in clinical assessments involving individuals with aMCI.
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Affiliation(s)
- Rahel Rabi
- Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Ricky Chow
- Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
| | - Shahier Paracha
- Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
| | - Lynn Hasher
- Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
- Department of Psychology, University of Toronto, Ontario, Canada
| | - Sandra Gardner
- Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
- Biostatistics Division, Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Nicole D. Anderson
- Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
- Department of Psychology, University of Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Ontario, Canada
| | - Claude Alain
- Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
- Department of Psychology, University of Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Ontario, Canada
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