Brain training game boosts executive functions, working memory and processing speed in the young adults: a randomized controlled trial

The effect of brain training video games on improving visuospatial working memory and executive function in children with dyscalculia

The aim was to investigate the effect of brain training video games on improving visuospatial working memory and executive function in children with dyscalculia. This study employed a quasi-experimental, within-subjects design. Pre- post- and follow up test scores on visuospatial working memory and executive function were used. Sixty children from a primary education public school in Taif were selected. This study employed simple random method for selecting participants. Children assigned to the experimental group completed 18, 30 ms training sessions at the technology room in the presence of the researcher over a period of six weeks. The analyses were conducted using SPSS by performing a repeated-measures analysis of variance with a between-group factor and a with-group factor (pretest and posttest). Scheffé's post hoc test was also applied. The training helped the intervention group gain better scores in visuospatial working memory and executive function in post test compared to control one. There were significant differences in visuospatial working memory and executive function across different measurements(pre-post-and follow up).

Cognitive training prevents stress-induced working memory deficits

BACKGROUND

Working memory is a fundamental cognitive process that is critically involved in planning, comprehension, reasoning, or problem-solving. Acute stress has been shown to impair working memory. This stress-induced working memory deficit has profound implications for our cognitive functioning in everyday life as well as for stress-related mental disorders. Here, we tested whether a cognitive training intervention can make working memory more resistant to disruptive effects of acute stress.

METHODS

In a pre-registered, fully-crossed between-subjects design with the factors stress (vs. control) and cognitive training (vs. sham), one hundred twenty-three healthy men and women (aged 18-35 years) completed a daily cognitive training program targeting working memory-related processes or a sham training over a period of six weeks. After this six-week training intervention, participants underwent a standardized stress or control manipulation shortly before their working memory performance was tested.

RESULTS

As expected, the exposure to acute stress led to a significant working memory impairment in the sham training group. Critically, although the subjective, autonomic, and endocrine stress responses were comparable in the two training groups, this stress-induced working memory impairment was abolished in the intervention training group.

CONCLUSIONS

These results are the first to show that a cognitive training intervention directed at prefrontal and hippocampal functioning can prevent the detrimental effects of stressful events on working memory performance.

Efficacy and Neural Mechanisms of Mindfulness Meditation Among Adults With Internet Gaming Disorder: A Randomized Clinical Trial

Importance

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), recently identified internet gaming disorder (IGD) as a condition warranting more research, and few empirically validated treatments exist. Mindfulness meditation (MM) has multiple health benefits; however, its efficacy in treating IGD and potential neural mechanisms underlying MM treatment of the disorder remain largely unknown.

Objective

To explore the efficacy of MM used to treat adults with IGD and to identify neural mechanisms underlying MM.

Design, Setting, and Participants

This randomized clinical trial was performed from October 1 to November 30, 2023, at Hangzhou Normal University in Hangzhou, China. Adults (aged ≥18 years) who met at least 6 of the 9 DSM-5-TR proposed criteria for IGD were recruited to receive either MM or progressive muscle relaxation (PMR). Data analysis was performed on December 1, 2023.

Intervention

Participants underwent MM training (an 8-session meditation program that focuses on attention and acceptance) and PMR training (an 8-time program for body relaxation) delivered in groups that met 2 times each week for 4 weeks.

Main Outcomes and Measures

This per-protocol analysis included only participants who finished the pretest assessment, 8 training sessions, and posttest assessment. The main outcomes were addiction severity (measured with the DSM-5-TR proposed criteria for IGD and with Internet Addiction Test scores), gaming craving (measured with Questionnaire for Gaming Urges scores), and blood oxygen level-dependent signals assessed with cue-craving tasks on fMRI. Behavioral and brain measurements were compared using analysis of variance. Functional connectivity (FC) among identified brain regions was measured to test connectivity changes associated with MM.

Results

This study included 64 adults with IGD. A total of 32 participants received MM (mean [SD] age, 20.3 [1.9] years; 17 women [53%]) and 32 received PMR (mean [SD] age, 20.2 [1.5] years; 16 women [50%]). The severity of IGD decreased in the MM group (pretest vs posttest: mean [SD], 7.0 [1.1] vs 3.6 [0.8]; P < .001) and in the PMR group (mean [SD], 7.1 [0.9] vs 6.0 [0.9]; P = .04). The MM group had a greater decrease in IGD severity than the PMR group (mean [SD] score change for the MM group vs the PMR group, -3.6 [0.3] vs -1.1 [0.2]; P < .001). Mindfulness meditation was associated with decreased brain activation in the bilateral lentiform nuclei (r = 0.40; 95% CI, 0.19 to 0.60; P = .02), insula (r = 0.35; 95% CI, 0.09 to 0.60; P = .047), and medial frontal gyrus (MFG; r = 0.43; 95% CI, 0.16 to 0.70; P = .01). Increased MFG-lentiform FC and decreased craving (pretest vs posttest: mean [SD], 58.8 [15.7] vs 33.6 [12.0]; t = -8.66; ƞ2 = 0.30; P < .001) was observed after MM, and changes in MFG-lentiform FC mediated the relationship between increased mindfulness and decreased craving (mediate effect, -0.17; 95% CI, -0.32 to -0.08; P = .03).

Conclusions and Relevance

In this study, MM was more effective in decreasing addiction severity and gaming cravings compared with PMR. These findings indicate that MM may be an effective treatment for IGD and may exert its effects by altering frontopallidal pathways.

Trial Registration

Chinese Clinical Trial Registry Identifier: ChiCTR2300075869.

Evolutionary perspectives on substance and behavioural addictions: Distinct and shared pathways to understanding, prediction and prevention

Addiction poses significant social, health, and criminal issues. Its moderate heritability and early-life impact, affecting reproductive success, poses an evolutionary paradox: why are humans predisposed to addictive behaviours? This paper reviews biological and psychological mechanisms of substance and behavioural addictions, exploring evolutionary explanations for the origin and function of relevant systems. Ancestrally, addiction-related systems promoted fitness through reward-seeking, and possibly self-medication. Today, psychoactive substances disrupt these systems, leading individuals to neglect essential life goals for immediate satisfaction. Behavioural addictions (e.g. video games, social media) often emulate ancestrally beneficial behaviours, making them appealing yet often irrelevant to contemporary success. Evolutionary insights have implications for how addiction is criminalised and stigmatised, propose novel avenues for interventions, anticipate new sources of addiction from emerging technologies such as AI. The emerging potential of glucagon-like peptide 1 (GLP-1) agonists targeting obesity suggest the satiation system may be a natural counter to overactivation of the reward system.

Using the Indonesian Computer-Based Game Prototype as a Computer-Based Game Inventory for Executive Function in Children and Adolescents: A Confirmatory Factor Analysis and Concurrent Validity Study

Executive function influences children's learning abilities and organizes their cognitive processes, behaviors, and emotions. This cross-sectional study examined whether an Indonesian Computer-Based Game (ICbG) prototype could be used as a Computer-Based Game Inventory for Executive Function (CGIEF) in children and adolescents. The study was conducted with 200 children, adolescents, and their parents. The parents completed the Behavior Rating Inventory of Executive Functioning (BRIEF) questionnaire, and the children and adolescents completed the CGIEF. Confirmatory factor analysis (CFA) and structural equation modeling (SEM) were performed using LISREL Version 8.80. The construct of CGIEF was valid/fit with normal theory-weighted least squares = 15.75 (p > .05). SEM analysis showed that the theoretical construct of the CGIEF was a valid predictor of executive function. The critical t value of the pathway was 2.45, and normal theory-weighted least squares was 5.74 (p > .05). The construct reliability (CR) for CGIEF was 0.91. Concurrent validity was assessed using the Bland-Altman plot, and the coefficient of repeatability (bias/mean) was nearly zero between the t scores of total executive functions of the CGIEF and BRIEF. This preliminary study showed that the CGIEF can be useful as a screening tool for executive dysfunction, metacognitive deficits, and behavioral regulation problems among children and adolescents in clinical samples.

