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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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Chatterjee P, Kumar DA, Naqushbandi S, Chaudhary P, Khenduja P, Madan S, Fatma S, Khan MA, Singh V. Effect of Multimodal Intervention (computer based cognitive training, diet and exercise) in comparison to health awareness among older adults with Subjective Cognitive Impairment (MISCI-Trial)-A Pilot Randomized Control Trial. PLoS One 2022; 17:e0276986. [PMID: 36327345 PMCID: PMC9632783 DOI: 10.1371/journal.pone.0276986] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION This study was aimed to investigate the effect of multimodal intervention on the cognitive functions of older adults with subjective cognitive impairment (SCI). MATERIALS AND METHODS Sixty subjects were randomized 1:1:1:1 to receive either computer based cognitive therapy (CBCT) or CBCT+Mediterranean equivalent diet (MED) or CBCT+MED+ Exercise regime and the control group. The intervention group received supervised CBCT twice a week to have 40 sessions, each of 40 minutes duration, and/ or supervised aerobic and resistive exercise twice a week for 24 weeks and or MED at home under the supervision of a dietician. The control group was provided with health awareness instructions for brain stimulating activities such as sudoku, mental maths, and learning music and new skills. RESULTS Cognitive functions which was the primary outcome measure were assessed using the Post Graduate Institute Memory Scale (PGI-MS), and Stroop Colour and Word Test at baseline and after 6 months intervention period. As assessed by the PGI-MS, there was significant improvement in domains such as mental balance, attention and concentration, delayed recall, immediate recall, verbal retention of dissimilar pairs, Visual retention, and total score both in the unimodal and multimodal intervention groups. However, the improvement was observed to be the highest in the multimodal intervention group as compared to unimodal group. All the participants completed the trial. CONCLUSION This pilot randomized control trial indicated that multimodal intervention could be an effective non-pharmacological intervention in individuals with SCI for improving their cognitive functions.
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Affiliation(s)
- Prasun Chatterjee
- Department of Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, India
- * E-mail:
| | - Deepa Anil Kumar
- Department of Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sana Naqushbandi
- Department of Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Preeti Chaudhary
- Department of Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Preetika Khenduja
- Department of Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Swati Madan
- Department of Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sobia Fatma
- Department of Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Maroof A. Khan
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Vishwajeet Singh
- Department of Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, India
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Poptsi E, Tsatali M, Agogiatou C, Bakoglidou E, Batsila G, Dellaporta D, Kounti-Zafeiropoulou F, Liapi D, Lysitsas K, Markou N, Mouzakidis C, Ouzouni F, Papasozomenou C, Soumpourou A, Vasiloglou M, Zafeiropoulos S, Tsolaki M. Longitudinal Cognitive and Physical Training Effectiveness in MCI, Based on the Experience of the Alzheimer's Hellas Day Care Centre. J Geriatr Psychiatry Neurol 2022; 35:512-526. [PMID: 34060355 DOI: 10.1177/08919887211016057] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This study assesses the effectiveness of a multicomponent Longitudinal Cognitive Training (CT) program plus physical exercise (PE) for people with Mild Cognitive Impairment (MCI). 155 people with MCI, completed a 3 years (3Y) CT+PE, whilst 133 were control. Neuropsychological assessment was performed at baseline and 3 years later, whilst CT+PE had additional annual assessments. According to the results, the 3Y CT+PE outperformed control in cognitive abilities (p < 0.002), and Activities of Daily Living (ADL) (p < 0.001), stabilized their functional performances between 1st and 2nd year, but worsened in working and verbal memory between 2nd and 3 rd year (p < 0.002). Control deteriorated in cognitive functions (p < 0.001) and ADL (p < 0.001) after 3 years, whilst 1.33% of the experimental and 13.53% of the control group progressed to dementia (p < 0.001). Longitudinal CT+PE improves cognitive performance and ADL in MCI and delay the progression to dementia.
