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Manenti R, Baglio F, Pagnoni I, Gobbi E, Campana E, Alaimo C, Rossetto F, Di Tella S, Pagliari C, Geviti A, Bonfiglio NS, Calabrò RS, Cimino V, Binetti G, Quartarone A, Bramanti P, Cappa SF, Rossini PM, Cotelli M. Long-lasting improvements in episodic memory among subjects with mild cognitive impairment who received transcranial direct current stimulation combined with cognitive treatment and telerehabilitation: a multicentre, randomized, active-controlled study. Front Aging Neurosci 2024; 16:1414593. [PMID: 38966802 PMCID: PMC11223647 DOI: 10.3389/fnagi.2024.1414593] [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: 04/09/2024] [Accepted: 05/31/2024] [Indexed: 07/06/2024] Open
Abstract
Background In recent years, an increasing number of studies have examined the potential efficacy of cognitive training procedures in individuals with normal ageing and mild cognitive impairment (MCI). Objective The aims of this study were to (i) evaluate the efficacy of the cognitive Virtual Reality Rehabilitation System (VRRS) combined with anodal transcranial direct current stimulation (tDCS) applied to the left dorsolateral prefrontal cortex compared to placebo tDCS stimulation combined with VRRS and (ii) to determine how to prolong the beneficial effects of the treatment. A total of 109 subjects with MCI were assigned to 1 of 5 study groups in a randomized controlled trial design: (a) face-to-face (FTF) VRRS during anodal tDCS followed by cognitive telerehabilitation (TR) (clinic-atDCS-VRRS+Tele@H-VRRS); (b) FTF VRRS during placebo tDCS followed by TR (clinic-ptDCS-VRRS+Tele@H-VRRS); (c) FTF VRRS followed by cognitive TR (clinic-VRRS+Tele@H-VRRS); (d) FTF VRRS followed by at-home unstructured cognitive stimulation (clinic-VRRS+@H-UCS); and (e) FTF cognitive treatment as usual (clinic-TAU). Results An improvement in episodic memory was observed after the end of clinic-atDCS-VRRS (p < 0.001). We found no enhancement in episodic memory after clinic-ptDCS-VRRS or after clinic-TAU.Moreover, the combined treatment led to prolonged beneficial effects (clinic-atDCS-VRRS+Tele@H-VRRS vs. clinic-ptDCS-VRRS+Tele@H-VRRS: p = 0.047; clinic-atDCS-VRRS+Tele@H-VRRS vs. clinic-VRRS+Tele@H-VRRS: p = 0.06). Discussion The present study provides preliminary evidence supporting the use of individualized VRRS combined with anodal tDCS and cognitive telerehabilitation for cognitive rehabilitation. Clinical trial registration https://clinicaltrials.gov/study/NCT03486704?term=NCT03486704&rank=1, NCT03486704.
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Affiliation(s)
- Rosa Manenti
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | - Ilaria Pagnoni
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elena Gobbi
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elena Campana
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Cristina Alaimo
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | - Sonia Di Tella
- IRCCS Fondazione Don Carlo Gnocchi – ONLUS, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | | | - Andrea Geviti
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | | | | | - Giuliano Binetti
- MAC Memory Clinic and Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | - Placido Bramanti
- IRCCS Centro Neurolesi “Bonino Pulejo”, Messina, Italy
- Università Degli Studi eCAMPUS, Novedrate, Italy
| | - Stefano F. Cappa
- Istituto Universitario Studi Superiori IUSS, Pavia, Italy
- IRCCS Fondazione Mondino, Pavia, Italy
| | - Paolo Maria Rossini
- Department Neuroscience and Neurorehabilitation, IRCCS San Raffaele Roma, Rome, Italy
| | - Maria Cotelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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Ben Izhak S, Diedrich L, Antal A, Lavidor M. Beyond social engagement: cognitive training leads to greater cognitive improvement in older adults. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:556-574. [PMID: 37221447 DOI: 10.1080/13825585.2023.2216927] [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: 02/11/2023] [Accepted: 05/18/2023] [Indexed: 05/25/2023]
Abstract
Aging is often accompanied by a decline in cognitive functions, with memory being particularly affected. Recent studies suggest that cognitive training sessions that teach memory strategies relevant to daily life may benefit seniors who live in the community. However, it is possible that the cognitive improvement observed in these programs results from the social encounters embedded in them. In this study, we aimed to investigate the effect of a social cognitive training group, which met regularly for an extended period, on enhancing cognitive indices compared to a control group that only received social engagement meetings without training. Sixty-six participants with a mean age of 78 took part in 12 sessions of a social engagement group, with or without strategy training. Cognitive performance was assessed before and after training using four memory tasks, two similar to the trained tasks (near-transfer tasks) and two novel (far-transfer tasks). Both groups showed a slight improvement in most of the evaluation tasks, but the cognitive training combined with social engagement group showed a significant improvement in the Word Recall and Verbal Fluency tests compared to the social engagement group without training. Our findings suggest that cognitive training sessions may be a useful tool in promoting cognitive improvement among older adults living in the community, even beyond the improvement obtained from the social engagement that occurs during the training sessions.Trial registration number:NCT05016336. Date of registration: 20 August 2021. Retrospectively registered.
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Affiliation(s)
- Shachar Ben Izhak
- Department of Psychology, and the Gonda Brain Research Center, Bar Ilan University, Ramat Gan, Israel
| | - Lukas Diedrich
- Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - Andrea Antal
- Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - Michal Lavidor
- Department of Psychology, and the Gonda Brain Research Center, Bar Ilan University, Ramat Gan, Israel
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Maggio MG, Baglio F, Arcuri F, Borgnis F, Contrada M, Diaz MDM, Leochico CF, Neira NJ, Laratta S, Suchan B, Tonin P, Calabrò RS. Cognitive telerehabilitation: an expert consensus paper on current evidence and future perspective. Front Neurol 2024; 15:1338873. [PMID: 38426164 PMCID: PMC10902044 DOI: 10.3389/fneur.2024.1338873] [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: 11/15/2023] [Accepted: 01/16/2024] [Indexed: 03/02/2024] Open
Abstract
The progressive improvement of the living conditions and medical care of the population in industrialized countries has led to improvement in healthcare interventions, including rehabilitation. From this perspective, Telerehabilitation (TR) plays an important role. TR consists of the application of telemedicine to rehabilitation to offer remote rehabilitation services to the population unable to reach healthcare. TR integrates therapy-recovery-assistance, with continuity of treatments, aimed at neurological and psychological recovery, involving the patient in a family environment, with an active role also of the caregivers. This leads to reduced healthcare costs and improves the continuity of specialist care, as well as showing efficacy for the treatment of cognitive disorders, and leading to advantages for patients and their families, such as avoiding travel, reducing associated costs, improving the frequency, continuity, and comfort of performing the rehabilitation in its own spaces, times and arrangements. The aim of this consensus paper is to investigate the current evidence on the use and effectiveness of TR in the cognitive field, trying to also suggest some recommendations and future perspectives. To the best of our knowledge, this is the first consensus paper among multiple expert researchers that comprehensively examines TR in different neurological diseases. Our results supported the efficacy and feasibility of TR with good adherence and no adverse events among patients. Our consensus summarizes the current evidence for the application of cognitive TR in neurological populations, highlighting the potential of this tool, but also the limitations that need to be explored further.
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Affiliation(s)
| | | | - Francesco Arcuri
- S. Anna Institute and Research in Advanced Neurorehabilitation, Crotone, Italy
| | | | - Marianna Contrada
- S. Anna Institute and Research in Advanced Neurorehabilitation, Crotone, Italy
| | | | - Carl Froilan Leochico
- University of the Philippines Manila, Manila, Philippines
- St. Luke’s Medical Center, Quezon City, Philippines
| | | | - Stefania Laratta
- S. Anna Institute and Research in Advanced Neurorehabilitation, Crotone, Italy
| | - Boris Suchan
- Department of Neuropsychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Paolo Tonin
- S. Anna Institute and Research in Advanced Neurorehabilitation, Crotone, Italy
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Goumopoulos C, Skikos G, Frounta M. Feasibility and Effects of Cognitive Training with the COGNIPLAT Game Platform in Elderly with Mild Cognitive Impairment: Pilot Randomized Controlled Trial. Games Health J 2023; 12:414-425. [PMID: 37276027 DOI: 10.1089/g4h.2023.0029] [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] [Indexed: 06/07/2023] Open
Abstract
This study examines the effectiveness of a new multi-domain multimodal cognitive training game platform, COGNIPLAT, in improving cognitive performance in elderly with mild cognitive impairment (MCI). The platform combines standard serious games and cognitive stimulation leveraging virtual and augmented reality technologies. A double-arm, evaluator-blinded randomized controlled trial was conducted with 21 elderly participants in the MCI spectrum, with 11 in the intervention group (INT) and 10 in the control group (CTL). Feasibility was assessed in terms of adherence, effective learning, and perceived usefulness. The INT attended 24 training sessions, 60 minutes long, twice a week, whereas the CTL engaged in normal daily activities and usual care. Results showed that the INT had a statistically significant change in the Montreal Cognitive Assessment score, stages List B Recall, Short-term delayed Recall, and Long-term delayed Recall of the Rey Auditory Verbal Learning Test (RAVLT), Trail Making Test-A and B test scores, Digit Span Test (DST) Forward Span, and Functional Activities Questionnaire score. A trend level difference was also found for the RAVLT Recognition and the DST Backward Span. No significant differences were found for the CTL in any of the metrics. The completion rate of the INT was 91%, and the attendance rate was 100% for participants who completed the follow-up segment of the study. The engagement level was high, and effective learning was observed between the participants. The perceived usability and usefulness of the game platform was assessed as high. This study provides evidence of a positive effect of a multi-domain multimodal-based cognitive training program in elderly with MCI, with broader benefits on cognition by inducing more cooperative transfer effects over different domains.
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Affiliation(s)
- Christos Goumopoulos
- Information and Communication Systems Engineering Department, University of the Aegean, Samos, Greece
| | - Georgios Skikos
- Information and Communication Systems Engineering Department, University of the Aegean, Samos, Greece
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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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Lee J, Kim J, Park A, Hong RK, Ko M, Heo M, Kim H, Chung JY. Efficacy of a Mobile-Based Multidomain Intervention to Improve Cognitive Function and Health-Related Outcomes Among Older Korean Adults with Subjective Cognitive Decline. J Alzheimers Dis 2023; 93:1551-1562. [PMID: 37212108 PMCID: PMC10357136 DOI: 10.3233/jad-221299] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND Subjective cognitive decline (SCD) is a self-reported experience of declining cognitive function showing normal performance in cognitive assessments, which is a known risk factor for dementia. Recent studies highlight the importance of nonpharmacological multidomain interventions that can target multiple risk factors of dementia in older adults. OBJECTIVE This study investigated the efficacy of the Silvia program, a mobile-based multidomain intervention, to improve cognitive function and health-related outcomes of older adults with SCD. We compare its effects to a conventional paper-based multidomain program on various health indicators related to risk factors of dementia. METHODS This prospective randomized controlled trial involved 77 older adults with SCD recruited from the Dementia Prevention and Management Center in Gwangju, South Korea during May to October 2022. Participants were randomly assigned to either the mobile- or paper-based group. Interventions were administered for 12 weeks, where pre- and post-assessments were conducted. RESULTS The K-RBANS total score did not show significant differences between groups. The mobile group showed better improvement in K-PRMQ scores and PSS scores than the paper group. Differences within groups showed that mobile-based interventions significantly improved K-PRMQ, STAI-X-1, PSS, and EQ-5D-5 L scores, while paper-based interventions significantly improved PSS, and EQ-5D-5 L scores. Patient adherence rate was 76.6%. CONCLUSION Overall, the Silvia program was effective for improving self-reported memory failures, stress, anxiety, and health-related quality of life in older adults with SCD. However, longer periods of administration for more than 12 weeks may be needed to achieve significant improvements in cognitive function by objective measures.