Can we enhance working memory? Bias and effectiveness in cognitive training studies

Meta-analyses have found that working memory (WM) can be improved with cognitive training; however, some authors have suggested that these improvements are mostly driven by biases in the measurement of WM, especially the use of similar tasks for assessment and training. In the present meta-analysis, we investigated whether WM, fluid intelligence, executive functions, and short-term memory can be improved by cognitive training and evaluated the impact of possible sources of bias. We performed a risk of bias assessment of the included studies and took special care in controlling for practice effects. Data from 52 independent comparisons were analyzed, including cognitive training aimed at different cognitive functions. Our results show small improvements in WM after training (SMD = 0.18). Much larger effects were observed when the analysis was restricted to assessment tasks similar to those used for training (SMD = 1.15). Fluid intelligence was not found to improve as a result of training, and improvements in WM were not related to changes in fluid intelligence. Our analyses did however indicate that cognitive training can improve specific executive functions. Contrary to expectations, a set of meta-regressions indicated that characteristics of the training programme, such as dosage and type of training, do not have an impact on the effectiveness of training. The risk of bias assessment revealed some concerns in the randomization process and possible selective reporting among studies. Overall, our results identified various potential sources of bias, with the most significant being the choice of assessment tasks.

The Stress Phenotyping Framework: A multidisciplinary biobehavioral approach for assessing and therapeutically targeting maladaptive stress physiology

Although dysregulated stress biology is becoming increasingly recognized as a key driver of lifelong disparities in chronic disease, we presently have no validated biomarkers of toxic stress physiology; no biological, behavioral, or cognitive treatments specifically focused on normalizing toxic stress processes; and no agreed-upon guidelines for treating stress in the clinic or evaluating the efficacy of interventions that seek to reduce toxic stress and improve human functioning. We address these critical issues by (a) systematically describing key systems and mechanisms that are dysregulated by stress; (b) summarizing indicators, biomarkers, and instruments for assessing stress response systems; and (c) highlighting therapeutic approaches that can be used to normalize stress-related biopsychosocial functioning. We also present a novel multidisciplinary Stress Phenotyping Framework that can bring stress researchers and clinicians one step closer to realizing the goal of using precision medicine-based approaches to prevent and treat stress-associated health problems.

Slower Processing Speed in Autism Spectrum Disorder: A Meta-analytic Investigation of Time-Based Tasks

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition affecting information processing across domains. The current meta-analysis investigated whether slower processing speed is associated with the ASD neurocognitive profile and whether findings hold across different time-based tasks and stimuli (social vs. nonsocial; linguistic vs. nonlinguistic). Mean RTs of ASD and age-matched neurotypical comparison groups (N = 893 ASD, 1063 neurotypical; mean age ASD group = 17 years) were compared across simple RT, choice RT, and interference control tasks (44 studies, 106 effects) using robust variance estimation meta-analysis. Simple RT tasks required participants to respond to individual stimuli, whereas choice RT tasks required forced-choice responses to two or more stimuli. Interference control tasks required a decision in the context of a distractor or priming stimulus; in an effort to minimize inhibitory demands, we extracted RTs only from baseline and congruent conditions of such tasks. All tasks required nonverbal (motor) responses. The overall effect-size estimate indicated significantly longer mean RTs in ASD groups (g = .35, 95% CI = .16; .54) than comparison groups. Task type moderated effects, with larger estimates drawn from simple RT tasks than interference control tasks. However, across all three task types, ASD groups exhibited significantly longer mean RTs than comparison groups. Stimulus type and age did not moderate effects. Generalized slowing may be a domain-general characteristic of ASD with potential consequences for social, language, and motor development. Assessing processing speed may inform development of interventions to support autistic individuals and their diverse cognitive profiles.

The effects of a smartphone game training intervention on executive functions in youth soccer players: a randomized controlled study

Cognitive training primarily aims to improve executive functions (EFs). It has become a popular research topic, as previous studies have provided preliminary evidence that EFs relate to sports performance. However, whether a domain-generic cognitive training intervention can improve EFs in high-performance athletes is still unclear. The present randomized controlled study aimed to examine the effects of an eight-week (5 min/day, 5 days/week) smartphone-based domain-generic cognitive training intervention (i.e., the smartphone game "Fruit Ninja") on EFs in youth soccer athletes (N = 33; intervention: n = 15, passive control: n = 18; German youth soccer academy). We assessed working memory (3-back task), inhibition (Flanker & Go/NoGo task), and cognitive flexibility (number-letter task) in a pre-post design with computerized tasks. The results showed no significant time x group differences attributable to the cognitive training between the intervention group and the control group, except for a response time variable of the Go/NoGo task. These preliminary results do not suggest an application of CT as a smartphone-based game to improve EFs performance in soccer players. However, more research is needed to establish the efficacy of domain-specific interventions in high-level team sport athletes.

Benefits of video games for people with schizophrenia: a literature review

PURPOSE OF REVIEW

In spite of the overwhelming concerns about the deleterious impact of exposure to video games, a growing body of evidence suggests that it may be of potential interest for therapeutic purposes, particularly in schizophrenia. As literature is rapidly evolving, we carried out a systematic review of recent articles on this issue.

RECENT FINDINGS

We identified seven studies published from 2017 to 2022 exploring the benefits of commercial video games in people with schizophrenia and related disorders regarding symptoms, cognition and functional outcome. Six studies used an RCT design. Associations between gaming and better outcomes were found in three main areas: physical condition (walking speed, aerobic fitness), neurocognition (processing speed, memory and executive functions), and social functioning, self-efficacy in daily life activities and quality of life.

SUMMARY

Active use of video games is associated with better aerobic fitness and cognitive performances. Video gaming may contribute to better functional outcome and quality of life in patients suffering from cognitive impairments and difficulties in social functioning. Persons with schizophrenia may benefit from using commercial video games because of their potential therapeutic impact on functioning and cognition.

Puzzle game-based learning: a new approach to promote learning of principles of coronary artery bypass graft surgery

INTRODUCTION

Since learning with high educational quality requires an advanced intervention. This study seeks to answer how many puzzles game-based training can improve knowledge and cognitive function of surgical technology students in CABG surgery and its sequence, as well as the tools and equipment used in each stage of surgery and the sequence of their preparation.

MATERIALS AND METHODS

This study was carried out as a quasi-experimental single-group pre-test-post-test, during which, after designing a puzzle game including various stages of surgery (from the preparation of the patient for surgical sutures and the necessary equipment to perform each stage), 18 people from third-year surgical technology students who met the inclusion criteria were entered in the study by convenience sampling method and based on the sample size determined using a similar study and they participated in the test of knowledge and cognitive function, that the validity and reliability were measured, before the intervention and 14 days after the intervention (using a puzzle game). Data were analyzed using descriptive and Wilcoxon statistical tests.

RESULTS

After the withdrawal of 2 people, 15 person (93.80 per cent) of the students were female, the average age of students was 21.87 ± 0.71 years, and 50% (8 people) of them were 22 years old. Also, the average score of the end-of-semester exam of the heart surgery technology course was 15.19 ± 2.30 (the lowest score was 11.25, and the highest score was 18.63), and the score of 43.80% (7 people) of them were in the range of 15.01-17.70, and their average of grade point average was 17.31 ± 1.10 (the lowest grade point average is 15 and the highest grade point average is 19.36) and grade point average 75% (11 people) of students were 16-18. The average scores of knowledge(5.75 ± 1.65 vs. 2.68 ± 0.79) and cognitive performance(6.31 ± 2.57 vs. 2.00 ± 1.09) of students in the post-intervention phase were significantly higher than the pre-intervention phase (P < 0.0001).

CONCLUSION

The results of the present study showed that the use of puzzle games in CABG surgery training led to a significant improvement in the knowledge and cognitive performance of surgical technology students regarding the stages of CABG surgery and its sequence, as well as the tools and equipment used in each stage of surgery and the sequence of their preparation.

The Effect of Cognitive Training with Neurofeedback on Cognitive Function in Healthy Adults: A Systematic Review and Meta-Analysis

Background: Cognitive training aims to improve cognitive function through cognitive tasks or training games. Neurofeedback is a technique to monitor brain signals with either visual or auditory feedback. Previous studies suggest that a combination of cognitive training and neurofeedback has a superior effect on cognitive functions compared with cognitive training alone. However, no systematic reviews and meta-analyses of the benefits of cognitive training with neurofeedback (CTNF) exist. The purpose of this study was to examine the beneficial effects of CTNF in healthy adults using a systematic review and multilevel meta-analysis. Methods: PubMed, Scopus, PsychoINFO, and MEDLINE were searched for research papers reporting the results of interventions using CTNF. Results: After an initial screening of 234 records, three studies using near-infrared spectroscopy (NIRS) and one study using electroencephalography were extracted from the database. We performed a multi-level meta-analysis with three NIRS studies including 166 participants (mean ages ranged from 21.43 to 65.96 years). A multi-level meta-analysis revealed that CTNF has a beneficial effect on the episodic, long-term, and working memory domains. Conclusions: Although three studies were included in the systematic review and meta-analysis, our results indicate that CTNF using NIRS would lead to improvements in memory functioning.

