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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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Walter J, Grutza M, Vogt L, Unterberg A, Zweckberger K. The neuropsychological assessment battery (NAB) is a valuable tool for evaluating neuropsychological outcome after aneurysmatic subarachnoid hemorrhage. BMC Neurol 2020; 20:429. [PMID: 33243170 PMCID: PMC7689995 DOI: 10.1186/s12883-020-02003-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 11/17/2020] [Indexed: 12/03/2022] Open
Abstract
Background Detecting and treating neuropsychological deficits after aneurysmatic subarachnoid hemorrhage (aSAH) play a key role in regaining independence; however, detecting deficits relevant to social and professional reintegration has been difficult and optimal timing of assessments remains unclear. Therefore, we evaluated the feasibility of administering the Neuropsychological Assessment Battery screening module (NAB-S) to patients with aSAH, assessed its value in predicting the ability to return to work and characterized clinical as well as neuropsychological recovery over the period of 24 months. Methods A total of 104 consecutive patients treated for aSAH were recruited. After acute treatment, follow up visits were conducted at 3, 12 and 24 months after the hemorrhage. NAB-S, Montreal Cognitive Assessment (MoCA) and physical examination were performed at each follow up visit. Results The NAB-S could be administered to 64.9, 75.9 and 88.9% of the patients at 3, 12 and 24 months, respectively. Moderate impairment of two or more neuropsychological domains (e.g speech, executive function, etc.) significantly correlated with inability to return to work at 12 and 24 months as well as poor outcome assessed by the extended Glasgow Outcome Scale (GOSE) at 3, 12 and 24 months. The number of patients with favorable outcomes significantly increased from 25.5% at discharge to 56.5 and 57.1% at 3 and 12 months, respectively, and further increased to 74.1% after 24 months. Conclusion The NAB-S can be administered to the majority of patients with aSAH and can effectively detect clinically relevant neuropsychological deficits. Clinical recovery after aSAH continues for at least 24 months after the hemorrhage which should be considered in the design of future clinical trials.
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Affiliation(s)
- Johannes Walter
- Department of Neurosurgery, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | - Martin Grutza
- Department of Neurosurgery, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Lidia Vogt
- Department of Neurosurgery, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Andreas Unterberg
- Department of Neurosurgery, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Klaus Zweckberger
- Department of Neurosurgery, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
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Buczyłowska D, Petermann F, Daseking M. Executive functions and intelligence from the CHC theory perspective: Investigating the correspondence between the WAIS-IV and the NAB Executive Functions Module. J Clin Exp Neuropsychol 2020; 42:240-250. [PMID: 31893471 DOI: 10.1080/13803395.2019.1705250] [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: 10/25/2022]
Abstract
Substantial overlap between executive functions (EFs) and intelligence has been reported. Yet further research is required with respect to how the specific components of the two constructs are interrelated. The present study was aimed at exploring the relationship between EFs and intelligence by examining the latent structure of the Wechsler Adult Intelligence Scale (WAIS-IV) and the Executive Functions Module from the Neuropsychological Assessment Battery (NAB). The aim was also to test the correspondence of the two measures to the Cattell-Horn-Carroll (CHC) theory. 205 healthy participants, aged 18-89 years, were administered the NAB and WAIS-IV. Confirmatory factor analysis (CFA) was employed to explore the latent constructs underlying the two test batteries. Models based on the current WAIS-IV index structure showed worse model fit than models based on the CHC theory. In particular, factors representing broad CHC abilities comprehension knowledge (Gc), fluid reasoning (Gf), visual processing (Gv), processing speed (Gs), and working memory capacity (Gwm) proved model fit improvement. The best model fit, however, provided a five-factor model combining the Gf and Gwm abilities into one factor and additionally including a retrieval fluency (Gr) factor. The results demonstrate strong relationships between the WAIS-IV and the NAB Executive Functions Module and suggest substantial overlap between EFs and intelligence within the CHC framework. Nevertheless, according to the recent update of the CHC theory, the NAB fluency tasks may represent a distinct EF factor comprising Gr abilities independent from the WAIS-IV.