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Affiliation(s)
- Eleni Poptsi
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece.,Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Marianna Tsatali
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece.,University of Sheffield International Faculty, City College, Thessaloniki, Greece
| | - Christina Agogiatou
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Evaggelia Bakoglidou
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Georgia Batsila
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Dionysia Dellaporta
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | | | - Despoina Liapi
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Konstantinos Lysitsas
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Nefeli Markou
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Christos Mouzakidis
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Fani Ouzouni
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Chrysa Papasozomenou
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Aikaterini Soumpourou
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Maria Vasiloglou
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Stavros Zafeiropoulos
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Magda Tsolaki
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece.,Aristotle University of Thessaloniki, Thessaloniki, Greece
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Friedman D, Grimaldi L, Cariou A, Aegerter P, Gaudry S, Ben Salah A, Oueslati H, Megarbane B, Meunier-Beillard N, Quenot JP, Schwebel C, Jacob L, Robin Lagandré S, Kalfon P, Sonneville R, Siami S, Mazeraud A, Sharshar T. Impact of a Postintensive Care Unit Multidisciplinary Follow-up on the Quality of Life (SUIVI-REA): Protocol for a Multicenter Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e30496. [PMID: 35532996 PMCID: PMC9127649 DOI: 10.2196/30496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 12/07/2021] [Accepted: 12/22/2021] [Indexed: 11/25/2022] Open
Abstract
Background Critically ill patients are at risk of developing a postintensive care syndrome (PICS), which is characterized by physical, psychological, and cognitive impairments and which dramatically impacts the patient’s quality of life (QoL). No intervention has been shown to improve QoL. We hypothesized that a medical, psychological, and social follow-up would improve QoL by mitigating the PICS. Objective This multicenter, randomized controlled trial (SUIVI-REA) aims to compare a multidisciplinary follow-up with a standard postintensive care unit (ICU) follow-up. Methods Patients were randomized to the control or intervention arm. In the intervention arm, multidisciplinary follow-up involved medical, psychological, and social evaluation at ICU discharge and at 3, 6, and 12 months thereafter. In the placebo group, patients were seen only at 12 months by the multidisciplinary team. Baseline characteristics at ICU discharge were collected for all patients. The primary outcome was QoL at 1 year, assessed using the Euro Quality of Life-5 dimensions (EQ5D). Secondary outcomes were mortality, cognitive, psychological, and functional status; social and professional reintegration; and the rate of rehospitalization and outpatient consultations at 1 year. Results The study was funded by the Ministry of Health in June 2010. It was approved by the Ethics Committee on July 8, 2011. The first and last patient were randomized on December 20, 2012, and September 1, 2017, respectively. A total of 546 patients were enrolled across 11 ICUs. At present, data management is ongoing, and all parties involved in the trial remain blinded. Conclusions The SUVI-REA multicenter randomized controlled trial aims to assess whether a post-ICU multidisciplinary follow-up improves QoL at 1 year. Trial Registration Clinicaltrials.gov NCT01796509; https://clinicaltrials.gov/ct2/show/NCT01796509 International Registered Report Identifier (IRRID) DERR1-10.2196/30496
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Affiliation(s)
- Diane Friedman
- Raymond Poincaré Hospital, Versailles Saint-Quentin-en-Yvelines, Garches, France
| | - Lamiae Grimaldi
- U1018 Université Versailles, Saint Quentin en Yvelines-INSERM Unité 1018, Groupe Interrégional de Recherche Clinique er d'Innovation, Île-de-France, France
| | - Alain Cariou
- Cochin Hospital, Assistance-Publique Hôpitaux de Paris, Université de Paris, Paris, France
| | - Philippe Aegerter
- U1018 Université Versailles, Saint Quentin en Yvelines-INSERM Unité 1018, Groupe Interrégional de Recherche Clinique er d'Innovation, Île-de-France, France
| | - Stéphane Gaudry
- Louis Mourier Hospital, Assistance-Publique Hôpitaux de Paris, Université de Paris, Colombes, France
| | | | - Haikel Oueslati
- Saint-Louis Hospital, Assistance-Publique Hôpitaux de Paris, Université de Paris, Paris, France
| | - Bruno Megarbane
- Lariboisière Hospital, Assistance-Publique Hôpitaux de Paris, Université de Paris, Paris, France
| | - Nicolas Meunier-Beillard
- Institut National de la Santé Et de la Recherche Médicale (INSERM), Centre d'Investigation Clinique 1432, Module Epidémiologie Clinique, CHU Dijon Bourgogne, France;, Dijon, France.,Délégation à la Recherche Clinique et à l'Innovation (DRCI), Unité de Soutien Méthodologique à la Recherche, CHU Dijon Bourgogne, France, Dijon, France