Cognitive Computerized Training for Older Adults and Patients with Neurological Disorders: Do the Amount and Training Modality Count? An Umbrella Meta-Regression Analysis

Numerous applications have been created to train cognition and challenge the brain, a process known as computerized cognitive training (CCT). Despite potential positive results, important questions remain unresolved: the appropriate training duration, the efficacy of CCT depending on its type (commercial or developed in-house for the rehabilitation of specific patients) and delivery mode (at-home or on-site), and the patients most likely to benefit such intervention. This study aims to perform an umbrella meta-analysis and meta-regression to determine if the type of CCT, the delivery mode, the amount of training, and participants' age at inclusion influence the improvement of the cognitive function. To do so, we performed a umbrella meta-analysis. One hundred studies were included in this analysis representing 6407 participants. Statistical improvements were found for the different conditions after the training. We do not find statistical difference between the type of intervention or the delivery mode. No dose-response relationship between the total amount of training and the improvement of cognitive functions was found. CCT is effective in improving cognitive function in patients suffering from neurological conditions and in healthy aging. There is therefore an urgent need for health care systems to recognize its therapeutic potential and to evaluate at a larger scale their integration into the clinical pipeline as preventive and rehabilitation tool.

Cognitive and Psychological Recovery Patterns Across Different Care Pathways 12 months after hospitalization for COVID-19: A Multicenter Cohort Study (CO-FLOW)

BACKGROUND

The comparison of recovery patterns for different care pathways following COVID-19 is necessary for optimizing rehabilitation strategies.

OBJECTIVES

To evaluate cognitive and psychological outcomes across different care pathways up to 12 months after hospitalization for COVID-19.

METHODS

CO-FLOW is an ongoing multicenter prospective cohort study with assessments at 3, 6, and 12 months after hospitalization for COVID-19. The main outcomes are cognitive deficits (Montreal Cognitive Assessment, score <26), cognitive failure (Cognitive Failure Questionnaire, score >43), posttraumatic stress disorder (PTSD; Impact of Event Scale-Revised, score ≥33), and anxiety and depression (Hospital Anxiety and Depression Scale, subscale score ≥11).

RESULTS

In total, data from 617 participants were analyzed. Mean age was 59.7 (SD 11.4) years and 188 (31%) were female. Significant recovery occurred within the first 6 months post-discharge (p ≤ 0.001). Cognitive deficits persisted in 21% (101/474), and psychological problems in 15% (74/482) of people at 12 months. Significantly improved cognition scores were reported for people who did not receive rehabilitation ('No-rehab'; 124/617, 20%; mean difference, MD 2.32, 95% CI 1.47 to 3.17; p<0.001), those who received community-based rehabilitation ('Com-rehab'; 327/617, 53%; MD 1.27, 95% CI 0.77 to 1.78; p<0.001), and those who received medical rehabilitation ('Med-rehab'; 86/617, 14%; MD 1.63, 95% CI 0.17 to 3.10; p = 0.029). Med-rehab participants experienced more cognitive failure from 3 to 6 months (MD 4.24, 95% 1.63 to 6.84; p = 0.001). Com-rehab showed recovery for PTSD (MD -2.43, 95% -3.50 to -1.37; p<0.001), anxiety (MD -0.67, 95% -1.02 to -0.32; p<0.001), and depression (MD -0.60, 95% -0.96 to -0.25; p<0.001), but symptoms persisted at 12 months.

CONCLUSIONS

Survivors of COVID-19 showed cognitive and psychological recovery, especially within the first 6 months after hospitalization. Most persistent problems were related to cognitive functioning at 12 months. Recovery differed rehabilitation settings. Additional cognitive or psychological support might be warranted in people who medical or community-based rehabilitation.

Developmental Language Disorder Is Associated With Slower Processing Across Domains: A Meta-Analysis of Time-Based Tasks

PURPOSE

Individuals with developmental language disorder (DLD) often exhibit slower processing on time-based tasks in comparison with age-matched peers. Processing speed has been linked to various linguistic skills and might serve as a global indicator of individual differences in language abilities. Despite an extensive literature on processing speed in DLD, it remains unclear whether slower processing is domain general or restricted to linguistic and/or auditory tasks.

METHOD

This meta-analysis used robust variance estimation to compare response/reaction times (RTs) of DLD and age-matched groups (N = 812 DLD, 870 neurotypical; M _age [DLD] = 8.9 years, range: 4.3-22.7 years). Moderators included task (simple RT, choice RT, naming, congruent/baseline conditions of interference control tasks), stimulus type (linguistic/nonlinguistic), stimulus modality (auditory/nonauditory), and response modality (verbal/nonverbal). Age and publication year were covariates.

RESULTS

The overall effect based on 46 studies and 144 estimates indicated longer mean RTs in DLD groups (g = .47, p < .001, 95% CI [.38, .55]). Moderator analyses indicated larger effects when tasks required verbal as opposed to nonverbal responses. No other moderators approached significance. All subgroup analyses were significant, indicating longer mean RTs in DLD groups across tasks, stimulus types, stimulus modalities, and response modalities.

CONCLUSIONS

Individuals with DLD exhibit longer RTs across verbal and nonverbal tasks, which may contribute to observed difficulties in language, motor skills, and executive functioning. Simple processing speed measures should be included in screening for language delays but may not be suitable for differential diagnosis, given that slower processing may occur across multiple disorders.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.21809355.

Efficacy of Corsi Block Tapping Task training for improving visuospatial skills: a non-randomized two-group study

Even though impaired visuospatial abilities can negatively affect daily functioning, there are very few training programs that attempt to improve visuospatial abilities. The purpose of this study was to examine if a single training session with a computerized version of the Corsi Block Tapping Task could improve mental rotation skills. Fifty-three young adults were assigned to one of two groups: (1) control group (mean age = 21.4; 10 females), who had 20 min of rest after their baseline assessment, or (2) training group (mean age = 21.5; 17 females), who had 20 min of training on the Corsi Block Tapping Task after their baseline assessment. The primary outcome was reaction time on a computer-based mental rotation task, and it was assessed both before and after the rest or training. There was a significant interaction between time (pre vs. post) and group (control vs. training) on mental rotation performance (p = 0.04), with the training group performing on average 124 ms faster on accurate trials than the control group at post-test. This preliminary study suggested that improving mental rotation may be feasible through targeted cognitive training. Future studies will consider multiple sessions of Corsi Block Tapping Task training to maximize training benefits (i.e., dose-response), as well as longer term retention in cognitively intact and impaired individuals.

The prevalence and possible risk factors of internet gaming disorder among adolescents and young adults: Systematic reviews and meta-analyses

BACKGROUND

As a spreading addictive behaviour in recent years, internet gaming disorder (IGD) has been studied a lot and the overall research results indicate that IGD has a high prevalence among adolescents and young adults (AYAs). To update the status quo of prevalence, it is necessary to conduct comprehensive analyses.

METHODS

On the premise of following the PRISMA statement, the study conducted two systematic reviews and meta-analyses to assess the global prevalence of IGD among AYAs and identify its possible risk factors. To achieve the goals, PubMed and CNKI databases were used to select the concerned studies published up to May 31, 2021. Heterogeneity was assessed using a funnel plot, Begg's test, Egger's test, and trim-and-fil method, followed by sensitivity analysis, subgroup analysis, and meta-regression analysis.

RESULTS

For the meta-analysis of prevalence, 407,620 participants from 155 reports in 33 countries were included. The pooled prevalence of IGD among AYAs was 9.9% (95% CI: 8.6%-11.3%, P = 0.000, I² = 94.4%), including 8.8% (95% CI: 7.5%-10.0%) among adolescents and 10.4% (95% CI: 8.8%-11.9%) among young adults. The following 12 factors are the possible risk factors of IGD among AYAs, which are stress, long average game time, family dysfunction, poor academic performance, being bullied, bullying, interpersonal problems, hyperactivity/inattention, anxiety, depression, emotional distress and low self-esteem.

