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Mazo G, Pantaléo S, van der Oord A, Picq JL, Hertz-Pannier L, Brunet E, Azouvi P, Vallat-Azouvi C. Rehabilitation of working memory after acquired brain injury and multiple sclerosis: A systematic review. Neuropsychol Rehabil 2024:1-39. [PMID: 38430123 DOI: 10.1080/09602011.2024.2319909] [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: 05/02/2022] [Accepted: 02/12/2024] [Indexed: 03/03/2024]
Abstract
The objective is to study the effectiveness of working memory (WM) rehabilitation after Acquired brain injury (ABI) and multiple sclerosis (MS). A systematic database search of published studies, following PRISMA recommendations, with assessment of methodological quality and risk of bias, was conducted. The results were analysed according to the rehabilitation method used. 31 studies (including 14 class I) were included, and 11 different training programs were identified. Despite great variability in training methodology and outcome measures, the results were positive overall. However, only three rehabilitation programs showed a transfer effect to WM (near) and daily life with long-term maintenance. The results were more variable for protocols limited to the use of computerized n-back training tasks. Overall, the current evidence supports multi-task WM training rather than single-task-limited program. It also supports early and long duration training, with some therapist support. However, it is not possible, to date, to make strong recommendations regarding the rehabilitation program to be used preferentially. Although results are encouraging, level of evidence remains modest, particularly regarding the maintenance of the therapeutic effect after the end of training, and the transfer to everyday life skills. The influence of rehabilitation parameters (training duration, therapist involvement … ) remains difficult to assess.
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Affiliation(s)
- Guillaume Mazo
- DysCo Laboratory, Paris 8 Saint-Denis University, Paris, France
| | | | | | - Jean-Luc Picq
- DysCo Laboratory, Paris 8 Saint-Denis University, Paris, France
| | - Lucie Hertz-Pannier
- UNIACT/Neurospin/Joliot/CEA-SACLAY and U1141 NeuroDiderot, Inserm, Paris University, Paris, France
| | - Eric Brunet
- Team DevPsy, UVSQ, Inserm, CESP, UMR 1018, Paris-Saclay University, Villejuif, France
- Hospital Mignot-Versailles, Le Chesnay-Rocquencourt, France
| | - Philippe Azouvi
- AP-HP, GHU Paris-Saclay, Raymond. Poincaré Hospital, Department of Physical Medicine and Rehabilitation, Garches, France
- Team DevPsy, UVSQ, Inserm, CESP, UMR 1018, Paris-Saclay University, Villejuif, France
| | - Claire Vallat-Azouvi
- DysCo Laboratory, Paris 8 Saint-Denis University, Paris, France
- Antenne UEROS-UGECAMIDF, Raymond Poincaré Hospital, Garches, France
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2
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Rahmani-Katigari M, Mohammadian F, Shahmoradi L. Development of a serious game-based cognitive rehabilitation system for patients with brain injury. BMC Psychiatry 2023; 23:893. [PMID: 38031072 PMCID: PMC10688007 DOI: 10.1186/s12888-023-05396-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/22/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Traumatic brain injury (TBI) resulting from a forceful impact to the head can cause severe functional disabilities, with cognitive impairment being a major hindrance to patients' return to daily life. Encouraging patients to engage in rehabilitation programs consistently poses a significant challenge for therapists. To address this issue, gamification has gained momentum as an effective approach. This study aims to develop a serious game-based cognitive rehabilitation system tailored for patients with brain injury. METHODS The study included four stages. Initially, the requirements were analyzed through focus groups. Then the system structure and game content were discussed and was agreed as a conceptual model. In second stage, the system design was drawn using various modeling diagrams. In third stage, a system prototype was developed using the Unity game engine and C# programming. Finally, a heuristic evaluation method was employed to assess usability. RESULTS Based on the focus group meetings with seven participants, a conceptual model of the system structure and game content was designed. Game's interface was developed for both the therapist and patient versions. The focus groups determined a 2D casual gaming genre with a postman character and 10 missions on the smartphone platform. For example, in the first mission, the postman must move from mailboxes 1 to 10 and pick up the letters. This is according to Trail Making Test task. The 16 tasks in different subcategories of attention were selected to make these missions. The usability evaluation highlighted privacy, help and documentation, and aesthetic and minimalist design as the areas with the highest percentage of problems. CONCLUSIONS Cognitive rehabilitation is vital in facilitating patients' faster return to daily routines and enhancing their quality-of-life following brain injury. Incorporating a game-based system provides patients with increased motivation to engage in various cognitive exercises. Additionally, continuous monitoring by specialists ensures effective patient management. The game-based system offers different game stages to strengthen and rehabilitate attention in patients with brain injury. In the next step, the clinical effects of this system will be evaluated.
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Affiliation(s)
- Meysam Rahmani-Katigari
- Department of Health Information Management, Saveh University of Medical Sciences, Saveh, Iran
| | - Fatemeh Mohammadian
- Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Shahmoradi
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.
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3
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Maggio MG, De Bartolo D, Calabrò RS, Ciancarelli I, Cerasa A, Tonin P, Di Iulio F, Paolucci S, Antonucci G, Morone G, Iosa M. Computer-assisted cognitive rehabilitation in neurological patients: state-of-art and future perspectives. Front Neurol 2023; 14:1255319. [PMID: 37854065 PMCID: PMC10580980 DOI: 10.3389/fneur.2023.1255319] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 08/31/2023] [Indexed: 10/20/2023] Open
Abstract
Background and aim Advances in computing technology enabled researchers and clinicians to exploit technological devices for cognitive training and rehabilitation interventions. This expert review aims to describe the available software and device used for cognitive training or rehabilitation interventions of patients with neurological disorders. Methods A scoping review was carried out to analyze commercial devices/software for computerized cognitive training (CCT) in terms of feasibility and efficacy in both clinical and home settings. Several cognitive domains responding to the different patients' needs are covered. Results This review showed that cognitive training for patients with neurological diseases is largely covered by several devices that are widely used and validated in the hospital setting but with few translations to remote/home applications. It has been demonstrated that technology and software-based devices are potential and valuable tools to administer remotely cognitive rehabilitation with accessible costs. Conclusion According to our results, CCT entails the possibility to continue cognitive training also in different settings, such as home, which is a significant breakthrough for the improvement of community care. Other possible areas of use should be the increase in the amount of cognitive therapy in the free time during the hospital stay.
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Affiliation(s)
| | - Daniela De Bartolo
- Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Amsterdam Movement Sciences & Institute for Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- IRCCS Santa Lucia Foundation, Rome, Italy
| | | | - Irene Ciancarelli
- Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
| | - Antonio Cerasa
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy, Messina, Italy
- S’Anna Institute, Crotone, Italy
- Pharmaco Technology Documentation and Transfer Unit, Preclinical and Translational Pharmacology, Department of Pharmacy, Health Science and Nutrition, University of Calabria, Rende, Italy
| | | | | | | | | | - Giovanni Morone
- Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
- San Raffaele Institute of Sulmona, Sulmona, Italy
| | - Marco Iosa
- IRCCS Santa Lucia Foundation, Rome, Italy
- Department of Psychology, Sapienza University of Rome, Rome, Italy
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Corti C, Oldrati V, Papini M, Strazzer S, Poggi G, Romaniello R, Borgatti R, Urgesi C, Bardoni A. Randomized clinical trial on the effects of a computerized cognitive training for pediatric patients with acquired brain injury or congenital malformation. Sci Rep 2023; 13:14559. [PMID: 37666983 PMCID: PMC10477344 DOI: 10.1038/s41598-023-41810-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/31/2023] [Indexed: 09/06/2023] Open
Abstract
Both acquired injuries and congenital malformations often cause lifelong disabilities in children, with a significant impact on cognitive abilities. Remote computerized cognitive training (CCT) may be delivered in ecological settings to favour rehabilitation continuity. This randomized clinical trial (RCT) evaluated the efficacy of an 8-week multi-domain, home-based CCT in a sample of patients aged 11-16 years with non-progressive acquired brain injury (ABI), brain tumor (BT) and congenital brain malformation (CBM). Following a stepped-wedge research design, patients were randomized into two groups: Training-first group, which started the CCT immediately after baseline assessment and Waiting-first group, which started the CCT after a period of time comparable to that required by the training (8 weeks). Post-training and long-term (6 months) changes were assessed. Both groups improved on visual-spatial working memory after the CCT, with benefits maintained after 6 months, while no other changes in cognitive or psychological measures were found. These findings suggest that a multi-domain CCT can generate benefits in visual-spatial working memory, in accordance with data from extant literature reporting that computer games heavily engage visuo-spatial abilities. We speculate that is tapping on the same cognitive ability with a prolonged training that may generate the greatest change after a CCT.
