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Farah R, Dworetsky A, Coalson RS, Petersen SE, Schlaggar BL, Rosch KS, Horowitz-Kraus T. An executive-functions-based reading training enhances sensory-motor systems integration during reading fluency in children with dyslexia. Cereb Cortex 2024; 34:bhae166. [PMID: 38664864 PMCID: PMC11045473 DOI: 10.1093/cercor/bhae166] [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: 04/07/2023] [Revised: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
The Simple View of Reading model suggests that intact language processing and word decoding lead to proficient reading comprehension, with recent studies pointing at executive functions as an important component contributing to reading proficiency. Here, we aimed to determine the underlying mechanism(s) for these changes. Participants include 120 8- to 12-year-old children (n = 55 with dyslexia, n = 65 typical readers) trained on an executive functions-based reading program, including pre/postfunctional MRI and behavioral data collection. Across groups, improved word reading was related to stronger functional connections within executive functions and sensory networks. In children with dyslexia, faster and more accurate word reading was related to stronger functional connections within and between sensory networks. These results suggest greater synchronization of brain systems after the intervention, consistent with the "neural noise" hypothesis in children with dyslexia and support the consideration of including executive functions as part of the Simple View of Reading model.
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Affiliation(s)
- Rola Farah
- Educational Neuroimaging Group, Faculty of Education in Science and Technology, Technion, Haifa, Israel
- Faculty of Biomedical Engineering, Technion, Haifa, 3200003, Israel
| | - Ally Dworetsky
- Neurology and Radiology at Washington University Medical School, St Louis, MO, United States
| | - Rebecca S Coalson
- Neurology and Radiology at Washington University Medical School, St Louis, MO, United States
| | - Steven E Petersen
- Department of Neurology, Washington University Medical School, 1 Brookings Dr, St. Louis, MO 63130, United States
| | - Bradley L Schlaggar
- Kennedy Krieger Institute, 707 North Broadway Baltimore, MD 21205, United States
- Departments of Neurology and Pediatrics, Johns Hopkins University School of Medicine, 1800 Orleans St Baltimore, MD 21287, United States
| | - Keri S Rosch
- Kennedy Krieger Institute, 707 North Broadway Baltimore, MD 21205, United States
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 1800 Orleans St Baltimore, MD 21287, United States
| | - Tzipi Horowitz-Kraus
- Educational Neuroimaging Group, Faculty of Education in Science and Technology, Technion, Haifa, Israel
- Faculty of Biomedical Engineering, Technion, Haifa, 3200003, Israel
- Kennedy Krieger Institute, 707 North Broadway Baltimore, MD 21205, United States
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 1800 Orleans St Baltimore, MD 21287, United States
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Sanchez-Castañeda C, Luis-Ruiz S, Ramon-Krauel M, Lerin C, Sanchez C, Miró N, Martínez S, Garolera M, Jurado MA. Executive Function Training in Childhood Obesity: Food Choice, Quality of Life, and Brain Connectivity (TOuCH): A Randomized Control Trial Protocol. Front Pediatr 2021; 9:551869. [PMID: 33718294 PMCID: PMC7943482 DOI: 10.3389/fped.2021.551869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 01/19/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Individuals with obesity are known to present cognitive deficits, especially in executive functions. Executive functions play an important role in health and success throughout the whole life and have been related to food decision-making and to the ability to maintain energy balance. It is possible to improve executive functions through targeted training. This would involve brain plasticity changes that could be studied through connectivity MRI. The general hypothesis of this study is that executive functions training in children with obesity can improve food choices and produce cognitive and neuroimaging changes (structural and functional connectivity), as well as improve emotional state and quality of life. Methods: Randomized controlled double-blind trial with 12-month follow-up. Thirty children with obesity will be randomly allocated into "executive training" (Cognifit with adaptive difficulty + Cogmed) or "control task" group (Cognifit without adaptive difficulty). Both groups will attend 30-45 min of individual gamified training (Cogmed and/or Cognifit systems) by iPad, five times per week during 6 weeks. Cogmed and Cognifit software are commercially available from Pearson and Cognifit, respectively. Participants will receive an iPad with both apps installed for a 6-week use. Participants will also receive counseling diet information via presentations sent to the iPad and will wear a Fitbit Flex 2 tracker to monitor daily activity and sleep patterns. Main outcomes will be cognitive, emotional, food decision, and quality-of-life measures, as well as neuroimaging measures. Participants are evaluated at baseline (T0), after treatment (T1), and 12 months since baseline (T2). Discussion: Longitudinal study with active control group and 3 time points: baseline, immediately after treatment, and 1 year after baseline. Threefold treatment: executive function training, psychoeducation, and feedback on activity/sleep tracking. We will evaluate the transfer effects of the intervention, including emotional and functional outcomes, as well as the effects on neural plasticity by connectivity MRI. Trial registration: This project has been registered in ClinicalTrials.gov (trial registration number NCT03615274), August 3, 2018.