CONCLUSIONS

This study confirms the prevalence and possible risk factors for IGD among AYAs. It's valuable in understanding the threat of IGD and finding intervention strategies for IGD among AYAs.

Effects of Two Short-Term Aerobic Exercises on Cognitive Function in Healthy Older Adults during COVID-19 Confinement in Japan: A Pilot Randomized Controlled Trial

Aerobic exercise improves executive function-which tends to decline with age-and dual-task training with aerobic exercise improves the global cognitive function. However, home-based older adults could not follow these programs due to social isolation during the coronavirus disease 2019 pandemic. Therefore, we conducted a single-blind randomized controlled trial with 88 healthy older adults without dementia or sarcopenia who were randomly assigned into the Nordic walking (aerobic exercise), dance (dual-task training with aerobic exercise), or control group. The participants in both exercise intervention groups trained for 30 min, three times per week, for 4 weeks. All groups consumed amino acid-containing foods three times per week. We found that both exercise intervention groups showed improvements in executive function, while the dance group showed additional improvement in global cognitive function. The dance group showed a higher maximum gait speed, greater improvement in imitation ability, and improved executive function and cognitive function than the Nordic walking group. The intervention programs did not significantly affect the muscle mass or muscle output than the control group; however, both programs improved the participant neurological functions such as the heel lift, with dance training being the most effective intervention. In conclusion, dance training effectively improves cognitive function.

Mental Rotation Skill Shapes Haptic Exploration Strategies

Haptic exploration strategies have been traditionally studied focusing on hand movements and neglecting how objects are moved in space. However, in daily life situations touch and movement cannot be disentangled. Furthermore, the relation between object manipulation as well as performance in haptic tasks and spatial skill is still little understood. In this study, we used iCube, a sensorized cube recording its orientation in space as well as the location of the points of contact on its faces. Participants had to explore the cube faces where little pins were positioned in varying number and count the number of pins on the faces with either even or odd number of pins. At the end of this task, they also completed a standard visual mental rotation test (MRT). Results showed that higher MRT scores were associated with better performance in the task with iCube both in term of accuracy and exploration speed and exploration strategies associated with better performance were identified. High performers tended to rotate the cube so that the explored face had the same spatial orientation (i.e., they preferentially explored the upward face and rotated iCube to explore the next face in the same orientation). They also explored less often twice the same face and were faster and more systematic in moving from one face to the next. These findings indicate that iCube could be used to infer subjects' spatial skill in a more natural and unobtrusive fashion than with standard MRTs.

Evaluation of Processing Speed of Different Cognitive Functions Across the Life Span Using Cognitive Mobile Games

Objective: Processing speed (PS) is an important indicator of cognitive functioning and normal aging. However, the tools used to evaluate these are often rather simplistic and only assess one cognitive component. The aim of this study was to use cognitive mobile games (CMG) to evaluate the evolution of reaction times over the life span during different cognitive tasks. Methodology: We carried out a retrospective observational study in which we obtained anonymized results of 15,000 subjects. Scores of five CMG that train arithmetic, vocabulary, response control, visual attention and recognition, and working memory were analyzed. Results: Overall, we observed a highly statistically significant decrease (P < 0.001) in PS and a decrease of accuracy (P < 0.001) with increasing participant age, indicating that for each cognitive function tested, older participants performed cognitive tasks more slowly than younger participants. We also observed an interaction between the age of the participants and the number of errors. These results are consistent with physiological data with respect to aging and cognition. Conclusion: Owing to their wide availability and ease of use, CMG could be used as a simple tool to monitor cognitive function such as PS. Further studies are needed to study the influence of pathologies on those variables.

Cognitive Training with Neurofeedback Using NIRS Improved Cognitive Functions in Young Adults: Evidence from a Randomized Controlled Trial

(1) Background: A previous study has shown that cognitive training with neurofeedback (CT-NF) using down-regulation improves cognitive functions in young adults. Neurofeedback has two strategies for manipulating brain activity (down-regulation and upregulation). However, the benefit of CT-NF with the upregulation of cognitive functions is still unknown. In this study, we investigated whether the upregulation of CT-NF improves a wide range of cognitive functions compared to cognitive training alone. (2) Methods: In this double-blinded randomized control trial (RCT), 60 young adults were randomly assigned to one of three groups: CT-NF group, CT alone group, and an active control (ACT) group who played a puzzle game. Participants in the three groups used the same device (tablet PC and 2ch NIRS (near-infrared spectroscopy)) and performed the training game for 20 min every day for four weeks. We measured brain activity during training in all groups, but only CT-NFs received NF. We also measured a wide range of cognitive functions before and after the intervention period. (3) Results: The CT-NF groups showed superior beneficial effects on episodic memory, working memory, and attention compared to the CT alone and ACT groups. In addition, the CT-NF group showed an increase in brain activity during CT, which was associated with improvements in cognitive function. (4) Discussion: This study first demonstrated that the CT-NF using the upregulation strategy has beneficial effects on cognitive functions compared to the CT alone. Our results suggest that greater brain activities during CT would enhance a benefit from CT.

The effect of video games, exergames and board games on executive functions in kindergarten and 2nd grade: An explorative longitudinal study

We examined the relation between different kinds of play behavior (video games, exergames, board games) in kindergarten (T1) and components of executive function (EF; inhibition, switching, verbal and visuospatial updating) in kindergarten and second grade (T1 and T2). Ninety-seven children participated in this longitudinal study. Parents were asked to complete a questionnaire regarding children's play behavior, reporting frequency, duration, and game type. The results indicate that play behavior is associated with EF development in children; however, only exergames, electronic puzzle games, and board games predicted EF at T2. Additionally, the time spent on electronic games was negatively related to visuospatial updating at T1 but did not predict EF at T2. The results support further investigation of a potential link between board game and exergame play behavior and EF development.

Association between plasma dipeptidyl peptidase-4 levels and cognitive function in perinatal pregnant women with gestational diabetes mellitus

BACKGROUND

Dipeptidyl peptidase-4 (DPP4) is associated with cognitive dysfunction in patients with type 2 diabetes.

AIM

To assess a possible relationship between serum DPP4 and cognitive function in perinatal pregnant women with gestational diabetes mellitus (GDM).

METHODS

The study subjects were divided into three groups: GDM group (n = 81), healthy pregnant (HP) group (n = 85), and control group (n = 51). The Montreal Cognitive Assessment (MoCA) was used to assess the cognitive status of each group. Venous blood samples were collected to measure blood lipids, glycated hemoglobin, and glucose levels. For each participant, a 3-mL blood sample was collected and centrifuged, and the serum was collected. Blood samples were stored at -80 ℃, and DPP4, interleukin-6 (IL-6), and 8-iso-prostaglandin F2α (8-iso-PGF2α), and brain-derived neurotrophic factor (BDNF) were detected using ELISA.

RESULTS

The MoCA scores in the GDM and HP groups were significantly different from those in the control group in terms of visuospatial/executive function and attention (P < 0.05); however, the scores were not significantly different between the GDM and HP groups (P > 0.05). In terms of language, the GDM group had significantly different scores from those in the other two groups (P < 0.05). In terms of memory, a significant difference was found between the HP and control groups (P < 0.05), as well as between the GDM and HP groups. The levels of DPP4, IL-6, and 8-iso-PGF2α in the GDM group were significantly higher than those in the HP and control groups (P < 0.05); however, the differences between these levels in the HP and control groups were not significant (P > 0.05). The level of BDNF in the GDM group was significantly lower than that in the HP and control groups (P < 0.05), although the difference in this level between the HP and control groups was not significant (P > 0.05).

CONCLUSION

Cognitive dysfunction in perinatal pregnant women with GDM mainly manifested as memory loss, which might be associated with elevated DPP4 levels.

Cognitive Dysfunction of Pregnant Women with Gestational Diabetes Mellitus in Perinatal Period

Purpose

To explore whether pregnant women with gestational diabetes mellitus (GDM) had cognitive impairment and assess cognitive function in normal pregnant women.

Methods

A total of 75 consecutive women diagnosed with GDM (GDM group), 70 normal pregnant women (NP group) without diabetes and matched for age, and 51 female volunteers (CG group) with the similar age level, normal blood glucose, and nonpregnancy were included in the study. For the assessment of cognitive functions, Montreal Cognitive Assessment (MoCA) was performed. Venous blood samples were collected to measure blood glucose, glycated hemoglobin (HbA1c), methylglyoxal (MGO), beta amyloid (Aβ), and tau protein.