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Affiliation(s)
- Claudia Corti
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, Italy
| | - Viola Oldrati
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, Italy.
| | - Marta Papini
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, Italy
| | - Sandra Strazzer
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, Italy
| | - Geraldina Poggi
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, Italy
| | | | - Renato Borgatti
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, Italy
| | - Cosimo Urgesi
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, Italy
- Laboratory of Cognitive Neuroscience, Department of Languages and Literatures, Communication, Education and Society, University of Udine, Udine, Italy
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5
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Gil-Pagés M, Solana J, Sánchez-Carrión R, Tormos JM, Enseñat-Cantallops A, García-Molina A. Functional improvement in chronic stroke patients when following a supervised home-based computerized cognitive training. Brain Inj 2022; 36:1349-1356. [PMID: 36331895 DOI: 10.1080/02699052.2022.2140832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Computerized Cognitive Training (CCT) is an effective treatment for cognitive impairment in the post-acute stage of stroke. However, it is still not clear if it is suitable for chronic stage. OBJECTIVES To explore if patients with cognitive deficit following stroke may benefit from CCT. METHODS Thirty patients post-stroke between 24 and 62 years old were randomized into two groups (A and B) to receive two different types of CCT. All patients were tested with a neuropsychological battery and functional questionnaires, before and after each CCT and also 6 months after the end of the study. In phase I, Group A received a customized CCT and Group B received a non-customized CCT, over 6 weeks. Three months after, each group received the other intervention (phase II). RESULTS After phase I, between-group analyses revealed that Group A showed a relative decrease in subjective complaints. In contrast, Group B showed improvement in performance-based measures. After phase II, the decrease in subjective complaints continued in Group A, and both groups showed improvement in performance-based measures. CONCLUSIONS Patients with chronic stroke improved cognitive functioning after performing supervised home-based multi-domain computerized cognitive training.
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Affiliation(s)
- Macarena Gil-Pagés
- Institut Guttmann, Institut Universitari de Neurorehabilitació, adscrit a la Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain.,Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain.,Fundació Institut d´Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain.,Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Javier Solana
- Institut Guttmann, Institut Universitari de Neurorehabilitació, adscrit a la Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain.,Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain.,Fundació Institut d´Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Rocío Sánchez-Carrión
- Institut Guttmann, Institut Universitari de Neurorehabilitació, adscrit a la Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain.,Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain.,Fundació Institut d´Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Jose M Tormos
- Institut Guttmann, Institut Universitari de Neurorehabilitació, adscrit a la Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain.,Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain.,Fundació Institut d´Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Antonia Enseñat-Cantallops
- Institut Guttmann, Institut Universitari de Neurorehabilitació, adscrit a la Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain.,Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain.,Fundació Institut d´Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Alberto García-Molina
- Institut Guttmann, Institut Universitari de Neurorehabilitació, adscrit a la Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain.,Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain.,Fundació Institut d´Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain
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6
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Law C, Juraskova I, Lah S. [Formula: see text]Systematic review of pediatric memory questionnaires. Child Neuropsychol 2021; 27:734-781. [PMID: 33632075 DOI: 10.1080/09297049.2021.1888908] [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] [Received: 09/05/2020] [Accepted: 02/07/2021] [Indexed: 10/22/2022]
Abstract
Memory disturbances are common in children with neurological and developmental conditions. One way to measure memory disturbances and their functional implications is via a memory questionnaire. Several pediatric memory questionnaires have been published but no systematic review has been conducted to establish their psychometric properties. This review evaluated currently available pediatric memory questionnaires using the Evidence-Based Assessment (EBA) criteria developed by the American Psychological Association Task force. A systematic search of CINAHL, EMBASE, Medline, and PsychINFO was completed on June 2019. The selection process was guided by pre-defined inclusion and exclusion criteria, followed by full manuscript reviews, and hand-search of reference lists of relevant papers. Selected questionnaires were evaluated by two independent raters against the EBA criteria and classified into "well established", "approaching well-established", and "promising" categories. The electronic searches yielded 9888 articles, 24 of which met the inclusion criteria. Hand searches identified additional 21 studies. The 45 identified studies reported on 24 versions of 10 memory questionnaires assessed working memory, everyday memory, prospective and retrospective memory, and self-awareness of memory functions. Based on EBA criteria, only one memory questionnaire (The Working Memory Rating Scale - 20 item version) was classified as "well-established", 3 as "approaching well-established", and 20 as "promising". Most (n = 19) had good reliability but lacked concurrent validity; had low or no correlations with objective memory tests, and low predictive power. In conclusion, this review highlights an urgent need for the development and validation of pediatric memory questionnaires to increase the evidence base and improve questionnaires' clinical utility.
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Affiliation(s)
- Cecilia Law
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Ilona Juraskova
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
| | - Suncica Lah
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Australia
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7
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Afsar M, Shukla D, Bhaskarapillai B, Rajeswaran J. Cognitive Retraining in Traumatic Brain Injury: Experience from Tertiary Care Center in Southern India. J Neurosci Rural Pract 2021; 12:295-301. [PMID: 33927520 PMCID: PMC8064862 DOI: 10.1055/s-0041-1722817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Objective
Traumatic brain injury (TBI) is a leading cause of mortality and chronic disability across the globe. This study aimed to understand the effects of cognitive retraining (CR) intervention on neuropsychological functions, symptom reporting, and quality of life in patients with moderate to severe TBI.
Materials and Methods
The present single-group intervention study with a pre–post design included 12 patients diagnosed with moderate to severe TBI within 3–24 months post injury. Outcome measures included National Institute of Mental Health and Neuro Sciences (NIMHANS) Neuropsychology Battery, Perceived Stress Scale, Rivermead Post-Concussion Symptom Questionnaire, World Health Organization Quality of Life Scale—Brief, and Visual Analogue Scale. All patients underwent a total of 20 sessions of hospital-based CR, spanning over a period of 2 months. The CR included tasks targeting to enhance processing speed, attention, executive function, learning, and memory. Outcome assessments were conducted at baseline and immediately at post intervention.
Statistical Analysis
Mean, standard deviation, frequency, and percentage were used as measures of descriptive statistics. Pre- and post-intervention scores were compared using Wilcoxon signed-rank test.
Results
The results showed that at post intervention, significant improvements were found in processing speed, working memory, planning, visuo-spatial construction, visual memory, and verbal encoding. Subjective symptom reporting, perceived stress, and quality of life in psychological domain also improved.
Conclusion
CR can be helpful in improving not only cognition but also symptom reporting and quality of life in moderate to severe TBI.