| | - Jean-Pierre Quenot
- François Mitterrand University Hospital, University of Burgundy, Dijon, France
| | | | - Laurent Jacob
- Saint-Louis Hospital, Assistance-Publique Hôpitaux de Paris, Université de Paris, Paris, France
| | - Ségloène Robin Lagandré
- Georges Pompidou Hospital, Assistance-Publique Hôpitaux de Paris, Université de Paris, Paris, France
| | | | - Romain Sonneville
- Bichat Hospital, Assistance-Publique Hôpitaux de Paris, Université de Paris, Paris, France
| | | | - Aurelien Mazeraud
- GHU-Paris Psychiatrie & Neurosciences, Sainte-Anne Hospital, Université de Paris, Paris, France
| | - Tarek Sharshar
- GHU-Paris Psychiatrie & Neurosciences, Sainte-Anne Hospital, Université de Paris, Paris, France
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Xue C, Yuan B, Yue Y, Xu J, Wang S, Wu M, Ji N, Zhou X, Zhao Y, Rao J, Yang W, Xiao C, Chen J. Distinct Disruptive Patterns of Default Mode Subnetwork Connectivity Across the Spectrum of Preclinical Alzheimer's Disease. Front Aging Neurosci 2019; 11:307. [PMID: 31798440 PMCID: PMC6863958 DOI: 10.3389/fnagi.2019.00307] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 10/25/2019] [Indexed: 12/28/2022] Open
Abstract
Background: The early progression continuum of Alzheimer’s disease (AD) has been considered to advance through subjective cognitive decline (SCD), non-amnestic mild cognitive impairment (naMCI), and amnestic mild cognitive impairment (aMCI). Altered functional connectivity (FC) in the default mode network (DMN) is regarded as a hallmark of AD. Furthermore, the DMN can be divided into two subnetworks, the anterior and posterior subnetworks. However, little is known about distinct disruptive patterns in the subsystems of the DMN across the preclinical AD spectrum. This study investigated the connectivity patterns of anterior DMN (aDMN) and posterior DMN (pDMN) across the preclinical AD spectrum. Methods: Resting-state functional magnetic resonance imaging (rs-fMRI) was used to investigate the FC in the DMN subnetworks in 20 healthy controls (HC), eight SCD, 11 naMCI, and 28 aMCI patients. Moreover, a correlation analysis was used to examine associations between the altered connectivity of the DMN subnetworks and the neurocognitive performance. Results: Compared to the HC, SCD patients showed increased FC in the bilateral superior frontal gyrus (SFG), naMCI patients showed increased FC in the left inferior parietal lobule (IPL), and aMCI patients showed increased FC in the bilateral IPL in the aDMN; while SCD patients showed decreased FC in the precuneus, naMCI patients showed increased FC in the left middle temporal gyrus (MTG), and aMCI patients also showed increased FC in the right middle frontal gyrus (MFG) in the pDMN. Notably, the FC between the ventromedial prefrontal cortex (vmPFC) and the left MFG and the IPL in the aDMN was associated with episodic memory in the SCD and aMCI groups. Interestingly, the FC between the posterior cingulated cortex (PCC) and several regions in the pDMN was associated with other cognitive functions in the SCD and naMCI groups. Conclusions: This study demonstrates that the three preclinical stages of AD exhibit distinct FC alternations in the DMN subnetworks. Furthermore, the patient group data showed that the altered FC involves cognitive function. These findings can provide novel insights for tailored clinical intervention across the preclinical AD spectrum.
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Affiliation(s)
- Chen Xue
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Fourth Clinical College of Nanjing Medical University, Nanjing, China
| | - Baoyu Yuan
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yingying Yue
- Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Jiani Xu
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Fourth Clinical College of Nanjing Medical University, Nanjing, China
| | - Siyu Wang
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Fourth Clinical College of Nanjing Medical University, Nanjing, China
| | - Meilin Wu
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Fourth Clinical College of Nanjing Medical University, Nanjing, China
| | - Nanxi Ji
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Fourth Clinical College of Nanjing Medical University, Nanjing, China
| | - Xingzhi Zhou
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Fourth Clinical College of Nanjing Medical University, Nanjing, China
| | - Yilin Zhao
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Fourth Clinical College of Nanjing Medical University, Nanjing, China
| | - Jiang Rao
- Department of Rehabilitation, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
| | - Wenjie Yang
- Department of Rehabilitation, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
| | - Chaoyong Xiao
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
| | - Jiu Chen
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Fourth Clinical College of Nanjing Medical University, Nanjing, China.,Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
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