Results

The score of MoCA of GDM was lowest, and the score of the NP group was lower than volunteers (P < 0.05). The incidence of cognitive dysfunction increased significantly in the GDM group with statistical significance (P < 0.05). The levels of tau and MGO in the GDM group were significantly less than those in the NP and CG groups, and Aβ in the GDM group was significantly more than that in the NP and CG groups (P < 0.05), but the differences between NP and CG groups were not statistically significant (P < 0.05).

Conclusion

The pregnant women with GDM showed a significant decline in cognitive function, and the normal pregnant women also showed a decline in cognitive function which is very light.

Effect of one-session focused attention meditation on the working memory capacity of meditation novices: A functional near-infrared spectroscopy study

INTRODUCTION

Previous studies have revealed that one-session focused attention meditation (FAM) can improve top-down attention control, which is one of the factors of working memory capacity (WMC). In addition, FAM shares various neural substrates, including the dorsolateral prefrontal cortex (DLPFC), with WMC. Thus, we hypothesized that one-session FAM would improve WMC by activating the DLPFC evoked by the top-down attention control. In this study, we examined whether FAM modified WMC in individuals with little to no meditation experience.

METHODS

The participants were randomly assigned to either the FAM group (N = 13) or the control group (N = 17) who engaged in random thinking (i.e., mind-wandering). Before and after each 15-min intervention, the participants' WMC was measured according to the total number of correct answers in the Reading Span Test. During each intervention, functional near-infrared spectroscopy was employed to measure the blood flow in the participants' DLPFC and determine the top-down attention control effect.

RESULTS

In the FAM group, WMC increased, and the bilateral DLPFC was activated during the intervention. As for the control group, WMC decreased after the intervention, and the bilateral DLPFC was not activated during the intervention. A correlation was also found among all participants between the increase in WMC and the activation of the bilateral DLPFC.

CONCLUSION

The study findings suggest that top-down attention control during FAM can activate the bilateral DLPFC and increase WMC among meditation novices.

Brain training using cognitive apps can improve cognitive performance and processing speed in older adults

Managing age-related decrease of cognitive function is an important public health challenge, especially in the context of the global aging of the population. Over the last years several Cognitive Mobile Games (CMG) have been developed to train and challenge the brain. However, currently the level of evidence supporting the benefits of using CMG in real-life use is limited in older adults, especially at a late age. In this study we analyzed game scores and the processing speed obtained over the course of 100 sessions in 12,000 subjects aged 60 to over 80 years. Users who trained with the games improved regardless of age in terms of scores and processing speed throughout the 100 sessions, suggesting that old and very old adults can improve their cognitive performance using CMG in real-life use.

Effects of training of shadowing and reading aloud of second language on working memory and neural systems

Shadowing and reading aloud both involve multiple complex cognitive processes, and both are considered effective methods for second-language learning. The working memory system, particularly the phonological loop, has been suggested to be involved in shadowing and reading aloud. The purpose of this study was to investigate the effects of a 4-week intensive adaptive training including shadowing and reading aloud of second language on working-memory capacity, regional gray matter volume (rGMV), and functional activation related to the n-back working-memory task in young adults. The results showed that compared with the training groups without speaking (listening to compressed speech and active control involving the second language), the training groups with speaking (shadowing and reading aloud) showed a tendency for greater test-retest increases in digit-span scores, and significantly greater test-retest decreases in N-back task reaction time (increase in working memory performance). Imaging analyses revealed compared with the active control group, shadowing group exhibited decreases in rGMV and brain activity during the working memory task (2-back task), in the left cerebellum and reading group exhibited decreases in them in the right anterior insula. These regions are parts of the phonological loop, suggesting the presence of training-induced neural plasticity in these neurocognitive mechanisms.

Do Older and Young Adults Learn to Integrate Geometry While Navigating in an Environment of a Serious Game?

We evaluated the outcomes of an intervention using a serious game designed to be played on iPads for improving spatial reorientation by training users to integrate geometry of the environment, instead of relying solely on featural cues. Using data logged online through a clinical study of using this game, the effect of training among 16 older adults (69.3 ± 6.4 years, 4 males), who played the game repeatedly (self-administered) over a period of 8 weeks, was investigated. The game contains a hexagonal room with 3 objects, textured walls, and grids on the floor, which are removed one by one as the participant played the game. In each level, the room also rotates such that the viewpoint of the user is different from that of the previous level. Participants cannot play a higher level unless they make no mistake during the trials of the lower test level. In addition to data of older adults available from that clinical trial, we recruited 16 young adults (27.3 ± 5.6 years, 4 males) to play the game for 5 sessions and compared their results with those of the older adults. We evaluated the error type made in each test level and the scores for each session among older adults. Further, we compared the frequency of each error type between young and older adults during the test levels that a landmark adjacent to the target was removed over the first 5 sessions. The results of older adults’ performance suggest they learned to make fewer mistakes over the sessions. Also, both young and older adults learned to integrate the geometrical cues rather than relying on the landmark cue adjacent to the target to find the target. Overall, the results indicate the designed hexagonal room game can enhance spatial cognition among all age groups of adults.

The Food, Feelings, and Family Study: comparison of the efficacy of traditional methods, social media, and broadcast email to recruit pregnant women to an observational, longitudinal nutrition study

Background

It is well known that recruitment is a challenging aspect of any study involving human subjects. This challenge is exacerbated when the population sought is reticent to participate in research as is the case with pregnant women and individuals with depression. This paper compares recruitment methods used for the Food, Feelings, and Family Study, an observational, longitudinal pilot study concerning how diet and bisphenol A exposure affect maternal mood and cognitive function during and after pregnancy.

Methods

Pregnant women were recruited to this study over a period of 15 months using traditional methods, social media including paid and unpaid posts, and emails broadcast to the university community. Contingency analysis using the Pearson’s Chi-square test was used to determine if recruitment method was associated with likelihood of participation. T-tests were used to analyze Facebook advertisement success. ANOVAs and Fisher exact tests were used to determine if recruitment method was related to continuous and categorical demographics, respectively.

Results

Social media resulted in the largest number of recruits, followed by traditional methods and broadcast email. Women recruited through social media were less likely to participate. In contrast, use of broadcast email resulted in a smaller pool of recruits but these recruits were more likely to be eligible for and complete the study. Most women recruited via social media were the result of unpaid posts to the study’s Facebook page. Paid posts lasting at least 4 days were the most successful. Recruitment method was not associated with participant demographics.

Conclusions

Social media has the potential to recruit a large pool of potential subjects; however, when studies require a large time investment such as the case here, women recruited through social media are less likely to participate and complete the study than women recruited through other means.

Trial registration

N/A. This study does not describe a health care intervention.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12884-021-03680-1.

Brain Training and Sulforaphane Intake Interventions Separately Improve Cognitive Performance in Healthy Older Adults, Whereas a Combination of These Interventions Does Not Have More Beneficial Effects: Evidence from a Randomized Controlled Trial

Background: Earlier studies have demonstrated that a single-domain intervention, such as a brain-training (BT) game alone and a sulforaphane (SFN) intake, positively affects cognition. This study examined whether a combined BT and SFN intake intervention has beneficial effects on cognitive function in older adults. Methods: In a 12-week double-blinded randomized control trial, 144 older adults were randomly assigned to one of four groups: BT with SFN (BT-S), BT with placebo (BT-P), active control game (AT) with SFN (AT-S), and active control game with placebo (AT-P). We used Brain Age in BT and Tetris in AT. Participants were asked to play BT or AT for 15 min a day for 12 weeks while taking a supplement (SFN or placebo). We measured several cognitive functions before and after the intervention period. Results: The BT (BT-S and BT-P) groups showed more improvement in processing speed than the active control groups (AT-S and AT-P). The SFN intake (BT-S and AT-S) groups recorded significant improvements in processing speed and working memory performance unlike the placebo intake groups (BT-P and AT-P). However, we did not find any evidence of the combined intervention’s beneficial effects on cognition. Discussion: We discussed a mechanism to improve cognitive functions in the BT and SFN alone interventions.