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Affiliation(s)
- Mohammed Afsar
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Dhaval Shukla
- Department of Neurosurgery, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Binukumar Bhaskarapillai
- Department of Biostatistics, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Jamuna Rajeswaran
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
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8
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Giehl K, Ophey A, Hammes J, Rehberg S, Lichtenstein T, Reker P, Eggers C, Kalbe E, van Eimeren T. Working memory training increases neural efficiency in Parkinson's disease: a randomized controlled trial. Brain Commun 2020; 2:fcaa115. [PMID: 32954349 PMCID: PMC7472906 DOI: 10.1093/braincomms/fcaa115] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/23/2020] [Accepted: 06/26/2020] [Indexed: 12/16/2022] Open
Abstract
Impairment of working memory and executive functions is already frequently observed in early stages of Parkinson's disease. Improvements in working memory performance in this cohort could potentially be achieved via working memory training. However, the specific neural mechanisms underlying different working memory processes such as maintenance as opposed to manipulation are largely under-investigated in Parkinson's disease. Moreover, the plasticity of these correlates as a function of working memory training is currently unknown in this population. Thus, the working memory subprocesses of maintenance and manipulation were assessed in 41 cognitively healthy patients with Parkinson's disease using a newly developed working memory paradigm and functional MRI. Nineteen patients were randomized to a 5-week home-based digital working memory training intervention while the remaining patients entered a control, wait list condition. Working memory task-related activation patterns and context-dependent functional connectivity, as well as the change of these neural correlates as a function of training, were assessed. While both working memory processes activated an extended frontoparietal-cerebellar network, only the manipulation of items within working memory also recruited the anterior striatum. The intervention effect on the neural correlates was small, but decreased activation in areas relevant for working memory could be observed, with activation changes correlating with behavioural change. Moreover, training seemed to result in decreased functional connectivity when pure maintenance was required, and in a reorganization of functional connectivity when items had to be manipulated. In accordance with the neural efficacy hypothesis, training resulted in overall reduced activation and reorganized functional connectivity, with a differential effect on the different working memory processes under investigation. Now, larger trials including follow-up examinations are needed to further explore the long-term effects of such interventions on a neural level and to estimate the clinical relevance to potentially delay cognitive decline in cognitively healthy patients with Parkinson's disease.
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Affiliation(s)
- Kathrin Giehl
- Faculty of Medicine and University Hospital of Cologne, Department of Nuclear Medicine, University of Cologne, Cologne, Germany
- Research Centre Jülich, Institute of Neuroscience and Medicine (INM-2), Jülich, Germany
| | - Anja Ophey
- Faculty of Medicine and University Hospital of Cologne, Department of Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), University of Cologne, Cologne, Germany
| | - Jochen Hammes
- Faculty of Medicine and University Hospital of Cologne, Department of Nuclear Medicine, University of Cologne, Cologne, Germany
| | - Sarah Rehberg
- Faculty of Medicine and University Hospital of Cologne, Department of Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), University of Cologne, Cologne, Germany
| | - Thorsten Lichtenstein
- Faculty of Medicine and University Hospital of Cologne, Department for Radiology, University of Cologne, Cologne, Germany
| | - Paul Reker
- Faculty of Medicine and University Hospital of Cologne, Department of Neurology, University of Cologne, Cologne, Germany
| | - Carsten Eggers
- Faculty of Medicine and University Hospital of Marburg, Department of Neurology and Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Elke Kalbe
- Faculty of Medicine and University Hospital of Cologne, Department of Medical Psychology, Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), University of Cologne, Cologne, Germany
| | - Thilo van Eimeren
- Faculty of Medicine and University Hospital of Cologne, Department of Nuclear Medicine, University of Cologne, Cologne, Germany
- Faculty of Medicine and University Hospital of Cologne, Department of Neurology, University of Cologne, Cologne, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn-Cologne, Germany
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9
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Weicker J, Hudl N, Hildebrandt H, Obrig H, Schwarzer M, Villringer A, Thöne-Otto A. The effect of high vs. low intensity neuropsychological treatment on working memory in patients with acquired brain injury. Brain Inj 2020; 34:1051-1060. [PMID: 32511937 DOI: 10.1080/02699052.2020.1773536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AIM To evaluate the combined effect of compensation therapy and functional training on working memory (WM) in patients with acquired injury and chronic cognitive deficits by investigating the dose-response relationship and specificity of transfer effects. RESEARCH DESIGN Double-blind randomized controlled trial. METHODS All patients underwent 4 weeks of compensation therapy in a day-care setting. In addition, they received either 20 sessions of computer-based WM training (n = 11) or attention training (n = 9). Transfer effects on cognition and their functional relevance in daily life were assessed before treatment, after 2 weeks (10 additional training sessions), and after 4 weeks (20 additional training sessions) of therapy. RESULTS The combined treatment led to significant improvements in WM performance, verbal memory, and self-reported changes in daily life. The amount of training was identified to modulate efficacy: Significant improvements showed only in the later training phase. We observed no differences between the two training schemes (WM vs. attentional training). CONCLUSIONS Even in the chronic phase after brain lesion WM performance can be enhanced by the combination of compensation therapy and computerized cognitive training when applied intensely; both a more general attention and a specific WM training regimen are effective.
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Affiliation(s)
- Juliane Weicker
- Clinic of Cognitive Neurology, University of Leipzig , Leipzig, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences , Leipzig, Germany
| | - Nicole Hudl
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences , Leipzig, Germany.,Professorship of Sports Psychology, Chemnitz University of Technology , Chemnitz, Germany
| | - Helmut Hildebrandt
- Department of Psychology, Carl Von Ossietzky University of Oldenburg , Oldenburg, Germany
| | - Hellmuth Obrig
- Clinic of Cognitive Neurology, University of Leipzig , Leipzig, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences , Leipzig, Germany
| | - Magdalena Schwarzer
- Department of Psychology, Carl Von Ossietzky University of Oldenburg , Oldenburg, Germany
| | - Arno Villringer
- Clinic of Cognitive Neurology, University of Leipzig , Leipzig, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences , Leipzig, Germany
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10
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Peers PV, Astle DE, Duncan J, Murphy FC, Hampshire A, Das T, Manly T. Dissociable effects of attention vs working memory training on cognitive performance and everyday functioning following fronto-parietal strokes. Neuropsychol Rehabil 2020; 30:1092-1114. [PMID: 30569816 PMCID: PMC7266670 DOI: 10.1080/09602011.2018.1554534] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 11/22/2018] [Indexed: 10/29/2022]
Abstract
Difficulties with attention are common following stroke, particularly in patients with frontal and parietal damage, and are associated with poor outcome. Home-based online cognitive training may have the potential to provide an efficient and effective way to improve attentional functions in such patients. Little work has been carried out to assess the efficacy of this approach in stroke patients, and the lack of studies with active control conditions and rigorous evaluations of cognitive functioning pre and post-training means understanding is limited as to whether and how such interventions may be effective. Here, in a feasibility pilot study, we compare the effects of 20 days of cognitive training using either novel Selective Attention Training (SAT) or commercial Working Memory Training (WMT) programme, versus a waitlist control on a range of attentional and working memory tasks. We demonstrate separable effects of each training condition, with SAT leading to improvements in spatial and non-spatial aspects of attention and WMT leading to improvements on closely related working memory tasks. In addition, both training groups reported improvements in everyday functioning, which were associated with improvements in attention, suggesting that improving attention may be of particular importance in maximising functional improvements in this patient group.