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Affiliation(s)
| | | | | | | | | | - Mina Heo
- Gwangju Alzheimer’s Disease and Related Dementia Cohort Research Center, Chosun University, Gwangju, South Korea
| | - Hoowon Kim
- Department of Neurology, School of Medicine, Chosun University, Chosun University Hospital, Gwangju, South Korea
| | - Ji Yeon Chung
- Department of Neurology, School of Medicine, Chosun University, Chosun University Hospital, Gwangju, South Korea
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Perus L, Busto GU, Mangin JF, Le Bars E, Gabelle A. Effects of preventive interventions on neuroimaging biomarkers in subjects at-risk to develop Alzheimer's disease: A systematic review. Front Aging Neurosci 2022; 14:1014559. [PMID: 36506466 PMCID: PMC9730537 DOI: 10.3389/fnagi.2022.1014559] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/01/2022] [Indexed: 11/25/2022] Open
Abstract
Alzheimer's Disease (AD) is a multifactorial and complex neurodegenerative disorder. Some modifiable risk factors have been associated with an increased risk of appearance of the disease and/or cognitive decline. Preventive clinical trials aiming at reducing one or combined risk factors have been implemented and their potential effects assessed on cognitive trajectories and on AD biomarkers. However, the effect of interventions on surrogate markers, in particular imaging biomarkers, remains poorly understood. We conducted a review of the literature and analyzed 43 interventional studies that included physical exercise, nutrition, cognitive training or multidomain interventions, and assessed various brain imaging biomarkers, to determine the effects of preventive interventions on imaging biomarkers for subjects at-risk to develop AD. Deciphering the global and regional brain effect of each and combined interventions will help to better understand the interplay relationship between multimodal interventions, cognition, surrogate brain markers, and to better design primary and secondary outcomes for future preventive clinical trials. Those studies were pondered using generally-admitted quality criteria to reveal that interventions may affect the brain of patients with cognitive impairment rather than those without cognitive impairment thus indicating that particular care should be taken when selecting individuals for interventions. Additionally, a majority of the studies concurred on the effect of the interventions and particularly onto the frontal brain areas.
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Affiliation(s)
- Lisa Perus
- INM, Univ Montpellier, INSERM, CHU Montpellier, Montpellier, France,Department of Neurology, Memory Resources and Research Center, Gui de Chauliac Hospital, Montpellier, France,Institut d'Imagerie Fonctionnelle Humaine, I2FH, Department of Neuroradiology, Gui de Chauliac Hospital and University of Montpellier, Montpellier, France,CATI, US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France
| | - Germain U. Busto
- INM, Univ Montpellier, INSERM, CHU Montpellier, Montpellier, France,Department of Neurology, Memory Resources and Research Center, Gui de Chauliac Hospital, Montpellier, France,*Correspondence: Germain U. Busto
| | - Jean-François Mangin
- CATI, US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France,Université Paris-Saclay, CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France
| | - Emmanuelle Le Bars
- Institut d'Imagerie Fonctionnelle Humaine, I2FH, Department of Neuroradiology, Gui de Chauliac Hospital and University of Montpellier, Montpellier, France
| | - Audrey Gabelle
- INM, Univ Montpellier, INSERM, CHU Montpellier, Montpellier, France,Department of Neurology, Memory Resources and Research Center, Gui de Chauliac Hospital, Montpellier, France
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Jeun YJ, Nam Y, Lee SA, Park JH. Effects of Personalized Cognitive Training with the Machine Learning Algorithm on Neural Efficiency in Healthy Younger Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13044. [PMID: 36293619 PMCID: PMC9602107 DOI: 10.3390/ijerph192013044] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/05/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
To date, neural efficiency, an ability to economically utilize mental resources, has not been investigated after cognitive training. The purpose of this study was to provide customized cognitive training and confirm its effect on neural efficiency by investigating prefrontal cortex (PFC) activity using functional near-infrared spectroscopy (fNIRS). Before training, a prediction algorithm based on the PFC activity with logistic regression was used to predict the customized difficulty level with 86% accuracy by collecting data when subjects performed four kinds of cognitive tasks. In the next step, the intervention study was designed using one pre-posttest group. Thirteen healthy adults participated in the virtual reality (VR)-based spatial cognitive training, which was conducted four times a week for 30 min for three weeks with customized difficulty levels for each session. To measure its effect, the trail-making test (TMT) and hemodynamic responses were measured for executive function and PFC activity. During the training, VR-based spatial cognitive performance was improved, and hemodynamic values were gradually increased as the training sessions progressed. In addition, after the training, the performance on the trail-making task (TMT) demonstrated a statistically significant improvement, and there was a statistically significant decrease in the PFC activity. The improved performance on the TMT coupled with the decreased PFC activity could be regarded as training-induced neural efficiency. These results suggested that personalized cognitive training could be effective in improving executive function and neural efficiency.
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Affiliation(s)
- Yu Jin Jeun
- Department of ICT Convergence, Graduate School of Soonchunhyang University, Asan 31538, Korea
| | - Yunyoung Nam
- Department of Computer Science, Engineering Soonchunhyang University, Asan 31538, Korea
| | - Seong A Lee
- Department of Occupational Therapy, Soonchunhyang University, Asan 31538, Korea
| | - Jin-Hyuck Park
- Department of Occupational Therapy, Soonchunhyang University, Asan 31538, Korea
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Mendes L, Oliveira J, Barbosa F, Castelo-Branco M. A Conceptual View of Cognitive Intervention in Older Adults With and Without Cognitive Decline-A Systemic Review. FRONTIERS IN AGING 2022; 3:844725. [PMID: 35821828 PMCID: PMC9261456 DOI: 10.3389/fragi.2022.844725] [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] [Received: 12/28/2021] [Accepted: 02/28/2022] [Indexed: 11/17/2022]
Abstract
Background: Dementia is the one of the most common and prominent disease in the elderly person that results in the Cognitive interventions. In this study, we aim to conceptualize the cognitive intervention for older adults with and without cognitive dysfunction and to clarify the heterogeneity existing in this literature field by determining the main variables implicated. Methods: We conducted a study analysis using previous literature highlighting the significant data reporting empirical results from cognitive intervention for healthy older adults and other seniors with different types of dementia. Each paper was reviewed in terms of compensatory cognitive training, cognitive remediation, enrichment, cognitive activation, brain training, cognitive stimulation, cognitive training, and cognitive rehabilitation. The research analysis was performed following rigorous inclusion and exclusion criteria with the purpose of collecting relevant answers to our research questions. Results: We included a total of 168 studies in our review. Our findings indicated heterogeneity regarding methods, concepts, and procedures. Additionally, the values were integrated using different information existing in this field. Conclusion: In conclusion, we highlighted that this is the first review that clarify the discrepancy of various existing definitions, methods, and procedures, as well as the overlapping information in the cognitive interventions.
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Affiliation(s)
- Liliana Mendes
- Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Joana Oliveira
- Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Fernando Barbosa
- Faculty of Psychology and Education Science, University of Porto, Porto, Portugal
| | - Miguel Castelo-Branco
- Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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Liu W, Li J, Li L, Zhang Y, Yang M, Liang S, Li L, Dai Y, Chen L, Jia W, He X, Lin H, Tao J. Enhanced Medial Prefrontal Cortex and Hippocampal Activity Improves Memory Generalization in APP/PS1 Mice: A Multimodal Animal MRI Study. Front Cell Neurosci 2022; 16:848967. [PMID: 35386301 PMCID: PMC8977524 DOI: 10.3389/fncel.2022.848967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 02/08/2022] [Indexed: 02/03/2023] Open
Abstract
Memory generalization allows individuals to extend previously learned movement patterns to similar environments, contributing to cognitive flexibility. In Alzheimer’s disease (AD), the disturbance of generalization is responsible for the deficits of episodic memory, causing patients with AD to forget or misplace things, even lose track of the way home. Cognitive training can effectively improve the cognition of patients with AD through changing thinking mode and memory flexibility. In this study, a T-shaped maze was utilized to simulate cognitive training in APP/PS1 mice to elucidate the potential mechanisms of beneficial effects after cognitive training. We found that cognitive training conducted by a T-shaped maze for 4 weeks can improve the memory generalization ability of APP/PS1 mice. The results of functional magnetic resonance imaging (fMRI) showed that the functional activity of the medial prefrontal cortex (mPFC) and hippocampus was enhanced after cognitive training, and the results of magnetic resonance spectroscopy (MRS) showed that the neurochemical metabolism of N-acetyl aspartate (NAA) and glutamic acid (Glu) in mPFC, hippocampus and reuniens (Re) thalamic nucleus were escalated. Furthermore, the functional activity of mPFC and hippocampus was negatively correlated with the escape latency in memory generalization test. Therefore, these results suggested that cognitive training might improve memory generalization through enhancing the functional activity of mPFC and hippocampus and increasing the metabolism of NAA and Glu in the brain regions of mPFC, hippocampus and Re nucleus.
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Affiliation(s)
- Weilin Liu
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jianhong Li
- TCM Rehabilitation Research Center of SATCM, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Le Li
- TCM Rehabilitation Research Center of SATCM, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yuhao Zhang
- TCM Rehabilitation Research Center of SATCM, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Minguang Yang
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Shengxiang Liang
- TCM Rehabilitation Research Center of SATCM, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Long Li
- TCM Rehabilitation Research Center of SATCM, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yaling Dai
- TCM Rehabilitation Research Center of SATCM, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Lewen Chen
- TCM Rehabilitation Research Center of SATCM, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Weiwei Jia
- TCM Rehabilitation Research Center of SATCM, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xiaojun He
- TCM Rehabilitation Research Center of SATCM, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Huawei Lin
- TCM Rehabilitation Research Center of SATCM, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jing Tao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- *Correspondence: Jing Tao,
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Determinants of Adherence to a “GRADIOR” Computer-Based Cognitive Training Program in People with Mild Cognitive Impairment (MCI) and Mild Dementia. J Clin Med 2022; 11:jcm11061714. [PMID: 35330040 PMCID: PMC8955227 DOI: 10.3390/jcm11061714] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Computer-based programs have been implemented from a psychosocial approach for the care of people with dementia (PwD). However, several factors may determine adherence of older PwD to this type of treatment. The aim of this paper was to identify the sociodemographic, cognitive, psychological, and physical-health determinants that helped predict adherence or not to a “GRADIOR” computerized cognitive training (CCT) program in people with mild cognitive impairment (MCI) and mild dementia. Method: This study was part of a randomized clinical trial (RCT) (ISRCTN: 15742788). However, this study will only focus on the experimental group (n = 43) included in the RCT. This group was divided into adherent people (compliance: ≥60% of the sessions and persistence in treatment up to 4 months) and non-adherent. The participants were 60–90 age and diagnosed with MCI and mild dementia. We selected from the evaluation protocol for the RCT, tests that evaluated cognitive aspects (memory and executive functioning), psychological and physical health. The CCT with GRADIOR consisted of attending 2–3 weekly sessions for 4 months with a duration of 30 min Data analysis: Phi and Biserial-point correlations, a multiple logical regression analysis was obtained to find the adherence model and U Mann–Whitney was used. Results: The adherence model was made up of the Digit Symbol and Arithmetic of Wechsler Adult Intelligence Scale (WAIS-III) and Lexical Verbal Fluency (LVF) -R tests. This model had 90% sensitivity, 50% specificity and 75% precision. The goodness-of-fit p-value of the model was 0.02. Conclusions: good executive functioning in attention, working memory (WM), phonological verbal fluency and cognitive flexibility predicted a greater probability that a person would be adherent.