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Affiliation(s)
- Cristina Sanchez-Castañeda
- Department of Clinical Psychology and Psychobiology, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Sandra Luis-Ruiz
- Department of Clinical Psychology and Psychobiology, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Marta Ramon-Krauel
- Institut de Recerca Sant Joan de Déu, Barcelona, Spain.,Endocrinology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Carles Lerin
- Institut de Recerca Sant Joan de Déu, Barcelona, Spain.,Endocrinology Department, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Consuelo Sanchez
- Paediatric Endocrinology Unit, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Núria Miró
- Diabetes Education Unit, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Sònia Martínez
- Pharmacy and Nutrition Unit, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Maite Garolera
- Neuropsychology Unit, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Maria Angeles Jurado
- Department of Clinical Psychology and Psychobiology, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.,Institut de Recerca Sant Joan de Déu, Barcelona, Spain
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Luis-Ruiz S, Caldú X, Sánchez-Castañeda C, Pueyo R, Garolera M, Jurado MÁ. Is cognitive training an effective tool for improving cognitive function and real-life behaviour in healthy children and adolescents? A systematic review. Neurosci Biobehav Rev 2020; 116:268-282. [PMID: 32565174 DOI: 10.1016/j.neubiorev.2020.06.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 01/09/2023]
Abstract
Computerised cognitive training (CCT) has been applied to improve cognitive function in pathological conditions and in healthy populations. Studies suggest that CCT produces near-transfer effects to cognitive functions, with less evidence for far-transfer. Newer applications of CTT in adults seem to produce certain far-transfer effects by influencing eating behaviour and weight loss. However, this is more unexplored in children and adolescents. We conducted a systematic review of 16 studies with randomised controlled design to assess the impact of CCT on cognitive functioning and real-life outcomes, including eating behaviour, in children and adolescents with typical development (PROSPERO registration number: CRD42019123889). Results show near-transfer effects to working memory, with inconsistent results regarding far-transfer effects to other cognitive functions and real-life measures. Long-term effects show the same trend. Far-transfer effects occurred after cue-related inhibitory control and attentional training, although effects seem not to last. CCT may be a potential weight-loss treatment option but more research is needed to determine the specific characteristics to enhance treatment outcomes.
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Affiliation(s)
- Sandra Luis-Ruiz
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Neurociències (UBNeuro), Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Xavier Caldú
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Grup de Neuropsicologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Neurociències (UBNeuro), Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Cristina Sánchez-Castañeda
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Grup de Neuropsicologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Neurociències (UBNeuro), Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Roser Pueyo
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Grup de Neuropsicologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Neurociències (UBNeuro), Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
| | - Maite Garolera
- Grup de Neuropsicologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Unitat de Neuropsicologia, Consorci Sanitari de Terrassa, Carretera de Torrebonica, S/N, 08227, Terrasa, Barcelona, Spain; Brain, Cognition and Behaviour Clinical Research Group, Consorci Sanitari de Terrassa, Carretera de Torrebonica, S/N, 08227, Terrasa, Barcelona, Spain
| | - María Ángeles Jurado
- Departament de Psicologia Clínica i Psicobiologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Grup de Neuropsicologia, Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Neurociències (UBNeuro), Universitat de Barcelona, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Hospital Sant Joan de Déu, Passeig de Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain.
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Effect of Vergence/Accommodative Therapy on Reading in Children with Convergence Insufficiency: A Randomized Clinical Trial. Optom Vis Sci 2019; 96:836-849. [PMID: 31651592 PMCID: PMC6855328 DOI: 10.1097/opx.0000000000001442] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 11/14/2018] [Accepted: 07/29/2019] [Indexed: 01/02/2023] Open
Abstract
SIGNIFICANCE The results of this study suggest that clinicians providing vergence/accommodative therapy for the treatment of childhood convergence insufficiency should not suggest that such treatment, on average, will lead to improvements on standardized assessments of reading performance after 16 weeks of treatment. PURPOSE The purpose of this study was to determine the effect of office-based vergence/accommodative therapy on reading performance in 9- to 14-year-old children with symptomatic convergence insufficiency. METHODS In a multicenter clinical trial, 310 children 9 to 14 years old with symptomatic convergence insufficiency were randomized in a 2:1 ratio to 16 weeks of office-based vergence/accommodative therapy or office-based placebo therapy, respectively. The primary outcome was change in reading comprehension as measured by the reading comprehension subtest of the Wechsler Individual Achievement Test, Third Edition (WIAT-III) at the 16-week outcome. Secondary reading outcomes of word identification, reading fluency, listening comprehension, comprehension of extended text, and reading comprehension were also evaluated. RESULTS The adjusted mean improvement in WIAT-III reading comprehension was 3.7 (95% confidence interval [CI], 2.6 to 4.7) standard score points in the vergence/accommodative therapy group and 3.8 (95% CI, 2.4 to 5.2) points in the placebo therapy group, with an adjusted mean group difference of -0.12 (95% CI, -1.89 to 1.66) points that was not statistically significant. No statistically significant treatment group differences were found for any of the secondary reading outcome measures. CONCLUSIONS For children aged 9 to 14 years with symptomatic convergence insufficiency, office-based vergence/accommodative therapy was no more effective than office-based placebo therapy for improving reading performance on standardized reading tests after 16 weeks of treatment.
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