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Affiliation(s)
- Polly V Peers
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Duncan E Astle
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - John Duncan
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Fionnuala C Murphy
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Adam Hampshire
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
| | - Tilak Das
- Department of Radiology, Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - Tom Manly
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
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11
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Barkus E. Effects of working memory training on emotion regulation: Transdiagnostic review. Psych J 2020; 9:258-279. [PMID: 32166891 DOI: 10.1002/pchj.353] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 10/20/2019] [Accepted: 11/19/2019] [Indexed: 12/18/2022]
Abstract
Working memory training is widely used transdiagnostically to improve cognition. However, more recently, studies using working memory training packages have targeted emotion-regulation outcomes to determine whether far transfer effects can be achieved. A narrative review is conducted of studies that have used standardized computerized working memory training packages across healthy volunteers, affect, anxiety, post-traumatic stress disorder (PTSD), and eating disordered populations with emotion-regulation outcomes. Working memory training has been used in children, adolescents, and adults to improve emotion regulation. Many studies have reported gains in mood as well as emotion-regulation strategies following working memory training, regardless of clinical indication and whether near transfer gains were achieved in cognitive domains. Significant emotion-regulation outcomes include: state and trait anxiety, rumination, brooding, positive appraisal, decreasing maladaptive emotion-regulation strategies, and decreasing intrusive thoughts. It is speculated that these far transfer outcomes from working memory training are possible due to the cognitive and neural overlap between cognitive and affective working memory, and emotion regulation. Working memory training could improve cognitive efficiency, which, in turn, increases the availability of cognitive resources during times when emotion regulation is taxed. Future studies need to consider the role of participant expectancy in predicting outcome measure performance, and including subjective and objective outcomes is paramount to study design. Furthermore, sample sizes require additional attention, given that the current review highlights that individual differences in non-clinical and clinical populations influence the outcomes from working memory training. Working memory training offers a possibility for improving emotion regulation transdiagnostically.
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Affiliation(s)
- Emma Barkus
- School of Psychology, University of Wollongong, Wollongong, Australia
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12
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Cepeda-Freyre HA, Garcia-Aguilar G, Eguibar JR, Cortes C. Brain Processing of Complex Geometric Forms in a Visual Memory Task Increases P2 Amplitude. Brain Sci 2020; 10:E114. [PMID: 32093308 PMCID: PMC7071411 DOI: 10.3390/brainsci10020114] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 02/11/2020] [Accepted: 02/12/2020] [Indexed: 12/01/2022] Open
Abstract
We study the cognitive processing of visual working memory in three different conditions of memory load and configuration change. Altering this features has been shown to alter the brain's processing in memory tasks. Most studies dealing with this issue have used the verbal-phonological modality. We use complex geometric polygons to assess visual working memory in a modified change detection task. Three different types of backgrounds were used to manipulate memory loading and 18 complex geometric polygons to manipulate stimuli configuration. The goal of our study was to test whether the memory load and configuration affect the correct-recall ratios. We expected that increasing visual items loading and changing configuration of items would induce differences in working memory performance. Brain activity related to the task was assessed through event-related potentials (ERP), during the test phase of each trial. Our results showed that visual items loading and changing of item configuration affect working memory on test phase on ERP component P2, but does not affect performance. However frontal related ERP component-P3-was minimally affected by visual memory loading or configuration changing, supporting that working memory is related to a filtering processing in posterior brain regions.
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Affiliation(s)
- Héctor A. Cepeda-Freyre
- Facultad de Psicología, Benemérita Universidad Autónoma de Puebla, Puebla 72000, PUE, Mexico
| | - Gregorio Garcia-Aguilar
- Facultad de Psicología, Benemérita Universidad Autónoma de Puebla, Puebla 72000, PUE, Mexico
| | - Jose R. Eguibar
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla 72592, PUE, Mexico
| | - Carmen Cortes
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla 72592, PUE, Mexico
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13
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Home-based cognitive training in pediatric patients with acquired brain injury: preliminary results on efficacy of a randomized clinical trial. Sci Rep 2020; 10:1391. [PMID: 31996709 PMCID: PMC6989528 DOI: 10.1038/s41598-020-57952-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 01/09/2020] [Indexed: 12/19/2022] Open
Abstract
Cognitive rehabilitation may compensate for cognitive deficits of children with acquired brain injury (ABI), capitalizing on the use-dependent plasticity of a developing brain. Remote computerized cognitive training (CCT) may be delivered to patients in ecological settings, ensuring rehabilitation continuity. This work evaluated cognitive and psychological adjustment outcomes of an 8-week multi-domain, home-based CCT (Lumosity Cognitive Training) in a sample of patients with ABI aged 11–16 years. Two groups of patients were engaged in five CCT sessions per week for eight weeks (40 sessions). According to a stepped-wedge research design, one group (Training-first Group) started the CCT immediately, whereas the other group (Waiting-first Group) started the CCT after a comparable time of waiting list. Changes after the training and after the waiting period were compared in the two groups. Both groups improved in visual-spatial working memory more after the training than after the waiting-list period. The Training-first group improved also in arithmetic calculation speed. Findings indicate that a multi-domain CCT can produce benefits in visual-spatial working memory, probably because, in accordance with previous research, computer games heavily tax visuo-spatial abilities. This suggests that the prolonged stimulation of the same cognitive ability may generate the greatest benefits in children with ABI.
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14
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Chiaravalloti ND, Moore NB, Weber E, DeLuca J. The application of Strategy-based Training to Enhance Memory (STEM) in multiple sclerosis: A pilot RCT. Neuropsychol Rehabil 2019; 31:231-254. [PMID: 31752604 DOI: 10.1080/09602011.2019.1685550] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
New learning and memory (NLM) impairments are common in multiple sclerosis (MS), negatively impacting daily life. Few studies seek to remediate these deficits to improve everyday functioning. Self-generation, spaced learning and retrieval practice have been shown to improve NLM in healthy persons and have been incorporated into an 8-session treatment protocol, Strategy-based Training to Enhance Memory (STEM). STEM teaches participants about each of the techniques, how to apply them in daily life and provides practice. Participants are taught to restructure a memory-demanding situation to optimize self-generation, spaced learning and retrieval practice. This pilot double-blind, placebo-controlled, randomized clinical trial (RCT) tested the efficacy of STEM in 20 learning-impaired participants with clinically definite MS (9 treatment, 11 control). Significant treatment effects were noted on self-report measures of daily functioning (primary outcome). Objective neuropsychological testing approached significance, showing a medium-large effect on verbal NLM. Results suggest that STEM may improve everyday functioning in individuals with MS. A full-scale RCT is warranted to validate findings in a larger sample so that findings may be generalized to the broader MS community.
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Affiliation(s)
- Nancy D Chiaravalloti
- Kessler Foundation Neuropsychology and Neuroscience Laboratory, East Hanover, NJ, USA.,Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Nancy B Moore
- Kessler Foundation Neuropsychology and Neuroscience Laboratory, East Hanover, NJ, USA
| | - Erica Weber
- Kessler Foundation Neuropsychology and Neuroscience Laboratory, East Hanover, NJ, USA.,Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - John DeLuca
- Kessler Foundation Neuropsychology and Neuroscience Laboratory, East Hanover, NJ, USA.,Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA.,Department of Neurology, Rutgers New Jersey Medical School, Newark, NJ, USA
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15
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Choi MJ, Kim H, Nah HW, Kang DW. Digital Therapeutics: Emerging New Therapy for Neurologic Deficits after Stroke. J Stroke 2019; 21:242-258. [PMID: 31587534 PMCID: PMC6780014 DOI: 10.5853/jos.2019.01963] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 09/16/2019] [Indexed: 01/14/2023] Open
Abstract
Digital therapeutics is an evidence-based intervention using high-quality software, with the sole purpose of treatment. As many healthcare systems are encountering high demands of quality outcomes, the need for digital therapeutics is gradually increasing in the clinical field. We conducted review of the implications of digital therapeutics in the treatment of neurological deficits for stroke patients. The implications of digital therapeutics have been discussed in four domains: cognition, speech and aphasia, motor, and vision. It was evident that different forms of digital therapeutics such as online platforms, virtual reality trainings, and iPad applications have been investigated in many trials to test its feasibility in clinical use. Although digital therapeutics may deliver high-quality solutions to healthcare services, the medicalization of digital therapeutics is accompanied with many limitations. Clinically validated digital therapeutics should be developed to prove its efficacy in stroke rehabilitation.