Acute effects of 2D exergame on cognitive functions and frontal cortical activity

ABSTRACT This study aims to evaluate the effect of an exercise with a 2D virtual reality session on the cognition and cortical activity of young males. This is a randomized controlled trial with ten men aged 18 to 23 years. They were randomly assigned under two conditions: 1) exercise session with 2D virtual reality games and 2) control, which consisted of watching a two-episode video of a comic TV show. Cognition and frontal cortical activity were assessed immediately before and after the intervention, using the Mindset, performing the Digit Span Test, semantic verbal fluency, and executive function. Executive function improved with the exergame session (p=0.025). Exergames partially promote an immediate increase in the executive function of young people.

Use of Stroop Test for Sports Psychology Study: Cross-Over Design Research

Background: In sports psychology research, the Stroop test and its derivations are commonly used to investigate the benefits of exercise on cognitive function. The measures of the Stroop test and the computed interference often have different interclass correlation coefficients (ICC). However, the ICC is never reported in cross-over designs involving multiple variances associated with individual differences.

Objective: We investigated the ICC of the Stroop neutral and incongruent tests and interference (neutral test—incongruent test), and reverse Stroop task using the linear mixed model.

Methods: Forty-eight young adults participated in a cross-over design experiment composed of 2 factors: exercise mode (walking, resistance exercise, badminton, and seated rest as control) and time (pre- and post-tests). Before and after each intervention, participants completed the Stroop neutral and incongruent, and the reverse-Stroop neutral and incongruent tests. We analyzed for each test performance and interference and calculated ICC using the linear mixed model.

Results: The linear mixed model found a significant interaction of exercise mode and time for both the Stroop and reverse-Stroop tasks, suggesting that exercise mode influences the effect of acute exercise on inhibitory function. On the other hand, there was no significant effect of exercise mode for both the Stroop and reverse-Stroop interference. The results also revealed that calculating both the Stroop and reverse-Stroop interference resulted in smaller ICCs than the ICCs of the neutral and incongruent tests for both the Stroop and reverse-Stroop tasks.

Conclusion: The Stroop and reverse-Stroop interferences are known as valid measures of the inhibitory function for cross-sectional research design. However, to understand the benefits of acute exercise on inhibitory function comprehensively by cross-over design, comparing the incongruent test with the neutral test also seems superior because these tests have high reliability and statistical power.

Photo-Realistic Interactive Virtual Environments for Neurorehabilitation in Mild Cognitive Impairment (NeuroVRehab.PT): A Participatory Design and Proof-of-Concept Study

Mild cognitive impairment (MCI) is characterized by cognitive, psychological, and functional impairments. Digital interventions typically focus on cognitive deficits, neglecting the difficulties that patients experience in instrumental activities of daily living (IADL). The global conjecture created by COVID-19 has highlighted the seminal importance of digital interventions for the provision of healthcare services. Here, we investigated the feasibility and rehabilitation potential of a new design approach for creating highly realistic interactive virtual environments for MCI patients’ neurorehabilitation. Through a participatory design protocol, a neurorehabilitation digital platform was developed using images captured from a Portuguese supermarket (NeuroVRehab.PT). NeuroVRehab.PT’s main features (e.g., medium-sized supermarket, the use of shopping lists) were established according to a shopping behavior questionnaire filled in by 110 older adults. Seven health professionals used the platform and assessed its rehabilitation potential, clinical applicability, and user experience. Interviews were conducted using the think-aloud method and semi-structured scripts, and four main themes were derived from an inductive semantic thematic analysis. Our findings support NeuroVRehab.PT as an ecologically valid instrument with clinical applicability in MCI neurorehabilitation. Our design approach, together with a comprehensive analysis of the patients’ past experiences with IADL, is a promising technique to develop effective digital interventions to promote real-world functioning.

Effects and Moderators of Computer-Based Training on Children's Executive Functions: A Systematic Review and Meta-Analysis

Computer-based training has attracted increasing attention from researchers in recent years. Several studies have found that computer-based training resulted in improved executive functions (EFs) in adults. However, it remains controversial whether children can benefit from computer-based training and what moderator could influence the training effects. The focus of the present meta-analysis was to examine the effects of computer-based training on EFs in children: working memory, cognitive flexibility, and inhibitory control. A thorough search of published work yielded a sample of 36 studies with 216 effect sizes. The results indicated that computer-based training showed moderate training effects on improving EFs in children (g = 0.35, k = 36, p < 0.001), while training effects of working memory were significantly higher. Furthermore, we found near-transfer effects were marginally significantly higher than far-transfer effects. The standard training method was significantly more effective than training with game elements. In computer-based training, typically developing children had significantly better training effects than atypically developing children. Some additional factors, such as the number of training sessions and age, also modulated the training effects. In conclusion, the present study investigated the effects and moderators of computer-based training for children's EFs. The results provided evidence that computer-based training (especially standard training) may serve as an efficient way to improve EFs in children (especially typically developing individuals). We also discussed some directions for future computer-based training studies.

Investigating a new tablet-based telerehabilitation app in patients with aphasia: a randomised, controlled, evaluator-blinded, multicentre trial protocol

INTRODUCTION

Aphasia is a common language disorder acquired after stroke that reduces the quality of life of affected patients. The impairment is frequently accompanied by a deficit in cognitive functions. The state-of-the-art therapy is speech and language therapy but recent findings highlight positive effects of high-frequency therapy. Telerehabilitation has the potential to enable high-frequency therapy for patients at home. This study investigates the effects of high-frequency telerehabilitation speech and language therapy (teleSLT) on language functions in outpatients with aphasia compared with telerehabilitative cognitive training. We hypothesise that patients training with high-frequency teleSLT will show higher improvement in language functions and quality of life compared with patients with high-frequency tele-rehabilitative cognitive training (teleCT).

METHODS AND ANALYSIS

This study is a randomised controlled, evaluator-blinded multicentre superiority trial comparing the outcomes following either high-frequency teleSLT or teleCT. A total of 100 outpatients with aphasia will be recruited and assigned in a 1:1 ratio stratified by trial site and severity of impairment to one of two parallel groups. Both groups will train over a period of 4 weeks for 2 hours per day. Patients in the experimental condition will devote 80% of their training time to teleSLT and the remaining 20% (24 min/day) to teleCT, vice versa for patients in the control condition. The primary outcome measure is the understandability of verbal communication on the Amsterdam Nijmegen Everyday Language Test and secondary outcome measures are intelligibility of the verbal communication, impairment of receptive and expressive language functions, confrontation naming. Other outcomes measures are quality of life and acceptance (usability and subjective experience) of the teleSLT system.

ETHICS AND DISSEMINATION

This study is approved by the Ethics Committee Bern (ID 2016-01577). Results will be submitted to a peer-reviewed journal.

TRIAL REGISTRATION NUMBER

NCT03228264.

Training effects of attention and EF strategy-based training "Nexxo" in school-age students

Given the importance of attention and executive functions in children's behavior, programs directed to improve these processes are of interest. Nexxo-training combines the use of the Nexxo touchscreen application (go/no-go and stop signal tasks) with procedural metacognitive strategies. The present paper reports a test of Nexxo's impact on children aged 6-7 and 8-9 years. We conducted a randomized active-controlled trial involving 108 typically-developing children: 1st grade (N = 61, M = 6.46 years, SD = 0.35) and 3rd grade (N = 47, M = 8.5 years, SD = 0.27), randomly assigned to: (1) experimental, (2) active-control, or (3) passive-control groups. A 2-month follow-up was carried out after the intervention. The 3rd grade experimental group displayed a significant reduction in attentional problems at follow-up compared to both control groups. Executive Function problems were also reduced at follow-up in the experimental group. Participants in this group improved in Supervision (self-monitoring) at post-intervention and follow-up compared to passive-controls. Although group effect was not significant at t1, it was significant at post measures in experimental group compared to passive-controls. Nexxo-training revealed a trend-level improvement in attention and executive functions for children in the 3rd grade.

Changes in Cognitive Functions Following Violent and Football Video Games in Young Male Volunteers by Studying Brain Waves

Introduction:

This research investigated the effects of violent and football video games on cognitive functions, cortisol levels, and brain waves.

Methods:

A total of 64 participants competed in a single-elimination tournament. Saliva samples of all players were obtained before and after the games for the assessment of cortisol levels. The cognitive performances of the players were also assessed by paced auditory serial addition test. Moreover, the electroencephalogram recording was conducted during the games.

Results:

The results showed that salivary cortisol levels significantly decreased after playing both games. Also, playing the football game increased reaction time, whereas decreased sustained attention and mental fatigue.