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12
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Diaz Baquero AA, Franco-Martín MA, Parra Vidales E, Toribio-Guzmán JM, Bueno-Aguado Y, Martínez Abad F, Perea Bartolomé MV, Asl AM, van der Roest HG. The Effectiveness of GRADIOR: A Neuropsychological Rehabilitation Program for People with Mild Cognitive Impairment and Mild Dementia. Results of a Randomized Controlled Trial After 4 and 12 Months of Treatment. J Alzheimers Dis 2022; 86:711-727. [PMID: 35124649 PMCID: PMC9028667 DOI: 10.3233/jad-215350] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Computer-based cognitive training programs have been developed with promising results on the maintenance/improvement of cognitive performance in people with dementia. OBJECTIVE The objective was to evaluate the effectiveness of the cognitive rehabilitation program "GRADIOR" in people with mild cognitive impairment and mild dementia. METHOD This study was a single-blind multicenter randomized clinical trial. Participants were recruited from hospitals/day centers. The experimental group (EG) and control group (CG) received computer-based cognitive training (CCT) and routine daily care, respectively. Outcome measures at T0: baseline, T1: at 4 months, T2: at 12 months were compared within and between-groups. RESULTS Significant differences or important effect sizes were detected at the intragroup and intergroup level for most variables, observing a trend of improvement and/or maintenance at 4 months by Visual Reasoning of Cambridge Cognitive Examination (CAMCOG), Digit and Arithmetic of WAIS-III, Semantic Verbal Fluency, Mini-Mental State Exam (MMSE), Trail Making Test (TMT)-A-Mistakes and at 12 months by Visual Reasoning of CAMCOG, Digit Symbol of WAIS-III, TMT-B-mistakes, Visual Memory of Rivermead Behavioural Memory Test, Lexical Verbal Fluency-P, Yesavage's Geriatric Depression Scale (GDS), TMT-A-time scales whose objective was to evaluate some executive functions and/or the memory. The CG presented a worsening trend for most of the measures towards 12 months. There was also a significant interaction between "time and group" for MMSE (F = 8.971; p = 0.03; η 2 = 0.019) and the GDS (F = 3.414; p = 0.04; η 2 = 0.041), as well as small effect sizes for TMT-A-time (F = 1.641; p = 0.21; η 2 = 0.021) and TMT-A-mistakes (F = 0.908; p = 0.41; η 2 = 0.019). CONCLUSION CCT with GRADIOR has been proved to benefit cognitive functions (ISRCTN:15742788).
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Affiliation(s)
- Angie A Diaz Baquero
- Institute of Biomedical Research of Salamanca, University of Salamanca, Salamanca, Spain.,Department of Psychiatric, Rio Hortega University Hospital, Valladolid, Spain.,Department of Psychiatric, Zamora Healthcare Complex, Zamora, Spain.,IBIP Center for Clinical Care in Mental Health and Aging, INTRAS Foundation, Zamora, Spain.,Department of Research and Development, Iberico Institute for Research in Psychoscience (IBIP), INTRAS Foundation, Zamora, Spain
| | - Manuel A Franco-Martín
- Department of Psychiatric, Rio Hortega University Hospital, Valladolid, Spain.,Department of Psychiatric, Zamora Healthcare Complex, Zamora, Spain
| | - Esther Parra Vidales
- IBIP Center for Clinical Care in Mental Health and Aging, INTRAS Foundation, Zamora, Spain
| | - José Miguel Toribio-Guzmán
- Department of Research and Development, Iberico Institute for Research in Psychoscience (IBIP), INTRAS Foundation, Zamora, Spain
| | - Yolanda Bueno-Aguado
- Department of Gradior and Cognitive Research, INTRAS Foundation, Valladolid, Spain
| | | | - María V Perea Bartolomé
- Basic Psychology, Psychobiology and Methodology Department, Salamanca University, Salamanca, Spain
| | - Aysan Mahmoudi Asl
- Department of Research and Development, Iberico Institute for Research in Psychoscience (IBIP), INTRAS Foundation, Zamora, Spain
| | - Henriëtte G van der Roest
- Department on Aging, Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, The Netherlands
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13
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Dias TEDM, Cavalcanti FFL, Machado-Pinheiro W, Costa ADS, Conde EFQ. Spatial incompatibility training can prevent the occurrence of the enhanced Simon effect in elderly. ESTUDOS DE PSICOLOGIA (CAMPINAS) 2022. [DOI: 10.1590/1982-0275202239e210055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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14
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Tawfik HM, Tsatali M, Hassanin HI. Pilot feasibility study of cognitive training exercises for Egyptian adults: Proof of concept. Int J Geriatr Psychiatry 2021; 37. [PMID: 34569644 DOI: 10.1002/gps.5624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/06/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Cognitive training exercises (CTE) are promising and effective interventions to enhance cognitive reserve and slowdown cognitive deterioration in people with subjective memory impairment (SCI) and mild cognitive impairment (MCI). In this pilot study, we aimed to assess the feasibility of CTE among Egyptian adults. METHODS Eighteen participants above 40 years old were recruited. They underwent baseline neuropsychological assessment and functional assessment. However, after receiving a 6 weeks' cognitive training, eight participants (seven with MCI and one was cognitively intact) dropped out from the study. Finally, 10 participants (8 participants with MCI, 1 with SCI and 1 was cognitively intact) completed 12 weeks of CTE and undergone the post-assessment afterward. CTE included visual, verbal, memory, executive function, visuospatial, attention, and psychokinetic exercises through onsite and home-based sessions. RESULTS For the 10 participants who completed 12 weeks of CTE, the Wilcoxon signed-rank test showed a statistically significant change in the scores of mini-mental state examination (Z = -2.546, p = 0.011), semantic fluency test (Z = -2.913, p = 0.004), subjective memory complaint questionnaire (Z = -2.913, p = 0.004), Consortium to Establish a Registry for Alzheimer's Disease Word List (first trial: Z = -2.641, p = 0.008; Word list recall: Z = -2.825, p = 0.005), construction abilities (immediate: Z = -2.121, p = 0.034; delayed recall: Z = -2.414, p = 0.016), and Digit span test (forward: Z = -2.724, p = 0.006; backward: Z = -2.724, p = 0.006). CONCLUSIONS The results of this study suggested that CTE are feasible among Egyptian adults, especially those with MCI, and potentially effective in enhancing global cognition and after 12 weeks of training. Future research should shed light on the efficacy of longitudinal CTE implementation in Arab adults' populations.
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Affiliation(s)
- Heba M Tawfik
- Geriatrics and Gerontology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
- Ain Shams Ageing Research Center, Ain Shams Cognitive Training Lab, Cairo, Egypt
| | - Marianna Tsatali
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
- City College, University of York Europe campus, Thessaloniki, Greece
| | - Hany I Hassanin
- Geriatrics and Gerontology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
- Ain Shams Ageing Research Center, Ain Shams Cognitive Training Lab, Cairo, Egypt
- Global Brain Health Institute, Trinity College Dublin, Ireland and University of California San Francisco, San Francisco, California, USA
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15
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Nguyen L, Murphy K, Andrews G. A Game a Day Keeps Cognitive Decline Away? A Systematic Review and Meta-Analysis of Commercially-Available Brain Training Programs in Healthy and Cognitively Impaired Older Adults. Neuropsychol Rev 2021; 32:601-630. [PMID: 34251578 DOI: 10.1007/s11065-021-09515-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/15/2021] [Indexed: 12/31/2022]
Abstract
The rising prevalence rates of age-related cognitive impairment are a worldwide public concern, bringing about a surge in the number of "brain training" programs commercially available to the general public. Numerous companies advertise that their products improve memory and protect against cognitive decline, though researchers have voiced concerns regarding the validity of such claims. To address this issue, the current meta-analytic investigation examined evidence from 43 studies (encompassing 2,636 participants) to evaluate the efficacy of commercial training programs within two separate populations: healthy older adults and older adults with mild cognitive-impairment (MCI). Seven programs were identified: BrainGymmer, BrainHQ, CogMed, CogniFit, Dakim, Lumosity, and MyBrainTrainer. Analyses yielded small, significant near-transfer effects for both healthy and MCI samples. Far-transfer was not observed for the MCI sample, whereas a small, significant effect was found for subjective but not objective measures of far-transfer in the healthy sample. Analyses of individual domains (combining near-and far-transfer outcomes) yielded significant transfer to executive-functioning, memory, and processing-speed in healthy older adults. After adjusting for publication bias, only the effect size for processing speed remained significant. Transfer to attention, objective everyday functioning, fluid-intelligence, and visuospatial domains was not significant. Thus, whilst "brain training" may be suitable for enjoyment and entertainment purposes, there is currently insufficient empirical evidence to support that such training can improve memory, general cognition, or everyday functioning. This area of research is still in its infancy and warrants further investigation to provide more substantial evidence regarding the efficacy of this rapidly expanding industry.
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Affiliation(s)
- Lan Nguyen
- School of Applied Psychology, Griffith University, Griffith University, Gold Coast, QLD 4222, Australia.
| | - Karen Murphy
- School of Applied Psychology, Griffith University, Griffith University, Gold Coast, QLD 4222, Australia
| | - Glenda Andrews
- School of Applied Psychology, Griffith University, Griffith University, Gold Coast, QLD 4222, Australia
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16
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Alaimo C, Campana E, Stoppelli MR, Gobbi E, Baglio F, Rossetto F, Binetti G, Zanetti O, Manenti R, Cotelli M. Cognitive Tele-Enhancement in Healthy Older Adults and Subjects With Subjective Memory Complaints: A Review. Front Neurol 2021; 12:650553. [PMID: 34290660 PMCID: PMC8287022 DOI: 10.3389/fneur.2021.650553] [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: 01/07/2021] [Accepted: 06/03/2021] [Indexed: 11/13/2022] Open
Abstract
Background: In recent years, emphasis has been placed on cognitive enhancement to stimulate cognitive abilities and prevent functional decline. Considering that traditional face-to-face interventions can be very expensive and are not accessible to all individuals, the need to transfer care from the clinic to the patient's home is evident. In this regard, cognitive tele-enhancement interventions have received increased attention. Aim: The aim of this review was to provide an overview of protocols that apply remotely controlled cognitive training with individualized feedback on performance by the therapist in healthy older adults or participants with subjective memory complaints. Methods: Out of 35 articles assessed for eligibility, eight studies were identified. Of the selected studies, five included cognitively healthy older adults, while three included participants with subjective memory complaints. Results: Most of the reviewed studies showed beneficial effects of cognitive tele-enhancement interventions, reporting improvements in memory, sustained attention, working memory, executive functions, and language abilities. Moreover, reductions in anxiety and depression symptomatology levels, as well as in subjective memory difficulties, were described in some of the studies. Conclusions: Cognitive tele-enhancement treatment could be a good alternative to face-to-face intervention. This literature review highlights the importance of applying preventive cognitive interventions to subjects with initial subjective memory complaints. Remote modalities seem to facilitate the application of such interventions.
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Affiliation(s)
- Cristina Alaimo
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elena Campana
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Maria Rachele Stoppelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elena Gobbi
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | | | - Giuliano Binetti
- Macroattività Ambulatoriale Complessa (MAC) Memory Clinic and Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Orazio Zanetti
- Alzheimer's Research Unit, Macroattività Ambulatoriale Complessa (MAC) Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Rosa Manenti
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Maria Cotelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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17
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Reynolds GO, Willment K, Gale SA. Mindfulness and Cognitive Training Interventions in Mild Cognitive Impairment: Impact on Cognition and Mood. Am J Med 2021; 134:444-455. [PMID: 33385339 DOI: 10.1016/j.amjmed.2020.10.041] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 10/26/2020] [Accepted: 10/28/2020] [Indexed: 12/29/2022]
Abstract
With the lack of disease-modifying pharmacologic treatments for mild cognitive impairment and dementia, there has been an increasing clinical and research focus on nonpharmacological interventions for these disorders. Many treatment approaches, such as mindfulness and cognitive training, aim to mitigate or delay cognitive decline, particularly in early disease stages, while also offering potential benefits for mood and quality of life. In this review, we highlight the potential of mindfulness and cognitive training to improve cognition and mood in mild cognitive impairment. Emerging research suggests that these approaches are feasible and safe in this population, with preliminary evidence of positive effects on aspects of cognition (attention, psychomotor function, memory, executive function), depression, and anxiety, though some findings have been unclear or limited by methodological weaknesses. Even so, mindfulness and cognitive training warrant inclusion as current treatments for adults with mild cognitive impairment, even if there is need for additional research to clarify treatment outcomes and questions related to dose, mechanisms, and transfer and longevity of treatment effects.