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Affiliation(s)
- Mi Joo Choi
- School of Medical Sciences, University of Manchester, Manchester, UK
| | - Hana Kim
- Department of Neurology, University of Ulsan College of Medicine, Seoul, Korea
| | | | - Dong-Wha Kang
- Department of Neurology, University of Ulsan College of Medicine, Seoul, Korea.,Nunaps Inc., Seoul, Korea.,Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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16
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Hamzah N, Narayanan V, Ramli N, Mustapha NA, Mohammad Tahir NA, Tan LK, Danaee M, Muhamad NA, Drummond A, das Nair R, Goh SY, Mazlan M. Randomised controlled clinical trial of a structured cognitive rehabilitation in patients with attention deficit following mild traumatic brain injury: study protocol. BMJ Open 2019; 9:e028711. [PMID: 31537559 PMCID: PMC6756424 DOI: 10.1136/bmjopen-2018-028711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To measure the clinical, structural and functional changes of an individualised structured cognitive rehabilitation in mild traumatic brain injury (mTBI) population. SETTING A single centre study, Malaysia. PARTICIPANTS Adults aged between 18 and 60 years with mTBI as a result of road traffic accident, with no previous history of head trauma, minimum of 9 years education and abnormal cognition at 3 months will be included. The exclusion criteria include pre-existing chronic illness or neurological/psychiatric condition, long-term medication that affects cognitive/psychological status, clinical evidence of substance intoxication at the time of injury and major polytrauma. Based on multiple estimated calculations, the minimum intended sample size is 50 participants (Cohen's d effect size=0.35; alpha level of 0.05; 85% power to detect statistical significance; 40% attrition rate). INTERVENTIONS Intervention group will receive individualised structured cognitive rehabilitation. Control group will receive the best patient-centred care for attention disorders. Therapy frequency for both groups will be 1 hour per week for 12 weeks. OUTCOME MEASURES Primary: Neuropsychological Assessment Battery-Screening Module (S-NAB) scores. Secondary: Diffusion Tensor Imaging (DTI) parameters and Goal Attainment Scaling score (GAS). RESULTS Results will include descriptive statistics of population demographics, CogniPlus cognitive program and metacognitive strategies. The effect of intervention will be the effect size of S-NAB scores and mean GAS T scores. DTI parameters will be compared between groups via repeated measure analysis. Correlation analysis of outcome measures will be calculated using Pearson's correlation coefficient. CONCLUSION This is a complex clinical intervention with multiple outcome measures to provide a comprehensive evidence-based treatment model. ETHICS AND DISSEMINATION The study protocol was approved by the Medical Research Ethics Committee UMMC (MREC ID NO: 2016928-4293). The findings of the trial will be disseminated through peer-reviewed journals and scientific conferences. TRIAL REGISTRATION NUMBER NCT03237676.
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Affiliation(s)
- Norhamizan Hamzah
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Vairavan Narayanan
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Norlisah Ramli
- Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nor Atikah Mustapha
- Department of Rehabilitation Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
| | | | - Li Kuo Tan
- Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mahmoud Danaee
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nor Asiah Muhamad
- Institute for Public Health, National Institutes of Health, Ministry of Health, Setia Alam, Malaysia
| | - Avril Drummond
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Roshan das Nair
- School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Institute of Mental Health, Nottinghamshire Healthcare Trust, Nottingham, United Kingdom
| | - Sing Yau Goh
- Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Sungai Long Campus, Malaysia
| | - Mazlina Mazlan
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Cicerone KD, Goldin Y, Ganci K, Rosenbaum A, Wethe JV, Langenbahn DM, Malec JF, Bergquist TF, Kingsley K, Nagele D, Trexler L, Fraas M, Bogdanova Y, Harley JP. Evidence-Based Cognitive Rehabilitation: Systematic Review of the Literature From 2009 Through 2014. Arch Phys Med Rehabil 2019; 100:1515-1533. [DOI: 10.1016/j.apmr.2019.02.011] [Citation(s) in RCA: 140] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 02/19/2019] [Accepted: 02/20/2019] [Indexed: 10/27/2022]
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18
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Calderon J, Bellinger DC, Hartigan C, Lord A, Stopp C, Wypij D, Newburger JW. Improving neurodevelopmental outcomes in children with congenital heart disease: protocol for a randomised controlled trial of working memory training. BMJ Open 2019; 9:e023304. [PMID: 30782877 PMCID: PMC6377570 DOI: 10.1136/bmjopen-2018-023304] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 10/22/2018] [Accepted: 12/20/2018] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Executive function (EF) impairments are among the most prevalent neurodevelopmental morbidities in youth with congenital heart disease (CHD). To date, no studies have investigated the efficacy of cognitive interventions to improve EF outcomes in children with CHD. METHODS AND ANALYSIS This is a single-centre, single-blinded, two-arm randomised controlled trial to test the efficacy of Cogmed Working Memory Training (Cogmed) versus standard of care in children with CHD after open-heart surgery in infancy. Participants will consist of 100 children with CHD aged 7-12 years who underwent open-heart surgery before the age of 12 months. Participants are randomly allocated to either an intervention group including training on the home-based Cogmed intervention for a duration of approximately 5 weeks or a control group who receive the standard of care. We will evaluate the efficacy of Cogmed at post-treatment and 3 months after completion of the intervention. Baseline, post-treatment and 3-month follow-up assessments will include specific measures of EF, cognitive and social functioning, and attention deficit hyperactivity disorder (ADHD) symptoms. The primary outcome of this study is the change in standardised mean score on the List Sorting Working Memory test from the National Institutes of Health Toolbox for the Assessment of Neurological and Behavioral Function. Secondary outcomes include measures of social skills, inhibitory control, cognitive flexibility and behavioural EF as well as ADHD symptoms as measured by the Behavior Rating Inventory of Executive Function, Second Edition, and the Conners Third Edition. The efficacy of the intervention will be evaluated by comparing within-subject differences (baseline to post-treatment, baseline to 3-month follow-up) between the two groups using an intention-to-treat analysis. ETHICS AND DISSEMINATION This study has received Institutional Review Board (IRB) approval from Boston's Children's Hospital IRB (P00022440) and the Human Protection Agency from the US Department of Defense. TRIAL REGISTRATION NUMBER NCT03023644; Pre-results.