Conclusion:

Conversely, following playing a violent game, the reaction time decreased, and sustained attention and mental fatigue increased. Furthermore, the results of the EEG recording revealed that playing a violent game engaged more brain regions than the football game. In conclusion, playing violent game more effectively improved cognitive performances in the players than the football game.

Dorsolateral Prefrontal Cortex Activity during a Brain Training Game Predicts Cognitive Improvements after Four Weeks' Brain Training Game Intervention: Evidence from a Randomized Controlled Trial

BACKGROUND

Recent studies have demonstrated that brain activities using NIRS (near-infrared spectroscopy) at baseline during cognitive tasks (e.g., N-back task) can predict the cognitive benefits of a cognitive training. In this study, we investigated whether brain activities during brain training game (BT) at baseline would predict benefits to cognitive functions after the intervention period.

METHODS

In a four-week double-blinded randomized control trial (RCT) 72 young adults were randomly assigned to one of the two groups: participants in the BT group played specific game, called the Brain Age. Participants in an active control group (ACT) played the puzzle game Tetris. We measured brain activity during the training games using two channel NIRS before the intervention period. Cognitive functions were tested before and after the four-week intervention period.

RESULTS

The BT showed significant improvements in inhibition, processing speed, and working memory performance compared to ACT. The left and right DLPFC (dorsolateral prefrontal cortex) brain activities during the BT at baseline were associated with improvements in inhibition and processing speed.

DISCUSSION

This randomized control trial first provides scientific evidence that DLPFC activities during BT at baseline can predict cognitive improvements after a four-week intervention period.

Quality Criteria for Serious Games: Serious Part, Game Part, and Balance

Serious games are digital games that have an additional goal beyond entertainment. Recently, many studies have explored different quality criteria for serious games, including effectiveness and attractiveness. Unfortunately, the double mission of serious games, that is, simultaneous achievement of intended effects (serious part) and entertainment (game part), is not adequately considered in these studies. This paper aims to identify essential quality criteria for serious games. The fundamental goal of our research is to identify important factors of serious games and to adapt the existing principles and requirements from game-related literature to effective and attractive serious games. In addition to the review of the relevant literature, we also include workshop results. Furthermore, we analyzed and summarized 22 state-of-the-art serious games for education and health. The selected best-practice serious games either prove their effectiveness through scientific studies or by winning game awards. For the analysis of these games, we refer to "DIN SPEC 91380 Serious Games Metadata Format." A summarized text states quality criteria for both the serious and the game part, and especially the balance between them. We provide guidelines for high-quality serious games drawn from literature analysis and in close cooperation with domain experts.

Drum Communication Program Intervention in Older Adults With Cognitive Impairment and Dementia at Nursing Home: Preliminary Evidence From Pilot Randomized Controlled Trial

Introduction: Inactivity and consequent deterioration of cognitive and physical function is a major concern among older adults with the limited walking ability and need a high level of care in nursing homes. We aimed to test whether a drumming communication program (DCP) that uses the rhythmic response function of the elderly with cognitive impairment, dementia, and other debilitating disorders would improve their cognitive and physical function. Methods: We conducted a Randomized Controlled Trial (RCT) to investigate the effects of the DCP in 46 nursing home residents who needed high levels of nursing care. The participants were randomly assigned to an intervention and control group. The intervention group attended 30 min of the DCP thrice a week for 3 months. Cognitive function was measured using the Mini-Mental State Examination-Japanese (MMSE-J) and Frontal Assessment Battery (FAB). Physical function was measured using grip strength and active upper limb range of motion with the dominant hand. Body composition was measured using bioelectrical impedance analysis (BIA). These measures were analyzed before and after the DCP intervention period, and data for the two groups were compared thereafter. Results: Initially, the participants had low scores on the MMSE-J, and 84.78% of them used wheelchairs. Following the DCP intervention, the MMSE-J and FAB scores of the DCP group improved significantly. In terms of motor function, the active range of motion of the wrist palmar and the shoulder flexion improved in the intervention group. Regarding body composition, the skeletal muscle mass index, total body protein, and the dominant hand muscle mass that was adding physical load decreased. Conclusions: The DCP provided the participants with an opportunity to engage in continued exercise for 3 months. The intervention group exhibited improved cognitive function and upper limb motion range, and changes in body composition. The results suggest that DCP can be used as an intervention method to promote exercise and improve various health and cognitive functions. Trial Registration: This trial was registered at the University Hospital Medical Information Network Clinical Trial Registry (UMIN000024714) on 4 November 2016. The URL is available at https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000028399.

A Single 30 Minutes Bout of Combination Physical Exercises Improved Inhibition and Vigor-Mood in Middle-Aged and Older Females: Evidence From a Randomized Controlled Trial

Background

Long-term combination of physical exercises has reported benefits for cognitive functions and mood states. However, it remains unclear whether a single bout of combination exercise training has acute positive effects on cognitive functions and mood states in middle-aged and older women. It is important to investigate acute effect of physical exercise because it would help to understand a mechanism of benefits of physical exercise. The purpose of this study was to investigate 30 min of a single bout of combination exercise training on cognition and mood states in middle-aged and older females.

Methods

In this single-blinded randomized control trial (RCT), middle-aged and older females were assigned randomly to two groups: a combination exercise group and a no-exercise control group. The former group did the combination exercise training (aerobic, strength, and stretching exercises) for 30 min. Meanwhile, the latter group did not do any exercise and waited for 30 min. We measured cognitive functions and mood performance states before and after the exercise or control interventions.

Results

Our main results demonstrated that, compared to the control group, the combination exercise improved inhibition (reverse Stroop and Stroop) and increased vigor–activity mood scores in both middle-aged and older groups. We also found that the only combination exercise group showed the significant positive correlations between improved inhibition performance and improved vigor–activity mood.

Discussion

This randomized controlled trial revealed the acute benefits of combination exercise on inhibition in executive functions and vigor–activity in the healthy middle-aged and older females. Our results provided the scientific evidence related to acute effects of the single bout of the combination exercise training. It suggests that we would be better to do the 30 min physical exercise for our health.

Clinical Trial Registration

This trial was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000029681). Registered 24 October 2017, https://upload.umin.ac.jp/cgi-bin/ctr/ctr_view_reg.cgi?recptno=R000033922.

Age-Associated Capacity to Progress When Playing Cognitive Mobile Games: Ecological Retrospective Observational Study

Background

The decline of cognitive function is an important issue related to aging. Over the last few years, numerous mobile apps have been developed to challenge the brain with cognitive exercises; however, little is currently known about how age influences capacity for performance improvement when playing cognitive mobile games.

Objective

The objective of this study was to analyze the score data of cognitive mobile games over a period of 100 gaming sessions to determine age-related learning ability for new cognitive tasks by measuring the level of score improvement achieved by participants of different ages.

Methods

Scores from 9000 individuals of different ages for 7 cognitive mobile games over 100 gaming sessions were analyzed. Scores from the first session were compared between age groups using one-way analysis of variance. Mixed models were subsequently used to investigate the progression of scores over 100 sessions.

Results

Statistically significant differences were found between age groups for the initial scores of 6 of the 7 games (linear trend, P<.001). Cognitive mobile game scores increased for all participants (P<.001) suggesting that all participants were able to improve their performance. The rate of improvement was, however, strongly influenced by the age of the participant with slower progression for older participants (P<.001).

Conclusions

This study provides evidence to support two interesting insights—cognitive mobile game scores appear to be sensitive to the changes in cognitive ability that occur with advancing age; therefore, these games could be a convenient way to monitor cognitive function over long-term follow-up, and users who train with the cognitive mobile games improve regardless of age.

Treatment and management of cognitive dysfunction in patients with multiple sclerosis

Cognitive impairment is a common and devastating manifestation of multiple sclerosis (MS). Although disease-modifying therapies have been efficacious for reducing relapse rates in MS, such treatments are ineffective for treating cognitive dysfunction. Alternative treatment approaches for mitigating cognitive problems are greatly needed in this population. To date, cognitive rehabilitation and exercise training have been identified as possible candidates for treating MS-related cognitive impairment; however, cognitive dysfunction is still often considered to be poorly managed in patients with MS. This Review provides a comprehensive overview of recent developments in the treatment and management of cognitive impairment in people with MS. We describe the theoretical rationales, current states of the science, field-wide challenges and recent advances in cognitive rehabilitation and exercise training for treating MS-related cognitive impairment. We also discuss future directions for research into the treatment of cognitive impairment in MS that should set the stage for the inclusion of cognitive rehabilitation and exercise training into clinical practice within the next decade.