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Affiliation(s)
| | - Kim Willment
- Department of Neurology, Brigham and Women's Hospital, Boston, Mass
| | - Seth A Gale
- Department of Neurology, Brigham and Women's Hospital, Boston, Mass
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18
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Efficacy of cognitive intervention programs in amnesic mild cognitive impairment: A systematic review. Arch Gerontol Geriatr 2021; 94:104332. [PMID: 33486120 DOI: 10.1016/j.archger.2020.104332] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 12/20/2020] [Accepted: 12/22/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Amnesic mild cognitive impairment (aMCI) is considered a prodromal stage of Alzheimer's disease. Given the absence of an effective pharmacological treatment for aMCI, increasing numbers of studies are attempting to understand how cognitive interventions could benefit aMCI patients. The aim of this systematic review was to evaluate the current evidence regarding the efficacy on cognition of cognitive intervention programs in older adults with aMCI. METHODS We searched for randomized controlled trials and clinical trials published until March 2020 on PubMed, Web of Science, Cochrane Library, SCOPUS, and OTseeker. A total of 454 works were identified and 7 studies that met the inclusion criteria, were included in this review. PRISMA guidelines were followed and PEDro scale was included for the measurement of the quality of the selected studies. RESULTS Cognitive interventions showed positive effects on cognition. Cognitive training programs considerably enhanced the Mini Mental State Examination scores. However, no relevant differences in global cognition were found using other assessment tools as DRS-2 or ADAS-Cog Scale. Cognitive training and cognitive rehabilitation programs seemed to improve several cognitive domains as memory, language or executive function in aMCI patients in both post-training and at follow-up analysis. CONCLUSIONS Our findings support that cognitive interventions can be an effective option for people with aMCI. Cognitive interventions improved global cognitive function post-intervention, but also seemed to enhance some cognitive domains post-intervention and at follow-up. However, more studies are needed to analyze the potential benefits of cognitive intervention on aMCI.
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19
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Manenti R, Gobbi E, Baglio F, Macis A, Ferrari C, Pagnoni I, Rossetto F, Di Tella S, Alemanno F, Cimino V, Binetti G, Iannaccone S, Bramanti P, Cappa SF, Cotelli M. Effectiveness of an Innovative Cognitive Treatment and Telerehabilitation on Subjects With Mild Cognitive Impairment: A Multicenter, Randomized, Active-Controlled Study. Front Aging Neurosci 2020; 12:585988. [PMID: 33304267 PMCID: PMC7701275 DOI: 10.3389/fnagi.2020.585988] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/19/2020] [Indexed: 11/13/2022] Open
Abstract
Background In recent years, the potential usefulness of cognitive training procedures in normal aging and mild cognitive impairment (MCI) have received increased attention. Objective The main aim of this study was to evaluate the efficacy of the face-to-face cognitive virtual reality rehabilitation system (VRRS) and to compare it to that of face-to-face cognitive treatment as usual for individuals with MCI. Moreover, we assessed the possibility of prolonging the effects of treatment with a telerehabilitation system. Methods A total of 49 subjects with MCI were assigned to 1 of 3 study groups in a randomized controlled trial design: (a) those who received face-to-face cognitive VRRS (12 sessions of individualized cognitive rehabilitation over 4 weeks) followed by telerehabilitation (36 sessions of home-based cognitive VRRS training, three sessions for week); (b) those who received face-to-face cognitive VRRS followed by at-home unstructured cognitive stimulation (36 sessions of home-based unstructured cognitive stimulation, three sessions for week); and (c) those who received face-to-face cognitive treatment as usual (12 sessions of face-to-face cognitive treatment as usual). Results An improvement in memory, language and visuo-constructional abilities was observed after the end of face-to-face VRRS treatment compared to face-to-face treatment as usual. The application of home-based cognitive VRRS telerehabilitation seems to induce more maintenance of the obtained gains than home-based unstructured stimulation. Discussion The present study provides preliminary evidence in support of individualized VRRS treatment and telerehabilitation delivery for cognitive rehabilitation and should pave the way for future studies aiming at identifying optimal cognitive treatment protocols in subjects with MCI. Clinical Trial Registration www.ClinicalTrials.gov, identifier NCT03486704.
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Affiliation(s)
- Rosa Manenti
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elena Gobbi
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | - Ambra Macis
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Clarissa Ferrari
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Ilaria Pagnoni
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | - Sonia Di Tella
- IRCCS, Fondazione Don Carlo Gnocchi - ONLUS, Milan, Italy
| | - Federica Alemanno
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Hospital and Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | | | - Giuliano Binetti
- MAC Memory Clinic and Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Sandro Iannaccone
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Hospital and Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | | | - Stefano F Cappa
- NEtS, Scuola Universitaria Superiore IUSS-Pavia, Pavia, Italy.,IRCCS Fondazione Mondino, Pavia, Italy
| | - Maria Cotelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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20
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Simon SS, Castellani M, Belleville S, Dwolatzky T, Hampstead BM, Bahar‐Fuchs A. The design, evaluation, and reporting on non-pharmacological, cognition-oriented treatments for older adults: Results of a survey of experts. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2020; 6:e12024. [PMID: 32523978 PMCID: PMC7276188 DOI: 10.1002/trc2.12024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 03/11/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Cognitive decline and dementia significantly affect independence and quality of life in older adults; therefore, it is critical to identify effective cognition-oriented treatments (COTs; eg, cognitive training, rehabilitation) that can help maintain or enhance cognitive functioning in older adults, as well as reduce dementia risk or alleviate symptoms associated with pathological processes. METHODS The Cognitive Intervention Design Evaluation and Reporting (CIDER), a working group from the Non-Pharmacological Interventions Professional Interest Area (NPI-PIA) of the Alzheimer's Association conducted as survey in 2017 with experts in COTs worldwide. The survey's aims were three-fold: (1) determine the common attitudes, beliefs, and practices of experts involved in the COTs research targeting older people; (2) identify areas of relative agreement and disagreement among experts in the field; and (3) offer a critical review of the literature, including recommendations for future research. RESULTS The survey identified several areas of agreements among experts on critical features of COTs, and on study design and outcome measures. Nevertheless, there were some areas with relative disagreement. Critically, expert opinions were not always supported by scientific evidence, suggesting that methodologic improvements are needed regarding design, implementation, and reporting of COTs. There was a clear consensus that COTs provide benefits and should be offered to cognitively unimpaired older adults, mild cognitive impairment (MCI), and mild dementia, but opinions differed for moderate and severe dementia. In addition, there is no consensus on the potential role of COTs in dementia prevention, indicating that future research should prioritize this aspect. DISCUSSION Evidence of COTs in older adults is encouraging, but additional evidence is needed to enhance dementia prevention. Consensus building and guidelines in the field are critical to improve and accelerate the development of high-quality evidence for COTs in cognitively unimpaired older adults, and those with MCI and dementia.
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Affiliation(s)
- Sharon Sanz Simon
- Cognitive Neuroscience DivisionDepartment of NeurologyColumbia UniversityNew YorkNew York
- Old Age Research Group (PROTER)Department of PsychiatrySão Paulo Medical SchoolUniversity of São PauloSão PauloBrazil
| | - Mary Castellani
- Academic Unit for Psychiatry of Old AgeDepartment of PsychiatryUniversity of MelbourneMelbourneAustralia
| | - Sylvie Belleville
- Psychology DepartmentUniversité de MontréalMontrealCanada
- Research CenterInstitut Universitaire de Gériatrie de MontréalMontrealCanada
| | - Tzvi Dwolatzky
- Rambam Health Care Campus and Rappaport Faculty of MedicineTechnion—Israel Institute of TechnologyHaifaIsrael
| | - Benjamin M. Hampstead
- Mental Health ServiceVA Ann Arbor Healthcare SystemAnn ArborMichigan
- Neuropsychology SectionDepartment of PsychiatryUniversity of MichiganAnn ArborMichigan
| | - Alex Bahar‐Fuchs
- Academic Unit for Psychiatry of Old AgeDepartment of PsychiatryUniversity of MelbourneMelbourneAustralia
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21
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Irazoki E, Contreras-Somoza LM, Toribio-Guzmán JM, Jenaro-Río C, van der Roest H, Franco-Martín MA. Technologies for Cognitive Training and Cognitive Rehabilitation for People With Mild Cognitive Impairment and Dementia. A Systematic Review. Front Psychol 2020; 11:648. [PMID: 32373018 PMCID: PMC7179695 DOI: 10.3389/fpsyg.2020.00648] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 03/18/2020] [Indexed: 12/17/2022] Open
Abstract
Due to the growing number of older adults with cognitive impairment, it is essential to delay the onset and progression of cognitive decline and promote a healthy lifestyle. The rapid growth of technology has considerably advanced the field of computerized cognitive interventions. Consequently, traditional cognitive interventions are being adapted and new multimedia systems are being developed to encourage health and independent living in old age. The primary objective of this review was to identify cognitive stimulation, training and rehabilitation programs aimed at older people with mild cognitive impairment (MCI) and dementia. PsycINFO, Medline, CINAHL, Web of Science, PubMed, and CORDIS databases were searched from January 2008 to August 2018. Two researchers reviewed the potential studies individually for eligibility. Studies of computerized cognitive interventions for people with dementia and cognitive impairment were included if they clearly described objectives, users and functioning. A systematic review of the studies was carried out, providing a qualitative synthesis of the features and study characteristics of each software. Nineteen studies met the inclusion criteria, and 11 different cognitive stimulation, training, and rehabilitation programs were identified. The studies found on cognitive intervention software indicate the existence of various technological programs for people with MCI and dementia. On the overall, the programs were aimed at people with different clinical conditions, able to create specific treatments and personalized training, optimized for portable devices, and user-friendly. However, the selected programs differ from each other in terms of objectives, usage mode and characteristics, even if they were used for the same purposes. Therefore, the information obtained in the review may be relevant to distinguish between programs and select the one that best suits each user. Thus, more information about the features and context of use is needed as well as more clinical studies to be able to compare among computerized cognitive programs.
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Affiliation(s)
- Eider Irazoki
- Faculty of Psychology, University of Salamanca, Salamanca, Spain.,Department of Research and Development, Iberian Research Psycho-Sciences Institute, INTRAS Foundation, Zamora, Spain
| | - Leslie María Contreras-Somoza
- Faculty of Psychology, University of Salamanca, Salamanca, Spain.,Department of Research and Development, Iberian Research Psycho-Sciences Institute, INTRAS Foundation, Zamora, Spain
| | - José Miguel Toribio-Guzmán
- Department of Research and Development, Iberian Research Psycho-Sciences Institute, INTRAS Foundation, Zamora, Spain
| | | | - Henriëtte van der Roest
- Department on Aging, Netherlands Institute of Mental Health and Addiction (Trimbos-Institute), Utrecht, Netherlands
| | - Manuel A Franco-Martín
- Faculty of Psychology, University of Salamanca, Salamanca, Spain.,Department of Psychiatry, University Rio Hortega Hospital, Valladolid, Spain.,Zamora Hospital, Zamora, Spain
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22
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Fu L, Kessels RPC, Maes JHR. The effect of cognitive training in older adults: be aware of CRUNCH. AGING NEUROPSYCHOLOGY AND COGNITION 2020; 27:949-962. [DOI: 10.1080/13825585.2019.1708251] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Li Fu
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Roy P. C. Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Joseph H. R. Maes
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
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23
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Simon SS, Tusch ES, Feng NC, Håkansson K, Mohammed AH, Daffner KR. Is Computerized Working Memory Training Effective in Healthy Older Adults? Evidence from a Multi-Site, Randomized Controlled Trial. J Alzheimers Dis 2019; 65:931-949. [PMID: 30103334 DOI: 10.3233/jad-180455] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Developing effective interventions to attenuate age-related cognitive decline and prevent or delay the onset of dementia are major public health goals. Computerized cognitive training (CCT) has been marketed increasingly to older adults, but its efficacy remains unclear. Working memory (WM), a key determinant of higher order cognitive abilities, is susceptible to age-related decline and a relevant target for CCT in elders. OBJECTIVE To evaluate the efficacy of CCT focused on WM compared to an active control condition in healthy older adults. METHODS Eighty-two cognitively normal adults from two sites (USA and Sweden) were randomly assigned to Cogmed Adaptive or Non-Adaptive (active control) CCT groups. Training was performed in participants' homes, five days per week over five weeks. Changes in the performance of the Cogmed trained tasks, and in five neuropsychological tests (Trail Making Test Part A and Part B, Digit Symbol, Controlled Oral Word Association Test and Semantic Fluency) were used as outcome measures. RESULTS The groups were comparable at baseline. The Adaptive group showed robust gains in the trained tasks, and there was a time-by-group interaction for the Digit Symbol test, with significant improvement only after Adaptive training. In addition, the magnitude of the intervention effect was similar at both sites. CONCLUSION Home-based CCT Adaptive WM training appears more effective than Non-Adaptive training in older adults from different cultural backgrounds. We present evidence of improvement in trained tasks and on a demanding untrained task dependent upon WM and processing speed. The benefits over the active control group suggest that the Adaptive CCT gains were linked to providing a continuously challenging level of WM difficulty.