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Affiliation(s)
- Johanna Calderon
- Boston Children’s Hospital, Department of Psychiatry, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - David C Bellinger
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Catherine Hartigan
- Department of Cardiology, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Alison Lord
- Department of Cardiology, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Christian Stopp
- Department of Cardiology, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - David Wypij
- Department of Cardiology, Boston Children’s Hospital, Boston, Massachusetts, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jane W Newburger
- Department of Cardiology, Boston Children’s Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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19
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Gamito P, Oliveira J, Morais D, Coelho C, Santos N, Alves C, Galamba A, Soeiro M, Yerra M, French H, Talmers L, Gomes T, Brito R. Cognitive Stimulation of Elderly Individuals with Instrumental Virtual Reality-Based Activities of Daily Life: Pre-Post Treatment Study. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2019; 22:69-75. [DOI: 10.1089/cyber.2017.0679] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Pedro Gamito
- School of Psychology and Life Sciences, Lusophone University of Humanities and Technologies, Lisbon, Portugal
- HEI-Lab: Digital Human-Environment Interaction Lab, Lisbon, Portugal
| | - Jorge Oliveira
- School of Psychology and Life Sciences, Lusophone University of Humanities and Technologies, Lisbon, Portugal
- HEI-Lab: Digital Human-Environment Interaction Lab, Lisbon, Portugal
| | - Diogo Morais
- School of Psychology and Life Sciences, Lusophone University of Humanities and Technologies, Lisbon, Portugal
- HEI-Lab: Digital Human-Environment Interaction Lab, Lisbon, Portugal
| | - Cátia Coelho
- Junta de Freguesia de Benfica, Gabinete de Psicologia do Pelouro dos Direitos Sociais e Saúde, Lisbon, Portugal
| | - Nuno Santos
- Junta de Freguesia de Benfica, Gabinete de Psicologia do Pelouro dos Direitos Sociais e Saúde, Lisbon, Portugal
| | - Catarina Alves
- Junta de Freguesia de Benfica, Gabinete de Psicologia do Pelouro dos Direitos Sociais e Saúde, Lisbon, Portugal
| | - Ana Galamba
- Junta de Freguesia de Benfica, Gabinete de Psicologia do Pelouro dos Direitos Sociais e Saúde, Lisbon, Portugal
| | - Miguel Soeiro
- Department of Informatics, Universidade de Lisboa Instituto Superior Tecnico
| | - Madhurrima Yerra
- University of Michigan College of Literature Science and the Arts, Ann Arbor, Michigan, Lisbon, Portugal
| | - Hannan French
- University of Michigan College of Literature Science and the Arts, Ann Arbor, Michigan, Lisbon, Portugal
| | - Lily Talmers
- University of Michigan College of Literature Science and the Arts, Ann Arbor, Michigan, Lisbon, Portugal
| | - Tiago Gomes
- School of Psychology and Life Sciences, Lusophone University of Humanities and Technologies, Lisbon, Portugal
| | - Rodrigo Brito
- School of Psychology and Life Sciences, Lusophone University of Humanities and Technologies, Lisbon, Portugal
- HEI-Lab: Digital Human-Environment Interaction Lab, Lisbon, Portugal
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20
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Sood N, Godfrey C, Anderson V, Catroppa C. Rehabilitation of Executive function in Paediatric Traumatic brain injury (REPeaT): protocol for a randomized controlled trial for treating working memory and decision-making. BMC Pediatr 2018; 18:362. [PMID: 30458737 PMCID: PMC6247519 DOI: 10.1186/s12887-018-1338-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 11/12/2018] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Working memory allows us to hold information in an active state for short periods of time, and is essential in facilitating goal directed cognitive functioning. Difficulties in working memory and decision-making are common post childhood Traumatic Brain Injury (TBI). Despite this, there is a paucity of research pertaining to implementation and effectiveness of interventions to reduce these common difficulties which impact significantly on one's ability to function independently. One such intervention, Cogmed Working Memory Training Program, has shown success in improving working memory in other childhood clinical populations, but has received little evaluation in the TBI area. This study aims to evaluate whether Cogmed improves working memory and decision-making post childhood TBI and whether these benefits generalize to functional areas. METHODS The study is a randomized controlled trial (RCT) of the Cogmed (RM version) intervention for children post-TBI. Children aged 7-15 years are initially screened for working memory impairments. Eligible participants are then randomized into either the treatment group (Cogmed) or the active-control group (Lexia Reading). Each group trains online for 50 min each day, 5 days per week, for 5 consecutive weeks. The online training is supported by online clinician meetings each week. Outcome neuropsychological and functional assessments are carried out immediately at the completion of the intervention and at 6 months follow-up. DISCUSSION This study follows gold standard methodology in intervention research; uses a novel measure of decision-making; measures the effects of intervention on functional outcomes immediately and longer-term post intervention; uses online clinician support in order to allow more families easy access to the program; and promotes the use of technology to improve health services. If efficacious in improving working memory, decision-making, and functional outcomes, our team will then take a key role in implementing Cogmed into clinical care. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12617000085370 . Trial Registration Date: 16/01/2017. Protocol Version/Date: HREC 35181G/18.08.2017. Study Status: Ongoing.
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Affiliation(s)
- Nikita Sood
- Level 4 West, Brain and Mind, Clinical Sciences, Murdoch Children’s Research Institute, 50 Flemington Road, Parkville, VIC 3052 Australia
- The Royal Children’s Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Celia Godfrey
- Level 4 West, Brain and Mind, Clinical Sciences, Murdoch Children’s Research Institute, 50 Flemington Road, Parkville, VIC 3052 Australia
| | - Vicki Anderson
- Level 4 West, Brain and Mind, Clinical Sciences, Murdoch Children’s Research Institute, 50 Flemington Road, Parkville, VIC 3052 Australia
- The Royal Children’s Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Department of Psychology, The Royal Children’s Hospital, Melbourne, Australia
- Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Cathy Catroppa
- Level 4 West, Brain and Mind, Clinical Sciences, Murdoch Children’s Research Institute, 50 Flemington Road, Parkville, VIC 3052 Australia
- The Royal Children’s Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Department of Psychology, The Royal Children’s Hospital, Melbourne, Australia
- Psychological Sciences, University of Melbourne, Melbourne, Australia
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21
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Geraldo A, Dores AR, Coelho B, Ramião E, Castro-Caldas A, Barbosa F. Efficacy of ICT-Based Neurocognitive Rehabilitation Programs for Acquired Brain Injury. EUROPEAN PSYCHOLOGIST 2018. [DOI: 10.1027/1016-9040/a000319] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Abstract. This systematic review aims to analyze the methods used in the assessment of the efficacy of Neurocognitive Rehabilitation Programs (NRP) based on Information and Communication Technologies in patients with Acquired Brain Injury, namely platforms and online rehabilitation programs. Studies with the main purpose of evaluating the efficacy of those programs were retrieved from multiple literature databases, accordingly to inclusion and exclusion criteria. The inclusion and analysis of the studies followed preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) and Cochrane Collaboration Guidelines. Thirty-one studies were included in this review. Results showed that most studies used a pre-post methodological design, with few studies performing assessment moments during intervention or follow-up. Attention, memory, and executive functions were the cognitive variables considered by a larger number of studies at the assessment of NRP efficacy. Despite that, there is a growing evidence on the inclusion of variables related to everyday functioning in this process, increasing its ecological validity. Concerning the instruments used, the studies presented a large heterogeneity of the instruments and methods used, even for the same assessment purpose, highlighting a lack of consensus regarding assessment protocol. Psychophysiological and neuroimaging techniques are seldom used on this field. This review identifies the main characteristics of the methodology used at the assessment of NRP and potential limitations, providing useful information to guide the practice of the health care professionals in rehabilitation of Acquired Brain Injury. It also suggests new directions for future studies.