Computerised cognitive training for 12 or more weeks for maintaining cognitive function in cognitively healthy people in late life

BACKGROUND

Increasing age is associated with a natural decline in cognitive function and is the greatest risk factor for dementia. Cognitive decline and dementia are significant threats to independence and quality of life in older adults. Therefore, identifying interventions that help to maintain cognitive function in older adults or that reduce the risk of dementia is a research priority. Cognitive training uses repeated practice on standardised exercises targeting one or more cognitive domains and may be intended to improve or maintain optimal cognitive function. This review examines the effects of computerised cognitive training interventions lasting at least 12 weeks on the cognitive function of healthy adults aged 65 or older and has formed part of a wider project about modifying lifestyle to maintain cognitive function. We chose a minimum 12 weeks duration as a trade-off between adequate exposure to a sustainable intervention and feasibility in a trial setting.

OBJECTIVES

To evaluate the effects of computerised cognitive training interventions lasting at least 12 weeks on cognitive function in cognitively healthy people in late life.

SEARCH METHODS

We searched to 31 March 2018 in ALOIS (www.medicine.ox.ac.uk/alois), and we performed additional searches of MEDLINE, Embase, PsycINFO, CINAHL, ClinicalTrials.gov, and the WHO Portal/ICTRP (www.apps.who.int/trialsearch), to ensure that the search was as comprehensive and as up-to-date as possible to identify published, unpublished, and ongoing trials.

SELECTION CRITERIA

We included randomised controlled trials (RCTs) and quasi-RCTs, published or unpublished, reported in any language. Participants were cognitively healthy people, and at least 80% of the study population had to be aged 65 or older. Experimental interventions adhered to the following criteria: intervention was any form of interactive computerised cognitive intervention - including computer exercises, computer games, mobile devices, gaming console, and virtual reality - that involved repeated practice on standardised exercises of specified cognitive domain(s) for the purpose of enhancing cognitive function; the duration of the intervention was at least 12 weeks; cognitive outcomes were measured; and cognitive training interventions were compared with active or inactive control interventions.

DATA COLLECTION AND ANALYSIS

We performed preliminary screening of search results using a 'crowdsourcing' method to identify RCTs. At least two review authors working independently screened the remaining citations against inclusion criteria. At least two review authors also independently extracted data and assessed the risk of bias of included RCTs. Where appropriate, we synthesised data in random-effects meta-analyses, comparing computerised cognitive training (CCT) separately with active and inactive controls. We expressed treatment effects as standardised mean differences (SMDs) with 95% confidence intervals (CIs). We used GRADE methods to describe the overall quality of the evidence for each outcome.

MAIN RESULTS

We identified eight RCTs with a total of 1183 participants. The duration of the interventions ranged from 12 to 26 weeks; in five trials, the duration of intervention was 12 or 13 weeks. The included studies had moderate risk of bias, and the overall quality of evidence was low or very low for all outcomes. We compared CCT first against active control interventions, such as watching educational videos. Negative SMDs favour CCT over control. Trial results suggest slight improvement in global cognitive function at the end of the intervention period (12 weeks) (standardised mean difference (SMD) -0.31, 95% confidence interval (CI) -0.57 to -0.05; 232 participants; 2 studies; low-quality evidence). One of these trials also assessed global cognitive function 12 months after the end of the intervention; this trial provided no clear evidence of a persistent effect (SMD -0.21, 95% CI -0.66 to 0.24; 77 participants; 1 study; low-quality evidence). CCT may result in little or no difference at the end of the intervention period in episodic memory (12 to 17 weeks) (SMD 0.06, 95% CI -0.14 to 0.26; 439 participants; 4 studies; low-quality evidence) or working memory (12 to 16 weeks) (SMD -0.17, 95% CI -0.36 to 0.02; 392 participants; 3 studies; low-quality evidence). Because of the very low quality of the evidence, we are very uncertain about the effects of CCT on speed of processing and executive function. We also compared CCT to inactive control (no interventions). We found no data on our primary outcome of global cognitive function. At the end of the intervention, CCT may lead to slight improvement in episodic memory (6 months) (mean difference (MD) in Rivermead Behavioural Memory Test (RBMT) -0.90 points, 95% confidence interval (CI) -1.73 to -0.07; 150 participants; 1 study; low-quality evidence) but can have little or no effect on executive function (12 weeks to 6 months) (SMD -0.08, 95% CI -0.31 to 0.15; 292 participants; 2 studies; low-quality evidence), working memory (16 weeks) (MD -0.08, 95% CI -0.43 to 0.27; 60 participants; 1 study; low-quality evidence), or verbal fluency (6 months) (MD -0.11, 95% CI -1.58 to 1.36; 150 participants; 1 study; low-quality evidence). We could not determine any effects on speed of processing because the evidence was of very low quality. We found no evidence on quality of life, activities of daily living, or adverse effects in either comparison.

AUTHORS' CONCLUSIONS

We found low-quality evidence suggesting that immediately after completion of the intervention, small benefits of CCT may be seen for global cognitive function when compared with active controls, and for episodic memory when compared with an inactive control. These benefits are of uncertain clinical importance. We found no evidence that the effect on global cognitive function persisted 12 months later. Our confidence in the results was low, reflecting the overall quality of the evidence. In five of the eight trials, the duration of the intervention was just three months. The possibility that more extensive training could yield larger benefit remains to be more fully explored. We found substantial literature on cognitive training, and collating all available scientific information posed problems. Duration of treatment may not be the best way to categorise interventions for inclusion. As the primary interest of older people and of guideline writers and policymakers involves sustained cognitive benefit, an alternative would be to categorise by length of follow-up after selecting studies that assess longer-term effects.

Frequent Karaoke Training Improves Frontal Executive Cognitive Skills, Tongue Pressure, and Respiratory Function in Elderly People: Pilot Study from a Randomized Controlled Trial

We tested whether karaoke training improves cognitive skills and reduces the risk of physical function impairments. We conducted a single-blinded randomized controlled trial in 26 elderly participants at residential care facilities, who were generally healthy or required the lowest level of care. Participants were near the threshold for mild cognitive impairment with the Montreal Cognitive Assessment (MoCA) and close to the sarcopenia cut-off with the skeletal muscle mass index. Pulmonary function as measured with spirometry and tongue strength were used as markers for physical functions affected by sarcopenia. Karaoke training occurred once a week for two hours, with an hour of homework assigned weekly. Karaoke training significantly improved the Frontal Assessment Battery at bedside (FAB) compared with an active control group receiving scratch art training (F = 8.04, permutation p-value = 0.013). Subscore improved with inhibitory control (F = 7.63, permutation p-value = 0.015) and sensitivity to interference (F = 11.98, permutation p-value = 0.001). We observed improved tongue pressure (F = 4.49, permutation p-value = 0.040) and pulmonary function by a greater increase in FIV1 (F = 5.22, permutation p-value = 0.047). Engaging elderly people, especially those in care homes, with karaoke training exercises that are moderately physically challenging may be a key to slowing cognitive decline and preventing dysphagia by sarcopenia.

Altered brain functional networks in Internet gaming disorder: independent component and graph theoretical analysis under a probability discounting task

OBJECTIVES

Internet gaming disorder (IGD) is becoming a matter of concern around the world. However, the neural mechanism underlying IGD remains unclear. The purpose of this paper is to explore the differences between the neuronal network of IGD participants and that of recreational Internet game users (RGU).

METHODS

Imaging and behavioral data were collected from 18 IGD participants and 20 RGU under a probability discounting task. The independent component analysis (ICA) and graph theoretical analysis (GTA) were used to analyze the data.

RESULTS

Behavioral results showed the IGD participants, compared to RGU, prefer risky options to the fixed ones and spent less time in making risky decisions. In imaging results, the ICA analysis revealed that the IGD participants showed stronger functional connectivity (FC) in reward circuits and executive control network, as well as lower FC in anterior salience network (ASN) than RGU; for the GTA results, the IGD participants showed impaired FC in reward circuits and ASN when compared with RGU.

CONCLUSIONS

These results suggest that IGD participants were more sensitive to rewards, and they were more impulsive in decision-making as they could not control their impulsivity effectively. This might explain why IGD participants cannot stop their gaming behaviors even when facing severe negative consequences.