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Affiliation(s)
- Sharon S Simon
- Department of Neurology, Center for Brain/Mind Medicine, Division of Cognitive and Behavioral Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Erich S Tusch
- Department of Neurology, Center for Brain/Mind Medicine, Division of Cognitive and Behavioral Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Nicole C Feng
- Department of Neurology, Center for Brain/Mind Medicine, Division of Cognitive and Behavioral Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Krister Håkansson
- Division of Clinical Geriatrics, Department of NVS, Karolinska Insitutet, Stockholm, Sweden.,Department of Psychology, Linnaeus University, Växjö, Sweden
| | - Abdul H Mohammed
- Department of Psychology, Linnaeus University, Växjö, Sweden.,Center of Alzheimer Research, Department of Neurobiology, Karolinska Insitutet, Stockholm, Sweden
| | - Kirk R Daffner
- Department of Neurology, Center for Brain/Mind Medicine, Division of Cognitive and Behavioral Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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24
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Di Rosa E, Brigadoi S, Cutini S, Tarantino V, Dell'Acqua R, Mapelli D, Braver TS, Vallesi A. Reward motivation and neurostimulation interact to improve working memory performance in healthy older adults: A simultaneous tDCS-fNIRS study. Neuroimage 2019; 202:116062. [PMID: 31369810 DOI: 10.1016/j.neuroimage.2019.116062] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 07/25/2019] [Accepted: 07/27/2019] [Indexed: 01/12/2023] Open
Abstract
Several studies have evaluated the effect of anodal transcranial direct current stimulation (tDCS) over the prefrontal cortex (PFC) for the enhancement of working memory (WM) performance in healthy older adults. However, the mixed results obtained so far suggest the need for concurrent brain imaging, in order to more directly examine tDCS effects. The present study adopted a continuous multimodal approach utilizing functional near-infrared spectroscopy (fNIRS) to examine the interactive effects of tDCS combined with manipulations of reward motivation. Twenty-one older adults (mean age = 69.7 years; SD = 5.05) performed an experimental visuo-spatial WM task before, during and after the delivery of 1.5 mA anodal tDCS/sham over the left prefrontal cortex (PFC). During stimulation, participants received performance-contingent reward for every fast and correct response during the WM task. In both sessions, hemodynamic activity of the bilateral frontal, motor and parietal areas was recorded across the entire duration of the WM task. Cognitive functions and reward sensitivity were also assessed with standard measures. Results demonstrated a significant impact of tDCS on both WM performance and hemodynamic activity. Specifically, faster responses in the WM task were observed both during and after anodal tDCS, while no differences were found under sham control conditions. However, these effects emerged only when taking into account individual visuo-spatial WM capacity. Additionally, during and after the anodal tDCS, increased hemodynamic activity relative to sham was observed in the bilateral PFC, while no effects of tDCS were detected in the motor and parietal areas. These results provide the first evidence of tDCS-dependent functional changes in PFC activity in healthy older adults during the execution of a WM task. Moreover, they highlight the utility of combining reward motivation with prefrontal anodal tDCS, as a potential strategy to improve WM efficiency in low performing healthy older adults.
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Affiliation(s)
- Elisa Di Rosa
- Department of Neuroscience & Padova Neuroscience Center, University of Padova, Padova, Italy; Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, USA.
| | - Sabrina Brigadoi
- Department of Developmental Psychology, University of Padova, Padova, Italy; Department of Information Engineering, University of Padova, Padova, Italy
| | - Simone Cutini
- Department of Developmental Psychology, University of Padova, Padova, Italy; Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Vincenza Tarantino
- Department of Neuroscience & Padova Neuroscience Center, University of Padova, Padova, Italy; Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Roberto Dell'Acqua
- Department of Developmental Psychology, University of Padova, Padova, Italy; Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Daniela Mapelli
- Department of General Psychology, University of Padova, Padova, Italy
| | - Todd S Braver
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, USA
| | - Antonino Vallesi
- Department of Neuroscience & Padova Neuroscience Center, University of Padova, Padova, Italy; Brain Imaging and Neural Dynamics Research Group, IRCCS San Camillo Hospital, Venice, Italy
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25
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Hampshire A, Sandrone S, Hellyer PJ. A Large-Scale, Cross-Sectional Investigation Into the Efficacy of Brain Training. Front Hum Neurosci 2019; 13:221. [PMID: 31338032 PMCID: PMC6629869 DOI: 10.3389/fnhum.2019.00221] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 06/17/2019] [Indexed: 11/24/2022] Open
Abstract
Brain training is a large and expanding industry, and yet there is a recurrent and ongoing debate concerning its scientific basis or evidence for efficacy. Much of evidence for the efficacy of brain training within this debate is from small-scale studies that do not assess the type of “brain training,” the specificity of transfer effects, or the length of training required to achieve a generalized effect. To explore these factors, we analyze cross-sectional data from two large Internet-cohort studies (total N = 60,222) to determine whether cognition differs at the population level for individuals who report that they brain train on different devices, and across different timeframes, with programs in common use circa 2010–2013. Examining scores for an assessment of working-memory, reasoning and verbal abilities shows no cognitive advantages for individuals who brain train. This contrasts unfavorably with significant advantages for individuals who regularly undertake other cognitive pursuits such as computer, board and card games. However, finer grained analyses reveal a more complex relationship between brain training and cognitive performance. Specifically, individuals who have just begun to brain train start from a low cognitive baseline compared to individuals who have never engaged in brain training, whereas those who have trained for a year or more have higher working-memory and verbal scores compared to those who have just started, thus suggesting an efficacy for brain training over an extended period of time. The advantages in global function, working memory, and verbal memory after several months of training are plausible and of clinically relevant scale. However, this relationship is not evident for reasoning performance or self-report measures of everyday function (e.g., employment status and problems with attention). These results accord with the view that although brain training programs can produce benefits, these might extend to tasks that are operationally similar to the training regime. Furthermore, the duration of training regime required for effective enhancement of cognitive performance is longer than that applied in most previous studies.
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Affiliation(s)
- Adam Hampshire
- The Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, London, United Kingdom
| | - Stefano Sandrone
- The Computational, Cognitive and Clinical Neuroimaging Laboratory, Division of Brain Sciences, Imperial College London, London, United Kingdom
| | - Peter John Hellyer
- Centre for Neuroimaging Sciences, King's College London, London, United Kingdom
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26
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Beishon L, Evley R, Panerai RB, Subramaniam H, Mukaetova-Ladinska E, Robinson T, Haunton V. Effects of brain training on brain blood flow (The Cognition and Flow Study-CogFlowS): protocol for a feasibility randomised controlled trial of cognitive training in dementia. BMJ Open 2019; 9:e027817. [PMID: 31122994 PMCID: PMC6538045 DOI: 10.1136/bmjopen-2018-027817] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 04/11/2019] [Accepted: 04/29/2019] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Cognitive training is an emerging non-pharmacological treatment to improve cognitive and physical function in mild cognitive impairment (MCI) and early Alzheimer's disease (AD). Abnormal brain blood flow is a key process in the development of cognitive decline. However, no studies have explored the effects of cognitive training on brain blood flow in dementia. The primary aim of this study is to assess the feasibility for a large-scale, randomised controlled trial of cognitive training in healthy older adults (HC), MCI and early AD. METHODS AND ANALYSIS This study will recruit 60 participants, in three subgroups of 20 (MCI, HC, AD), from primary, secondary and community services. Participants will be randomised to a 12-week computerised cognitive training programme (five × 30 min sessions per week), or waiting-list control. Participants will undergo baseline and follow-up assessments of: mood, cognition, quality of life and activities of daily living. Cerebral blood flow will be measured at rest and during task activation (pretraining and post-training) by bilateral transcranial Doppler ultrasonography, alongside heart rate (3-lead ECG), end-tidal CO2 (capnography) and beat-to-beat blood pressure (Finometer). Participants will be offered to join a focus group or semistructured interview to explore barriers and facilitators to cognitive training in patients with dementia. Qualitative data will be analysed using framework analysis, and data will be integrated using mixed methods matrices. ETHICS AND DISSEMINATION Bradford Leeds Research Ethics committee awarded a favourable opinion (18/YH/0396). Results of the study will be published in peer-reviewed journals, and presented at national and international conferences on ageing and dementia. TRIALS REGISTRATION NUMBER NCT03656107; Pre-results.
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Affiliation(s)
- Lucy Beishon
- Cardiovascular Sciences, University of Leicester College of Medicine Biological Sciences and Psychology, Leicester, UK
| | - Rachel Evley
- Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - Ronney B Panerai
- Cardiovascular Sciences, University of Leicester College of Medicine Biological Sciences and Psychology, Leicester, UK
- NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, University of Leicester, Leicester, UK
| | - Hari Subramaniam
- The Evington Centre, Leicestershire Partnership NHSTrust, Leicester, UK
| | | | - Thompson Robinson
- Cardiovascular Sciences, University of Leicester College of Medicine Biological Sciences and Psychology, Leicester, UK
- NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, University of Leicester, Leicester, UK
| | - Victoria Haunton
- Cardiovascular Sciences, University of Leicester College of Medicine Biological Sciences and Psychology, Leicester, UK
- NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, University of Leicester, Leicester, UK
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27
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Flak MM, Hol HR, Hernes SS, Chang L, Engvig A, Bjuland KJ, Pripp A, Madsen BO, Knapskog AB, Ulstein I, Lona T, Skranes J, Løhaugen GCC. Adaptive Computerized Working Memory Training in Patients With Mild Cognitive Impairment. A Randomized Double-Blind Active Controlled Trial. Front Psychol 2019; 10:807. [PMID: 31031677 PMCID: PMC6473070 DOI: 10.3389/fpsyg.2019.00807] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 03/25/2019] [Indexed: 01/14/2023] Open
Abstract
Objective We investigated if a 5-week computerized adaptive working memory training program (Cogmed®) of 20 to 25 sessions would be effective in improving the working memory capacity and other neuropsychological functions compared to a non-adaptive working memory training program (active-controlled) in adult patients with mild cognitive impairment (MCI). Methods This randomized double-blinded active control trial included 68 individuals aged 43 to 88 years, 45 men and 23 women, who were diagnosed with MCI at four Memory clinics. The study sample was randomized by block randomization to either adaptive or non-adaptive computerized working memory training. All participants completed the training, and were assessed with a comprehensive neuropsychological test battery before the intervention, and at 1 and 4 months after training. Results Compared to the non-adaptive training group, the adaptive training group did not show significantly greater improvement on the main outcome of working memory performance at 1 and 4 months after training. Conclusion No difference were found between the two types of training on the primary outcome of working memory, or on secondary outcomes of cognitive function domains, in this sample of MCI patients. Hence, the hypothesis that the adaptive training program would lead to greater improvements compared to the non-adaptive training program was not supported. Within group analyses was not performed due to the stringent RCT design.