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Affiliation(s)
- Andreia Geraldo
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Artemisa R. Dores
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- School of Health, Polytechnic Institute of Porto, Porto, Portugal
| | | | - Eduarda Ramião
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | | | - Fernando Barbosa
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
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22
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Bogdanova Y, Yee MK, Ho VT, Cicerone KD. Computerized Cognitive Rehabilitation of Attention and Executive Function in Acquired Brain Injury: A Systematic Review. J Head Trauma Rehabil 2018; 31:419-433. [PMID: 26709580 PMCID: PMC5401713 DOI: 10.1097/htr.0000000000000203] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Comprehensive review of the use of computerized treatment as a rehabilitation tool for attention and executive function in adults (aged 18 years or older) who suffered an acquired brain injury. DESIGN Systematic review of empirical research. MAIN MEASURES Two reviewers independently assessed articles using the methodological quality criteria of Cicerone et al. Data extracted included sample size, diagnosis, intervention information, treatment schedule, assessment methods, and outcome measures. RESULTS A literature review (PubMed, EMBASE, Ovid, Cochrane, PsychINFO, CINAHL) generated a total of 4931 publications. Twenty-eight studies using computerized cognitive interventions targeting attention and executive functions were included in this review. In 23 studies, significant improvements in attention and executive function subsequent to training were reported; in the remaining 5, promising trends were observed. CONCLUSIONS Preliminary evidence suggests improvements in cognitive function following computerized rehabilitation for acquired brain injury populations including traumatic brain injury and stroke. Further studies are needed to address methodological issues (eg, small sample size, inadequate control groups) and to inform development of guidelines and standardized protocols.
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Affiliation(s)
- Yelena Bogdanova
- VA Boston Healthcare System, Psychology Research Service (Dr Bogdanova and Mss Yee and Ho); and Department of Psychiatry, Boston University School of Medicine (Dr Bogdanova and Ms Ho), and Boston University School of Public Health (Ms Yee), Boston, Massachusetts; Department of Neuropsychology, JFK-Johnson Rehabilitation Institute, Edison, New Jersey (Dr Cicerone); and Department of Physical Medicine and Rehabilitation, Rutgers Robert Wood Johnson Medical School, Edison, New Jersey (Dr Cicerone)
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Till C, Kuni B, De Somma E, Yeh EA, Banwell B. A feasibility study of working memory training for individuals with paediatric-onset multiple sclerosis. Neuropsychol Rehabil 2017; 29:1177-1192. [PMID: 28920511 DOI: 10.1080/09602011.2017.1372786] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objective: To investigate the feasibility and experiences of paediatric-onset multiple sclerosis (MS) patients completing a working memory training programme. Methods: Nine paediatric-onset MS patients (mean age 19.3 ± 4.1 years) identified as having attention and/or working memory difficulties underwent a five-week (five days/week) internet-based working memory training programme (Cogmed™); weekly coaching was provided. Measures of adherence and tolerance were used to establish the feasibility of implementing computerised cognitive training. Qualitative experiences reported by the patients were analysed and factors that may modulate the effects of training were explored. Results: Six of the nine enrolled patients completed the programme within the recommended time, and all individuals, with the exception of one, were considered to tolerate the training well. Eight of the nine participants acknowledged that training was helpful in one or more ways. All but one participant reported improvements in working memory, although evidence for improvement on objective neuropsychological testing was limited. Lower normalised brain volume emerged as a potentially important variable in predicting extent of improvement on the training programme. Conclusion: Selected paediatric-onset MS patients can tolerate and complete an intensive cognitive rehabilitation programme. Future investigation of moderators of training effects and the stability of the findings over time is needed.
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Affiliation(s)
- Christine Till
- a Department of Psychology , York University , Toronto , Canada.,b Neurosciences and Mental Health Program, Research Institute , The Hospital for Sick Children , Toronto , Canada
| | - Bravina Kuni
- a Department of Psychology , York University , Toronto , Canada
| | - Elisea De Somma
- a Department of Psychology , York University , Toronto , Canada
| | - E Ann Yeh
- b Neurosciences and Mental Health Program, Research Institute , The Hospital for Sick Children , Toronto , Canada.,c Department of Neurology , The Hospital for Sick Children , Toronto , Canada
| | - Brenda Banwell
- b Neurosciences and Mental Health Program, Research Institute , The Hospital for Sick Children , Toronto , Canada.,d Division of Child Neurology, Children's Hospital of Philadelphia, Department of Neurology, Perelman School of Medicine , University of Pennsylvania , Philadelphia , USA
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Computer-Based Cognitive Rehabilitation Interventions for Traumatic Brain Injury: A Critical Review of the Literature. J Neurosci Nurs 2017; 49:235-240. [PMID: 28661947 DOI: 10.1097/jnn.0000000000000298] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Computer-based interventions have been developed to improve cognitive performance after mild traumatic brain injury; however, a thorough evaluation of this body of research has not been addressed in the literature. OBJECTIVES The aim of this study was to provide a synthesis and critical review of current research studies that have tested the efficacy of computer-based interventions on cognitive performance after mild traumatic brain injury. METHODS A critical review was conducted by identifying relevant studies in the electronic databases PubMed/MEDLINE, PsycInfo, and CINAHL from 2011 to the present. Because of the limited number of publications focused exclusively on mild traumatic brain injury, research studies that assessed the impact of computer-based interventions on cognitive outcomes in populations with acquired brain injury were included. RESULTS Of the 58 studies identified, only 10 publications included participants with mild traumatic brain injury. Overall, the identified studies did not use a standard method for assessing the severity of traumatic brain injury, and many studies included participants with a wide variety of etiologies for acquired brain injury and used multiple measures of cognitive performance, which made comparisons difficult across studies. In addition to small sample sizes, the study samples were heterogeneous in regard to the number of previous traumatic brain injuries, time elapsed since injury, and age and gender distributions. Preinjury comorbidities that may affect cognitive performance, such as depression, anxiety, or learning disabilities, were often not assessed. DISCUSSION There is weak evidence that computer-based interventions can improve working memory and cognitive function in individuals after mild traumatic brain injury. Because of the low-quality evidence, seminal questions remain regarding the optimal format, dosage, timing, and duration of computer-based intervention for improving cognitive performance. Future studies should focus on using a strong research design, such as a prospective, longitudinal, repeated-measures study, with an adequate number of participants who meet mild traumatic brain injury criteria. Preinjury comorbidities, cognitive reserve, time since injury, age, and gender should be addressed in the design because there may be differences in recovery time and mechanisms of cognitive plasticity among populations. CONCLUSIONS Overall, computer-based interventions seem promising as an approach to improve working memory in individuals with acquired brain injury. There is no evidence that currently available interventions are specific to mild traumatic brain injury. Well-designed research studies with adequate sample sizes are needed to assess the effect of computer-based interventions on cognitive performance after mild traumatic brain injury.
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Martin S, Armstrong E, Thomson E, Vargiu E, Solà M, Dauwalder S, Miralles F, Daly Lynn J. A qualitative study adopting a user-centered approach to design and validate a brain computer interface for cognitive rehabilitation for people with brain injury. Assist Technol 2017; 30:233-241. [PMID: 28708963 DOI: 10.1080/10400435.2017.1317675] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Cognitive rehabilitation is established as a core intervention within rehabilitation programs following a traumatic brain injury (TBI). Digitally enabled assistive technologies offer opportunities for clinicians to increase remote access to rehabilitation supporting transition into home. Brain Computer Interface (BCI) systems can harness the residual abilities of individuals with limited function to gain control over computers through their brain waves. This paper presents an online cognitive rehabilitation application developed with therapists, to work remotely with people who have TBI, who will use BCI at home to engage in the therapy. A qualitative research study was completed with people who are community dwellers post brain injury (end users), and a cohort of therapists involved in cognitive rehabilitation. A user-centered approach over three phases in the development, design and feasibility testing of this cognitive rehabilitation application included two tasks (Find-a-Category and a Memory Card task). The therapist could remotely prescribe activity with different levels of difficulty. The service user had a home interface which would present the therapy activities. This novel work was achieved by an international consortium of academics, business partners and service users.