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Affiliation(s)
- Dorota Buczyłowska
- Center for Clinical Psychology and Rehabilitation, University of Bremen, Bremen, Germany
| | - Franz Petermann
- Center for Clinical Psychology and Rehabilitation, University of Bremen, Bremen, Germany
| | - Monika Daseking
- Department of Educational Psychology, Helmut-Schmidt-University/University of the Federal Armed Forces Hamburg, Hamburg, Germany
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Buczylowska D, Petermann F. Intraindividual Variability in Executive Function Performance in Healthy Adults: Cross-Sectional Analysis of the NAB Executive Functions Module. Front Psychol 2018; 9:329. [PMID: 29593624 PMCID: PMC5861463 DOI: 10.3389/fpsyg.2018.00329] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 02/27/2018] [Indexed: 11/13/2022] Open
Abstract
The current study was aimed at investigating across-tasks intraindividual variability, also termed dispersion, in EF performance. The German adaptation of the Neuropsychological Assessment Battery (NAB) was used as a measure of EFs. Data of 444 participants aged 18-99 from six NAB Executive Functions Module subtests (i.e., Planning, Mazes, Letter Fluency, Judgment, Categories, and Word Generation) along with the NAB Total Index score as a measure of overall cognitive ability were analyzed. Maximum discrepancy (MD) was applied as a measure of dispersion. MD values ranged from 0.47 to 5.20 indicating substantial across-tasks dispersion in EF performance. Furthermore, dispersion moderately decreased with advancing age. Taking overall cognitive ability into account revealed that dispersion might be lower at older ages; especially, when associated with low overall ability levels. The dedifferentiation hypothesis offers a plausible explanation for these findings. That is, the cognitive profiles of older people might be less heterogenous than that of younger people, which may be due to age-related central nervous system constraints.
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Affiliation(s)
- Dorota Buczylowska
- Center of Clinical Psychology and Rehabilitation, University of Bremen, Bremen, Germany
| | - Franz Petermann
- Center of Clinical Psychology and Rehabilitation, University of Bremen, Bremen, Germany
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Diener C, Bornschlegl M, Menke B, Petermann F. Subjektive Einschätzung und objektive kognitive Leistung bei psychisch Gesunden. ZEITSCHRIFT FUR NEUROPSYCHOLOGIE 2016. [DOI: 10.1024/1016-264x/a000186] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung. Neuropsychologische Untersuchungen verweisen auf uneinheitliche Zusammenhänge zwischen der subjektiven und objektiven kognitiven Leistungsbeurteilung. Bei 286 psychisch Gesunden wurden objektive kognitive Leistungswerte in der deutschen Adaptation der Neuropsychological Assessment Battery (NAB) sowie der Fragebogen zur subjektiven Einschätzung der geistigen Leistungsfähigkeit (FLei) erhoben. Trotz sehr guter Reliabilitäten des FLei limitierten Bodeneffekte die Aufdeckung richtungskonformer Zusammenhänge mit objektiven Leistungswerten in den Bereichen Aufmerksamkeit, Gedächtnis und exekutiven Funktionen. Dennoch erwies sich die Gedächtnisleistung als sensitivste Einzeldomäne für einen positiven Zusammenhang zwischen subjektiver und objektiver Leistungseinschätzung. Dabei moderierte das subjektive Wohlbefinden (WHO-5-Index) den Zusammenhang beider (subjektiver/objektiver) Ebenen im Gedächtnisbereich und in der kognitiven Gesamtleistung. Vor dem Hintergrund dieses Ergebnismusters sollten zukünftige Zusammenhangsanalysen insbesondere bei Personen mit psychischen Belastungen zu weiteren klinisch relevanten Befunden führen.
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Affiliation(s)
- Carsten Diener
- Fakultät für Angewandte Psychologie, SRH Hochschule Heidelberg
| | - Mona Bornschlegl
- Zentrum für Klinische Psychologie und Rehabilitation (ZKPR), Universität Bremen
| | - Barbara Menke
- Fakultät für Angewandte Psychologie, SRH Hochschule Heidelberg
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation (ZKPR), Universität Bremen
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Buczylowska D, Daseking M, Petermann F. Age-related differences in the predictive ability of executive functions for intelligence. ZEITSCHRIFT FUR NEUROPSYCHOLOGIE 2016. [DOI: 10.1024/1016-264x/a000179] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract. The Executive Functions Module of the Neuropsychological Assessment Battery (NAB) and the Wechsler Adult Intelligence Scale – Fourth Edition (WAIS-IV) were used to investigate age-related differences in the predictability of intelligence with executive functions. The NAB subtests age and sex better predicted the WAIS-IV index scales and the Full Scale IQ in the older than in the younger age group, with total variance explained up to 75 % in 60- to 88-year-olds and up to 46 % in 18- to 59-year-olds. The NAB subtests Categories and Word Generation were most frequently included, whereas Letter Fluency was least frequently included in the best-fitting models of WAIS-IV prediction. Mazes predicted better in the younger age group, whereas Judgment predicted better in the older age group.
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Affiliation(s)
- Dorota Buczylowska
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen, Germany
| | - Monika Daseking
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen, Germany
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen, Germany
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Buczylowska D, Petermann F. Age-related commonalities and differences in the relationship between executive functions and intelligence: Analysis of the NAB executive functions module and WAIS-IV scores. APPLIED NEUROPSYCHOLOGY-ADULT 2016; 24:465-480. [DOI: 10.1080/23279095.2016.1211528] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Dorota Buczylowska
- Center for Clinical Psychology and Rehabilitation, University of Bremen, Bremen, Germany
| | - Franz Petermann
- Center for Clinical Psychology and Rehabilitation, University of Bremen, Bremen, Germany
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