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Affiliation(s)
- Marianne M Flak
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Pediatrics, Sørlandet Hospital HF, Arendal, Norway
| | - Haakon R Hol
- Department of Radiology, Sørlandet Hospital HF, Arendal, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Susanne S Hernes
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Medicine, The Memory Clinic Geriatric Unit, Sørlandet Hospital, Arendal, Norway
| | - Linda Chang
- Department of Diagnostic Radiology and Nuclear Medicine, and Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States.,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Andreas Engvig
- Department of Medicine, Diakonhjemmet Hospital, Oslo, Norway
| | | | - Are Pripp
- Oslo Centre of Biostatistics and Epidemiology Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Bengt-Ove Madsen
- Department of Medicine, The Memory Clinic Geriatric Unit, Sørlandet Hospital, Arendal, Norway
| | - Anne-Brita Knapskog
- Department of Geriatric Medicine, The Memory Clinic, Oslo University Hospital, Oslo, Norway
| | - Ingun Ulstein
- Department of Geriatric Medicine, The Memory Clinic, Oslo University Hospital, Oslo, Norway
| | - Trine Lona
- Department of Psychiatry, Age Psychiatry, The Hospital of Telemark, Skien, Norway
| | - Jon Skranes
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Pediatrics, Sørlandet Hospital HF, Arendal, Norway
| | - Gro C C Løhaugen
- Department of Pediatrics, Sørlandet Hospital HF, Arendal, Norway
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28
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Simon SS, Hampstead BM, Nucci MP, Duran FLS, Fonseca LM, Martin MDGM, Ávila R, Porto FHG, Brucki SMD, Martins CB, Tascone LS, Amaro E, Busatto GF, Bottino CMC. Training gains and transfer effects after mnemonic strategy training in mild cognitive impairment: A fMRI study. Int J Psychophysiol 2019; 154:15-26. [PMID: 30936043 DOI: 10.1016/j.ijpsycho.2019.03.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 03/21/2019] [Accepted: 03/28/2019] [Indexed: 12/14/2022]
Abstract
Prior work has revealed that mnemonic strategy training (MST) can enhance memory for specific content and engages regions in the frontoparietal cognitive control network. Evidence of transfer to novel content is less clear. Here, we provide secondary analysis of functional magnetic resonance imaging (fMRI) data acquired during a randomized controlled trial that compared MST to an active education control condition in patients with amnestic mild cognitive impairment (a-MCI). In the trial, thirty participants with a-MCI were randomized to the education program (EP) or MST, where they learned to apply the technique to face-name associations during four intervening hour long training sessions. Participants underwent pre- and post-training fMRI scans, during which they encoded both the trained (i.e., those used during the four training sessions) and untrained ('novel') face-name associations. The primary cognitive outcome measures revealed significantly improved memory for both trained and novel stimuli - effects supporting near transfer of MST. Relative to pre-training, there were significant and highly similar increases in activation for both trained and novel stimuli, especially in regions associated with the frontoparietal cognitive control network bilaterally, but also in temporal areas related to social cognition and emotional processing. Critically, this pattern of activation was notably different from the EP group. Thus, the changes in activation were consistent with the strategies trained and, combined with the cognitively-based near transfer effects, suggest that MST focused on face-name association enhances performance by engaging cognitive control and social/emotional processing. Finally, our data indicated that our MST is a relevant and efficient intervention to a-MCI.
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Affiliation(s)
- Sharon S Simon
- Old Age Research Group (PROTER), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
| | - Benjamin M Hampstead
- Division of Neuropsychology, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Mariana P Nucci
- Neuroimagem funcional (NIF) - Laboratory of Medical Investigations on Magnetic Resonance Imaging (LIM-44), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Brazil
| | - Fábio L S Duran
- Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Luciana M Fonseca
- Old Age Research Group (PROTER), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Maria da Graça M Martin
- Neuroimagem funcional (NIF) - Laboratory of Medical Investigations on Magnetic Resonance Imaging (LIM-44), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Brazil
| | - Renata Ávila
- Old Age Research Group (PROTER), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Fábio H G Porto
- Old Age Research Group (PROTER), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Sônia M D Brucki
- Department of Neurology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Camila B Martins
- Department of Preventive Medicine, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Lyssandra S Tascone
- Old Age Research Group (PROTER), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil; Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Edson Amaro
- Neuroimagem funcional (NIF) - Laboratory of Medical Investigations on Magnetic Resonance Imaging (LIM-44), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Brazil
| | - Geraldo F Busatto
- Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Cássio M C Bottino
- Old Age Research Group (PROTER), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
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29
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Tang Y, Xing Y, Zhu Z, He Y, Li F, Yang J, Liu Q, Li F, Teipel SJ, Zhao G, Jia J. The effects of 7‐week cognitive training in patients with vascular cognitive impairment, no dementia (the Cog‐VACCINE study): A randomized controlled trial. Alzheimers Dement 2019; 15:605-614. [DOI: 10.1016/j.jalz.2019.01.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 12/26/2018] [Accepted: 01/09/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Yi Tang
- Department of NeurologyXuanwu HospitalCapital Medical UniversityBeijingChina
- Innovation Center for Neurological DisordersXuanwu HospitalCapital Medical UniversityBeijingChina
- Key Laboratory of Neurodegenerative DiseasesMinistry of Education of the People's Republic of ChinaBeijingChina
| | - Yi Xing
- Department of NeurologyXuanwu HospitalCapital Medical UniversityBeijingChina
- Innovation Center for Neurological DisordersXuanwu HospitalCapital Medical UniversityBeijingChina
- Key Laboratory of Neurodegenerative DiseasesMinistry of Education of the People's Republic of ChinaBeijingChina
| | - Zude Zhu
- Collaborative Innovation Center for Language AbilityJiangsu Normal UniversityXuzhouChina
| | - Yong He
- State Key Laboratory of Cognitive Neuroscience and LearningBeijingChina
- Beijing Key Laboratory of Brain Imaging and ConnectomicsBeijingChina
- IDG/McGovern Institute for Brain ResearchBeijing Normal UniversityBeijingChina
| | - Fang Li
- Department of GeriatricFu Xing HospitalCapital Medical UniversityBeijingChina
| | - Jianwei Yang
- Department of NeurologyXuanwu HospitalCapital Medical UniversityBeijingChina
- Innovation Center for Neurological DisordersXuanwu HospitalCapital Medical UniversityBeijingChina
- Key Laboratory of Neurodegenerative DiseasesMinistry of Education of the People's Republic of ChinaBeijingChina
| | - Qing Liu
- Department of NeurologyXuanwu HospitalCapital Medical UniversityBeijingChina
- Innovation Center for Neurological DisordersXuanwu HospitalCapital Medical UniversityBeijingChina
| | - Fangyu Li
- Department of NeurologyXuanwu HospitalCapital Medical UniversityBeijingChina
- Innovation Center for Neurological DisordersXuanwu HospitalCapital Medical UniversityBeijingChina
- Key Laboratory of Neurodegenerative DiseasesMinistry of Education of the People's Republic of ChinaBeijingChina
| | - Stefan J. Teipel
- Department of Psychosomatic MedicineUniversity Medicine RostockRostockGermany
- DZNEGerman Center for Neurodegenerative DiseasesRostockGermany
| | - Guoguang Zhao
- Department of NeurosurgeryXuanwu HospitalCapital Medical UniversityBeijingChina
| | - Jianping Jia
- Department of NeurologyXuanwu HospitalCapital Medical UniversityBeijingChina
- Innovation Center for Neurological DisordersXuanwu HospitalCapital Medical UniversityBeijingChina
- Key Laboratory of Neurodegenerative DiseasesMinistry of Education of the People's Republic of ChinaBeijingChina
- Center of Alzheimer's DiseaseBeijing Institute for Brain DisordersBeijingChina
- Beijing Key Laboratory of Geriatric Cognitive DisordersBeijingChina
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30
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Abstract
Mild cognitive impairment (MCI) represents a transitional stage between healthy aging and dementia, and affects 10-15% of the population over the age of 65. The failure of drug trials in Alzheimer's disease (AD) treatment has shifted researchers' focus toward delaying progression from MCI to dementia, which would reduce the prevalence and costs of dementia profoundly. Diagnostic criteria for MCI increasingly emphasize the need for positive biomarkers to detect preclinical AD. The phenomenology of MCI comprises lower quality-of-life, greater symptoms of depression, and avoidant coping strategies including withdrawal from social engagement. Neurobiological features of MCI are hypoperfusion and hypometabolism in temporoparietal cortices, medial temporal lobe atrophy particularly in rhinal cortices, elevated tau and phosphorylated tau and decreased Aβ42 in cerebrospinal fluid, and brain Aβ42 deposition. Elevated tau can be identified in MCI, particularly in the entorhinal cortex, using positron emission tomography, and analysis of signal complexity using electroencephalography or magnetoencephalography holds promise as a biomarker. Assessment of MCI also relies on cognitive screening and neuropsychological assessment, but there is an urgent need for standardized cognitive tests to capitalize on recent discoveries in cognitive neuroscience that may lead to more sensitive measures of MCI. Cholinesterase inhibitors are frequently prescribed for MCI, despite the lack of evidence for their efficacy. Exercise and diet interventions hold promise for increasing reserve in MCI, and group psychoeducational programs teaching practical memory strategies appear effective. More work is needed to better understand the phenomenology and neurobiology of MCI, and how best to assess it and delay progression to dementia.
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31
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Zhang H, Wang Z, Wang J, Lyu X, Wang X, Liu Y, Zeng X, Yuan H, Wang H, Yu X. Computerized multi-domain cognitive training reduces brain atrophy in patients with amnestic mild cognitive impairment. Transl Psychiatry 2019; 9:48. [PMID: 30705261 PMCID: PMC6355814 DOI: 10.1038/s41398-019-0385-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 10/26/2018] [Accepted: 01/01/2019] [Indexed: 01/23/2023] Open
Abstract
The present study aimed to explore the effect of computerized multi-domain cognitive training (MDCT) on brain gray matter volume and neuropsychological performance in patients with amnestic mild cognitive impairment (amnestic MCI). Twenty-one patients with amnestic MCI participated in a computerized MDCT program. The program targeted a broad set of cognitive domains via programs focused on reasoning, memory, visuospatial, language, calculation, and attention. Seventeen Participants completed the intervention and all completed a battery of neuropsychological tests to evaluate cognitive function while 12 out of 17 underwent 3 T MRI scanning before and after the intervention to measure gray matter (GM) volume. We examined correlations between the changes in neuropsychological scores and GM volumes across participants after the intervention. After training, we observed significant increases in GM volume in the right angular gyrus (AG) and other parietal subareas near the intraparietal sulcus (p < 0.05, FWE-corrected, 10000 permutations). However, we found no significant changes in neuropsychological test scores (p > 0.05). A correlation analysis revealed positive correlations between the changes in GM volume in the right AG and scores in the immediate recall component of the Hopkins Verbal Learning Test-Revised (HVLT-R) (r = 0.64, p = 0.024) and the Brief Visuospatial Memory Test-Revised (BVMT-R) (r = 0.67, p = 0.016). Our findings indicate that a computerized MDCT program may protect patients with amnestic MCI against brain GM volume loss and has potential in preserving general cognition. Thus, our non-pharmacological intervention may slow the rate of disease progression.
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Affiliation(s)
- Haifeng Zhang
- 0000 0001 2256 9319grid.11135.37Peking University Institute of Mental Health (Sixth Hospital), Beijing, 100191 China ,0000 0001 2256 9319grid.11135.37National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, 100191 China ,Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia, Beijing, 100191 China
| | - Zhijiang Wang
- Peking University Institute of Mental Health (Sixth Hospital), Beijing, 100191, China. .,National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, 100191, China. .,Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia, Beijing, 100191, China.
| | - Jing Wang
- 0000 0001 2256 9319grid.11135.37Peking University Institute of Mental Health (Sixth Hospital), Beijing, 100191 China ,0000 0001 2256 9319grid.11135.37National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, 100191 China ,Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia, Beijing, 100191 China
| | - Xiaozhen Lyu
- 0000 0001 2256 9319grid.11135.37Peking University Institute of Mental Health (Sixth Hospital), Beijing, 100191 China ,0000 0001 2256 9319grid.11135.37National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, 100191 China ,Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia, Beijing, 100191 China
| | - Xiao Wang
- 0000 0001 2256 9319grid.11135.37Peking University Institute of Mental Health (Sixth Hospital), Beijing, 100191 China ,0000 0001 2256 9319grid.11135.37National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, 100191 China ,Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia, Beijing, 100191 China
| | - Ying Liu
- 0000 0004 0605 3760grid.411642.4Peking University Third Hospital, Beijing, 100191 China
| | - Xiangzhu Zeng
- 0000 0004 0605 3760grid.411642.4Peking University Third Hospital, Beijing, 100191 China
| | - Huishu Yuan
- 0000 0004 0605 3760grid.411642.4Peking University Third Hospital, Beijing, 100191 China
| | - Huali Wang
- Peking University Institute of Mental Health (Sixth Hospital), Beijing, 100191, China. .,National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, 100191, China. .,Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia, Beijing, 100191, China.
| | - Xin Yu
- 0000 0001 2256 9319grid.11135.37Peking University Institute of Mental Health (Sixth Hospital), Beijing, 100191 China ,0000 0001 2256 9319grid.11135.37National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, 100191 China ,Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia, Beijing, 100191 China
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García-Betances RI, Cabrera-Umpiérrez MF, Arredondo MT. Computerized neurocognitive interventions in the context of the brain training controversy. Rev Neurosci 2018; 29:55-69. [PMID: 28822228 DOI: 10.1515/revneuro-2017-0031] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 06/29/2017] [Indexed: 11/15/2022]
Abstract
This article presents, in the form of an analytic narrative review, a complete picture of the state-of-the-art, challenges, and perspectives in the field of information and communication technology (ICT)-based neurocognitive interventions for older adults. The narrative particularly focuses on applications aimed at mild cognitive impairment and similar age-related cognitive deficits, which are analyzed in the context of the brain training controversy. Clarifying considerations are provided about the nature and present extent of the brain training debate, regarding the possible influence it has on the support received by research and development initiatives dealing with innovative computerized neurocognitive interventions. It is recommended that, because of the preliminary nature of most data currently available in this area, further research initiatives must be supported in the quest for better effectiveness of computer-based interventions intended for age-related cognitive impairment. The conclusion suggests that advanced ICT-based tools, such as virtual and augmented reality technologies, are the most fitting platforms for applying nonpharmacological computerized neurocognitive interventions.
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Affiliation(s)
- Rebeca Isabel García-Betances
- Life Supporting Technologies (LifeSTech), Superior Technical School of Telecommunications Engineers (ETSIT), Universidad Politécnica de Madrid (UPM), Av. Complutense no. 30, Ciudad Universitaria, E-28040 Madrid, Spain
| | - María Fernanda Cabrera-Umpiérrez
- Life Supporting Technologies (LifeSTech), Superior Technical School of Telecommunications Engineers (ETSIT), Universidad Politécnica de Madrid (UPM), Av. Complutense no. 30, Ciudad Universitaria, E-28040 Madrid, Spain
| | - María T Arredondo
- Life Supporting Technologies (LifeSTech), Superior Technical School of Telecommunications Engineers (ETSIT), Universidad Politécnica de Madrid (UPM), Av. Complutense no. 30, Ciudad Universitaria, E-28040 Madrid, Spain
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Emmanouel A, Kontrafouri E, Nikolaos P, Kessels RPC, Fasotti L. Incorporation of a working memory strategy in GMT to facilitate serial-order behaviour in brain-injured patients. Neuropsychol Rehabil 2018; 30:888-914. [PMID: 30272538 DOI: 10.1080/09602011.2018.1517369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Goal Management Training (GMT) is an effective method for improving disorganised behaviour in multistep real-life tasks after brain damage. In the present study we incorporated Working Memory Training (WMT) in GMT to explore their combined efficacy in facilitating the serial-order maintenance of the steps that had to be learned. GMT+WMT was compared to a control WMT designed for other purposes. For this purpose 18 brain-injured patients (aged 20-54), who were at least 4 months post-onset, were randomly assigned to either the GMT+WMT or the WMT treatment. Inclusion was based on a baseline score of less than six correct steps on each of two multistep everyday tasks. Alternative versions of these tasks were used as primary outcome tasks. Pre-treatment and post-treatment comparisons of scores on these primary tasks and on several secondary neuropsychological measures were collected. The results show that post-treatment the GMT+WMT group performed significantly better than the WMT group on the primary outcome measures and on several ecologically valid executive tests that demanded a step-by-step maintenance of multiple actions. Time effects were found for both groups on the secondary measures. Other measures showed no significant differences. We conclude that our results support the efficacy of the combined GMT+WMT in facilitating performance in everyday multistep tasks.
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Affiliation(s)
- Anna Emmanouel
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands.,Department of Psychology, City College, International Faculty of the University of Sheffield, Thessaloniki, Greece
| | - Ellisavet Kontrafouri
- MSc International Medicine, Management of Health Crises, Medical School of Athens, Athens, Greece
| | - Psarras Nikolaos
- Neurosurgical Department, General Hospital of Papanikolaou, Thessaloniki, Greece.,Neurosurgical Department, Clinic of Saint Loukas, Thessaloniki, Greece
| | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands.,Department of Medical Psychology, Radboud University Medical Centre, Nijmegen, The Netherlands.,Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
| | - Luciano Fasotti
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands.,Rehabilitation Center Klimmendaal, Arnhem, The Netherlands
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Ge S, Zhu Z, Wu B, McConnell ES. Technology-based cognitive training and rehabilitation interventions for individuals with mild cognitive impairment: a systematic review. BMC Geriatr 2018; 18:213. [PMID: 30219036 PMCID: PMC6139138 DOI: 10.1186/s12877-018-0893-1] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 08/27/2018] [Indexed: 12/30/2022] Open
Abstract
Background Individuals with mild cognitive impairment (MCI) are at heightened risk of developing dementia. Rapid advances in computing technology have enabled researchers to conduct cognitive training and rehabilitation interventions with the assistance of technology. This systematic review aims to evaluate the effects of technology-based cognitive training or rehabilitation interventions to improve cognitive function among individuals with MCI. Methods We conducted a systematic review using the following criteria: individuals with MCI, empirical studies, and evaluated a technology-based cognitive training or rehabilitation intervention. Twenty-six articles met the criteria. Results Studies were characterized by considerable variation in study design, intervention content, and technologies applied. The major types of technologies applied included computerized software, tablets, gaming consoles, and virtual reality. Use of technology to adjust the difficulties of tasks based on participants’ performance was an important feature. Technology-based cognitive training and rehabilitation interventions had significant effect on global cognitive function in 8 out of 22 studies; 8 out of 18 studies found positive effects on attention, 9 out of 16 studies on executive function, and 16 out of 19 studies on memory. Some cognitive interventions improved non-cognitive symptoms such as anxiety, depression, and ADLs. Conclusion Technology-based cognitive training and rehabilitation interventions show promise, but the findings were inconsistent due to the variations in study design. Future studies should consider using more consistent methodologies. Appropriate control groups should be designed to understand the additional benefits of cognitive training and rehabilitation delivered with the assistance of technology. Electronic supplementary material The online version of this article (10.1186/s12877-018-0893-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shaoqing Ge
- Duke University School of Nursing, 307 Trent Drive, Durham, NC, USA.
| | - Zheng Zhu
- Fudan University School of Nursing, Shanghai, China.,Fudan University Center for Evidence-Based Nursing, a Joanna Briggs Institute Center of Excellence, Shanghai, China
| | - Bei Wu
- New York University Rory Meyers College of Nursing, New York, NY, USA.,Hartford Institute for Geriatric Nursing, New York University, New York, NY, USA
| | - Eleanor S McConnell
- Duke University School of Nursing, 307 Trent Drive, Durham, NC, USA.,Geriatric Research, Education and Clinical Center (GRECC) of the Department of Veterans Affairs Medical Center, Durham, NC, USA
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Djabelkhir-Jemmi L, Wu YH, Boubaya M, Marlats F, Lewis M, Vidal JS, Lenoir H, Charlieux B, Isabet B, Rigaud AS. Differential effects of a computerized cognitive stimulation program on older adults with mild cognitive impairment according to the severity of white matter hyperintensities. Clin Interv Aging 2018; 13:1543-1554. [PMID: 30214174 PMCID: PMC6121770 DOI: 10.2147/cia.s152225] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective This study aimed to explore whether a computerized cognitive stimulation program (CCS) induced differential effects in older adults with mild cognitive impairment (MCI) according to the severity of white matter hyperintensities (WMH), which are associated with cognitive impairment and increased risk of progression to Alzheimer’s disease because of the damage they cause to cortical and subcortical networks. Patients and methods Twenty-nine MCI patients with no or little WMH (MCI-non-WMH) and 22 MCI patients with moderate or severe WMH (MCI-WMH) attended a 24-session CCS program (two sessions per week for a duration of 3 months) focused on executive functions, attention, and processing speed. Cognitive and psychosocial assessments were performed at baseline, postintervention, and 3 months after the intervention. Results Both groups improved on several cognitive measures after the intervention. However, the MCI-non-WMH group improved on a higher number of cognitive measures than the MCI-WMH group. At postintervention assessment, CCS had a more beneficial effect on the MCI-non-WMH group than on the MCI-WMH group with regard to improving categorical fluency (4.6±6.8 vs 0.4±6.4; effect size=0.37; p=0.002). During the 3-month follow-up assessment, significantly higher score improvements were observed in the MCI-non-WMH group for the paired-associate learning test (6.4±3 vs 4.7±3.5 points; effect size=0.43; p=0.005) as well as categorical fluency (3.8±7.8 vs −0.7±6 points; effect size=0.55; p=0.0003). Conclusions These findings suggest that WMH severity was related to cognitive improvement induced by a CCS program and highlight the importance of considering WMH in interventional studies on subjects with MCI.
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Affiliation(s)
- Leila Djabelkhir-Jemmi
- Department of Clinical Gerontology, Broca Hospital-APHP, Paris, France, .,Research Team EA 4468, Alzheimer's Disease, Vascular Risk Factors and Diagnostic Markers, Care and Support for Patients and Families, Institute of Psychology of Paris Descartes University, Paris, France,
| | - Ya-Huei Wu
- Department of Clinical Gerontology, Broca Hospital-APHP, Paris, France, .,Research Team EA 4468, Alzheimer's Disease, Vascular Risk Factors and Diagnostic Markers, Care and Support for Patients and Families, Institute of Psychology of Paris Descartes University, Paris, France,
| | | | - Fabienne Marlats
- Department of Clinical Gerontology, Broca Hospital-APHP, Paris, France, .,Research Team EA 4468, Alzheimer's Disease, Vascular Risk Factors and Diagnostic Markers, Care and Support for Patients and Families, Institute of Psychology of Paris Descartes University, Paris, France,
| | - Manon Lewis
- Department of Clinical Gerontology, Broca Hospital-APHP, Paris, France,
| | - Jean-Sébastien Vidal
- Department of Clinical Gerontology, Broca Hospital-APHP, Paris, France, .,Research Team EA 4468, Alzheimer's Disease, Vascular Risk Factors and Diagnostic Markers, Care and Support for Patients and Families, Institute of Psychology of Paris Descartes University, Paris, France,
| | - Hermine Lenoir
- Department of Clinical Gerontology, Broca Hospital-APHP, Paris, France, .,Research Team EA 4468, Alzheimer's Disease, Vascular Risk Factors and Diagnostic Markers, Care and Support for Patients and Families, Institute of Psychology of Paris Descartes University, Paris, France,
| | - Benoit Charlieux
- Department of Clinical Gerontology, Broca Hospital-APHP, Paris, France,
| | - Baptiste Isabet
- Department of Clinical Gerontology, Broca Hospital-APHP, Paris, France,
| | - Anne-Sophie Rigaud
- Department of Clinical Gerontology, Broca Hospital-APHP, Paris, France, .,Research Team EA 4468, Alzheimer's Disease, Vascular Risk Factors and Diagnostic Markers, Care and Support for Patients and Families, Institute of Psychology of Paris Descartes University, Paris, France,
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Chan AS, Cheung WK, Yeung MK, Lee TL. Sustained Effects of Memory and Lifestyle Interventions on Memory Functioning of Older Adults: An 18-Month Follow-Up Study. Front Aging Neurosci 2018; 10:240. [PMID: 30131690 PMCID: PMC6090041 DOI: 10.3389/fnagi.2018.00240] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 07/20/2018] [Indexed: 12/19/2022] Open
Abstract
Background: There has been much research devoted to examining the short-term effects of different interventions for improving memory functioning of older adults with memory complaints. Nevertheless, very few studies have examined the long-term effects of these interventions. Thus, the present study compared the sustained effects of a conventional memory intervention (MI) and a Chinese lifestyle intervention on improving memory functioning in older adults. Methods: Twenty-nine older adults who were aged 60 years and older and had memory complaints were recruited. Each completed 10 weekly sessions of the Dejian Mind-body Intervention (DMBI; n = 11) or MI (n = 18) approximately 18 months ago. Participants’ verbal and visual memory functioning and their subjective impression of the changes of their memory performance and physical and psychological health status were evaluated. Results: Results showed significant improvements in memory in both intervention groups at the follow-up assessments when compared with baseline. In addition, older adults in both intervention groups perceived improved memory performance and physical and psychological wellness at follow-up, with the DMBI group reporting significantly greater improvements in physical health compared to the MI group. Conclusion: Altogether, the present study provides supportive evidence that the DMBI and MI might be two effective remedies for older adults to improve or preserve their memory functioning with relatively sustained effects.
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Affiliation(s)
- Agnes S Chan
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, Hong Kong.,Chanwuyi Research Center for Neuropsychological Well-Being, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Winnie K Cheung
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Michael K Yeung
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Tsz Lok Lee
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, Hong Kong
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Maidan I, Nieuwhof F, Bernad-Elazari H, Bloem BR, Giladi N, Hausdorff JM, Claassen JAHR, Mirelman A. Evidence for Differential Effects of 2 Forms of Exercise on Prefrontal Plasticity During Walking in Parkinson's Disease. Neurorehabil Neural Repair 2018; 32:200-208. [PMID: 29546797 DOI: 10.1177/1545968318763750] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND In a randomized control trial conducted in patients with Parkinson's disease, a treadmill training program combined with virtual reality that targeted motor and cognitive aspects of safe ambulation led to fewer falls, compared with treadmill training alone. OBJECTIVE To investigate if the 2 types of training differentially affected prefrontal activation and if this might explain differences in fall rates after the intervention. METHODS Sixty-four patients with Parkinson's disease were randomized into the treadmill training arm (n = 34, mean age 73.1 ± 1.1 years, 64% men, disease duration 9.7 ± 1.0 years) or treadmill training with virtual reality arm (n = 30, mean age 70.1 ± 1.3 years, 71% men, disease duration 8.9 ± 1.1 years). Prefrontal activation during usual, dual-task, and obstacle negotiation walking was assessed before and after 6 weeks of training, using a functional near-infrared spectroscopy system. RESULTS Treadmill training with and without virtual reality reduced prefrontal activation during walking ( P < .001), with specific interactions related to training arm ( P = .01), lateralization ( P = .05), and walking condition ( P = .001). For example, among the subjects who trained with treadmill training alone, prefrontal activation during dual-task walking and obstacle negotiation increased after training, while in the combined training arm, activation decreased. CONCLUSIONS Prefrontal activation during usual and during more challenging walking conditions can be altered in response to 2 different types of training. The addition of a cognitive training component to a treadmill exercise program apparently modifies the effects of the training on the magnitude and lateralization of prefrontal activation and on falls, extending the understanding of the plasticity of the brain in PD.
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Affiliation(s)
- Inbal Maidan
- 1 Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,2 Tel Aviv University, Tel Aviv, Israel
| | - Freek Nieuwhof
- 3 Radboud University, Nijmegen, Netherlands.,4 Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Bastiaan R Bloem
- 3 Radboud University, Nijmegen, Netherlands.,4 Radboud University Medical Center, Nijmegen, Netherlands
| | - Nir Giladi
- 1 Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,2 Tel Aviv University, Tel Aviv, Israel
| | - Jeffrey M Hausdorff
- 1 Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,2 Tel Aviv University, Tel Aviv, Israel.,5 Rush University Medical Center, Chicago, IL, USA
| | - Jurgen A H R Claassen
- 3 Radboud University, Nijmegen, Netherlands.,4 Radboud University Medical Center, Nijmegen, Netherlands
| | - Anat Mirelman
- 1 Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,2 Tel Aviv University, Tel Aviv, Israel
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Cotelli M, Manenti R, Brambilla M, Gobbi E, Ferrari C, Binetti G, Cappa SF. Cognitive telerehabilitation in mild cognitive impairment, Alzheimer's disease and frontotemporal dementia: A systematic review. J Telemed Telecare 2017; 25:67-79. [PMID: 29117794 DOI: 10.1177/1357633x17740390] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Given the limited effectiveness of pharmacological treatments, non-pharmacological interventions in neurodegenerative diseases have gained increasing attention in recent years and telerehabilitation has been proposed as a cognitive rehabilitation strategy. The purpose of this systematic review is to examine the evidence for the efficacy of cognitive telerehabilitation interventions compared with face-to-face rehabilitation in patients with mild cognitive impairment, Alzheimer's disease and frontotemporal dementia. METHODS In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search of the Medline database was conducted. Out of 14 articles assessed for eligibility, five studies were identified, three in participants with mild cognitive impairment or Alzheimer's disease, two in patients with primary progressive aphasia. RESULTS The Physiotherapy Evidence Database scale was used to assess the methodological quality of four out of five studies included in this systematic review, with only one report receiving a high-quality rating. Effect-size analysis evidenced positive effects of telerehabilitation interventions, comparable with those reported for face-to-face rehabilitation. DISCUSSION The available evidence for the effectiveness of cognitive telerehabilitation is limited, and the quality of the evidence needs to be improved. The systematic review provides preliminary evidence suggesting that cognitive telerehabilitation for neurodegenerative disease may have comparable effects as conventional in-person cognitive rehabilitation.
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Affiliation(s)
- Maria Cotelli
- 1 Neuropsychology Unit, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Italy
| | - Rosa Manenti
- 1 Neuropsychology Unit, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Italy
| | - Michela Brambilla
- 1 Neuropsychology Unit, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Italy
| | - Elena Gobbi
- 1 Neuropsychology Unit, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Italy
| | - Clarissa Ferrari
- 2 Statistics Service, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Italy
| | - Giuliano Binetti
- 3 MAC Memory Center, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Italy.,4 Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Italy
| | - Stefano F Cappa
- 5 IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,6 NEtS, Scuola Universitaria Superiore IUSS-Pavia, Italy
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Abstract
Brain training is topical yet controversial. Effects are often limited to trained tasks; and near and far effects to untrained tasks or everyday life measures are often small or lacking altogether. More recent approaches use evidence from cognitive neuroscience on neuroplasticity, resulting in novel cognitive interventions. This special issue encompasses the state of the art of these interventions. Two systematic reviews and nine experimental studies in a variety of patient groups or healthy participants are included, the results of which mostly confirm earlier findings: effects on trained tasks are consistently reported, but generalisation in terms of functional outcome is limited and little evidence is found of long-term effects. In general, the studies show promising, yet challenging training effects on cognition in healthy persons and patients with cognitive deficits. As such, they may be seen as positive "proof of principle" studies, highlighting that cognitive enhancement is possible. The field of brain training, however, is in urgent need of larger and more thoroughly designed studies. These future studies should also include outcome measures on daily functioning, self-efficacy and quality of life in addition to neuropsychological tests or tasks related to cognitive functioning.
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Affiliation(s)
- Caroline M van Heugten
- a Department Neuropsychology and Psychopharmacology , Maastricht University , Maastricht , The Netherlands.,b School for Mental Health and Neuroscience , Maastricht University Medical Centre , Maastricht , The Netherlands
| | - Rudolf W H M Ponds
- b School for Mental Health and Neuroscience , Maastricht University Medical Centre , Maastricht , The Netherlands.,c Department of Psychology , Maastricht University Medical Centre , Maastricht , The Netherlands.,d Adelante Rehabilitation Center , Hoensbroek , The Netherlands
| | - Roy P C Kessels
- e Donders Institute for Brain, Cognition and Behaviour, Radboud University , Nijmegen , The Netherlands.,f Department of Medical Psychology & Radboudumc Alzheimer Center , Radboud University Medical Center , Nijmegen , The Netherlands.,g Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry , Venray , The Netherlands
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Vermeij A, Kessels RPC, Heskamp L, Simons EMF, Dautzenberg PLJ, Claassen JAHR. Prefrontal activation may predict working-memory training gain in normal aging and mild cognitive impairment. Brain Imaging Behav 2017; 11:141-154. [PMID: 26843001 PMCID: PMC5415588 DOI: 10.1007/s11682-016-9508-7] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Cognitive training has been shown to result in improved behavioral performance in normal aging and mild cognitive impairment (MCI), yet little is known about the neural correlates of cognitive plasticity, or about individual differences in responsiveness to cognitive training. In this study, 21 healthy older adults and 14 patients with MCI received five weeks of adaptive computerized working-memory (WM) training. Before and after training, functional Near-Infrared Spectroscopy (fNIRS) was used to assess the hemodynamic response in left and right prefrontal cortex during performance of a verbal n-back task with varying levels of WM load. After training, healthy older adults demonstrated decreased prefrontal activation at high WM load, which may indicate increased processing efficiency. Although MCI patients showed improved behavioral performance at low WM load after training, no evidence was found for training-related changes in prefrontal activation. Whole-group analyses showed that a relatively strong hemodynamic response at low WM load was related to worse behavioral performance, while a relatively strong hemodynamic response at high WM load was related to higher training gain. Therefore, a 'youth-like' prefrontal activation pattern at older age may be associated with better behavioral outcome and cognitive plasticity.
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Affiliation(s)
- Anouk Vermeij
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Geriatric Medicine, Radboud University Medical Center, Route 925, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Linda Heskamp
- Department of Geriatric Medicine, Radboud University Medical Center, Route 925, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Esther M F Simons
- Department of Geriatric Medicine, Radboud University Medical Center, Route 925, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Paul L J Dautzenberg
- Department of Geriatric Medicine, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - Jurgen A H R Claassen
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.
- Department of Geriatric Medicine, Radboud University Medical Center, Route 925, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
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Chang L, Løhaugen GC, Andres T, Jiang CS, Douet V, Tanizaki N, Walker C, Castillo D, Lim A, Skranes J, Otoshi C, Miller EN, Ernst TM. Adaptive working memory training improved brain function in human immunodeficiency virus-seropositive patients. Ann Neurol 2016; 81:17-34. [PMID: 27761943 PMCID: PMC5299494 DOI: 10.1002/ana.24805] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 10/14/2016] [Accepted: 10/14/2016] [Indexed: 12/28/2022]
Abstract
Objective We aimed to evaluate the effectiveness of an adaptive working memory (WM) training (WMT) program, the corresponding neural correlates, and LMX1A‐rs4657412 polymorphism on the adaptive WMT, in human immunodeficiency virus (HIV) participants compared to seronegative (SN) controls. Methods A total of 201 of 206 qualified participants completed baseline assessments before randomization to 25 sessions of adaptive WMT or nonadaptive WMT. A total of 74 of 76 (34 HIV, 42 SN) completed adaptive WMT and all 40 completed nonadaptive WMT (20 HIV, 20 SN) and were assessed after 1 month, and 55 adaptive WMT participants were also assessed after 6 months. Nontrained near‐transfer WM tests (Digit‐Span, Spatial‐Span), self‐reported executive functioning, and functional magnetic resonance images during 1‐back and 2‐back tasks were performed at baseline and each follow‐up visit, and LMX1A‐rs4657412 was genotyped in all participants. Results Although HIV participants had slightly lower cognitive performance and start index than SN at baseline, both groups improved on improvement index (>30%; false discovery rate [FDR] corrected p < 0.0008) and nontrained WM tests after adaptive WMT (FDR corrected, p ≤ 0.001), but not after nonadaptive WMT (training by training type corrected, p = 0.01 to p = 0.05) 1 month later. HIV participants (especially LMX1A‐G carriers) also had poorer self‐reported executive functioning than SN, but both groups reported improvements after adaptive WMT (Global: training FDR corrected, p = 0.004), and only HIV participants improved after nonadaptive WMT. HIV participants also had greater frontal activation than SN at baseline, but brain activation decreased in both groups at 1 and 6 months after adaptive WMT (FDR corrected, p < 0.0001), with normalization of brain activation in HIV participants, especially the LMX1A‐AA carriers (LMX1A genotype by HIV status, cluster‐corrected‐p < 0.0001). Interpretation Adaptive WMT, but not nonadaptive WMT, improved WM performance in both SN and HIV participants, and the accompanied decreased or normalized brain activation suggest improved neural efficiency, especially in HIV‐LMX1A‐AA carriers who might have greater dopaminergic reserve. These findings suggest that adaptive WMT may be an effective adjunctive therapy for WM deficits in HIV participants. ANN NEUROL 2017;81:17–34
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Affiliation(s)
- Linda Chang
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI.,The Queen's Medical Center, Honolulu, HI
| | - Gro C Løhaugen
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI.,Department of Child Neurology and Rehabilitation (HABU-A), Sørlandet Sykehus HF, HABU, Arendal, Norway, and Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, MTFS, Trondheim, Norway
| | - Tamara Andres
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
| | - Caroline S Jiang
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
| | - Vanessa Douet
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
| | - Naomi Tanizaki
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
| | - Christina Walker
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
| | - Deborrah Castillo
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
| | - Ahnate Lim
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
| | - Jon Skranes
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI.,Department of Child Neurology and Rehabilitation (HABU-A), Sørlandet Sykehus HF, HABU, Arendal, Norway, and Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, MTFS, Trondheim, Norway
| | - Chad Otoshi
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
| | - Eric N Miller
- Department of Psychiatry, University of California, Los Angeles, CA
| | - Thomas M Ernst
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
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