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Affiliation(s)
- Suzanne Martin
- a Faculty of life and Health Sciences , Ulster University , Jordanstown , Northern Ireland , UK
| | | | | | | | - Marc Solà
- c eHealth Department , EURECAT , Barcelona , Spain
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Phillips NL, Mandalis A, Benson S, Parry L, Epps A, Morrow A, Lah S. Computerized Working Memory Training for Children with Moderate to Severe Traumatic Brain Injury: A Double-Blind, Randomized, Placebo-Controlled Trial. J Neurotrauma 2016; 33:2097-2104. [DOI: 10.1089/neu.2015.4358] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Natalie Lynette Phillips
- School of Psychology, The University of Sydney, Sydney, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
| | - Anna Mandalis
- Department of Psychology, Sydney Children's Hospital Randwick, Sydney, Australia
| | - Suzanne Benson
- Kids Rehab, The Children's Hospital at Westmead, Sydney, Australia
| | - Louise Parry
- Department of Psychology, Sydney Children's Hospital Randwick, Sydney, Australia
- Brain Injury Rehabilitation Program, Sydney Children's Hospital Randwick, Sydney, Australia
| | - Adrienne Epps
- Brain Injury Rehabilitation Program, Sydney Children's Hospital Randwick, Sydney, Australia
| | - Angie Morrow
- Kids Rehab, The Children's Hospital at Westmead, Sydney, Australia
| | - Suncica Lah
- School of Psychology, The University of Sydney, Sydney, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia
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Hyer L, Scott C, Atkinson MM, Mullen CM, Lee A, Johnson A, Mckenzie LC. Cognitive Training Program to Improve Working Memory in Older Adults with MCI. Clin Gerontol 2016; 39:410-427. [PMID: 29471774 DOI: 10.1080/07317115.2015.1120257] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Deficits in working memory (WM) are associated with age-related decline. We report findings from a clinical trial that examined the effectiveness of Cogmed, a computerized program that trains WM. We compare this program to a Sham condition in older adults with Mild Cognitive Impairment (MCI). METHODS Older adults (N = 68) living in the community were assessed. Participants reported memory impairment and met criteria for MCI, either by poor delayed memory or poor performance in other cognitive areas. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS, Delayed Memory Index) and the Clinical Dementia Rating scale (CDR) were utilized. All presented with normal Mini Mental State Exams (MMSE) and activities of daily living (ADLs). Participants were randomized to Cogmed or a Sham computer program. Twenty-five sessions were completed over five to seven weeks. Pre, post, and follow-up measures included a battery of cognitive measures (three WM tests), a subjective memory scale, and a functional measure. RESULTS Both intervention groups improved over time. Cogmed significantly outperformed Sham on Span Board and exceeded in subjective memory reports at follow-up as assessed by the Cognitive Failures Questionnaire (CFQ). The Cogmed group demonstrated better performance on the Functional Activities Questionnaire (FAQ), a measure of adjustment and far transfer, at follow-up. Both groups, especially Cogmed, enjoyed the intervention. CONCLUSIONS Results suggest that WM was enhanced in both groups of older adults with MCI. Cogmed was better on one core WM measure and had higher ratings of satisfaction. The Sham condition declined on adjustment.
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Affiliation(s)
- Lee Hyer
- a Georgia Neurosurgical Institute , Macon , Georgia , USA.,b Mercer University , School of Medicine , Macon , Georgia , USA.,c Medical Center of Central Georgia , Macon , Georgia , USA
| | - Ciera Scott
- a Georgia Neurosurgical Institute , Macon , Georgia , USA
| | | | - Christine M Mullen
- a Georgia Neurosurgical Institute , Macon , Georgia , USA.,b Mercer University , School of Medicine , Macon , Georgia , USA
| | - Anna Lee
- a Georgia Neurosurgical Institute , Macon , Georgia , USA.,b Mercer University , School of Medicine , Macon , Georgia , USA
| | - Aaron Johnson
- b Mercer University , School of Medicine , Macon , Georgia , USA.,c Medical Center of Central Georgia , Macon , Georgia , USA
| | - Laura C Mckenzie
- a Georgia Neurosurgical Institute , Macon , Georgia , USA.,b Mercer University , School of Medicine , Macon , Georgia , USA
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Brown JA, Hux K. Functional assessment of immediate task planning and execution by adults with acquired brain injury. NeuroRehabilitation 2016; 39:191-203. [DOI: 10.3233/nre-161351] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Jessica A. Brown
- Department of Speech-Language Hearing Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Karen Hux
- Department of Special Education and Communication Disorders, University of Nebraska-Lincoln, Lincoln, NE, USA
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De Luca R, Calabrò RS, Bramanti P. Cognitive rehabilitation after severe acquired brain injury: current evidence and future directions. Neuropsychol Rehabil 2016; 28:879-898. [DOI: 10.1080/09602011.2016.1211937] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Rosaria De Luca
- Behavioral and NeuroRobotic Rehabilitation Laboratory, IRCCS Centro Neurolesi “Bonino Pulejo”, Messina, Italy
| | - Rocco Salvatore Calabrò
- Behavioral and NeuroRobotic Rehabilitation Laboratory, IRCCS Centro Neurolesi “Bonino Pulejo”, Messina, Italy
| | - Placido Bramanti
- Behavioral and NeuroRobotic Rehabilitation Laboratory, IRCCS Centro Neurolesi “Bonino Pulejo”, Messina, Italy
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Eve M, O'Keeffe F, Jhuty S, Ganesan V, Brown G, Murphy T. Computerized Working-Memory Training for Children Following Arterial Ischemic Stroke: A Pilot Study With Long-Term Follow-Up. APPLIED NEUROPSYCHOLOGY-CHILD 2016; 5:273-82. [PMID: 26980059 DOI: 10.1080/21622965.2015.1055563] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Cognitive deficits in the domains of working memory (WM) and executive function are well documented following childhood arterial ischemic stroke (AIS). However, there are currently no evidence-based cognitive interventions for this population. Computerized, implicit WM training has been demonstrated to generate generalized cognitive gains for children with WM and attention deficits and for adults following brain injury. This study used a pilot design to investigate the efficacy and feasibility of such an intervention program (Cogmed WM Training) for a childhood AIS population. Outcomes were measured via psychometric assessment at preintervention and postintervention and again at 1-year follow-up. At longitudinal follow-up, participants were found to have significant and persistent cognitive difficulties, particularly with attention and response inhibition. Following the computerized, implicit WM intervention, a significant improvement in phonological-loop WM was seen; however, this improvement was not maintained after 12 months. No additional significant improvements on standardized psychometric outcome measures were seen either immediately or at 12-month follow-up. Findings of this pilot study therefore do not currently support Cogmed as an effective intervention for children with AIS but highlight the need for further research, including randomized, controlled trials, to investigate cognitive interventions for the childhood AIS population.
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Affiliation(s)
- Megan Eve
- a Department of Clinical Psychology , Royal Holloway University of London , London , United Kingdom
| | - Fiadhnait O'Keeffe
- b Research Department of Clinical, Educational, and Health Psychology , University College London , London , United Kingdom
| | - Simren Jhuty
- c Institute of Child Health , University College London , London , United Kingdom.,d Department of Clinical Neuropsychology , Great Ormond Street Hospital for Children NHS Foundation Trust , London , United Kingdom
| | - Vijeya Ganesan
- c Institute of Child Health , University College London , London , United Kingdom.,d Department of Clinical Neuropsychology , Great Ormond Street Hospital for Children NHS Foundation Trust , London , United Kingdom
| | - Gary Brown
- a Department of Clinical Psychology , Royal Holloway University of London , London , United Kingdom
| | - Tara Murphy
- c Institute of Child Health , University College London , London , United Kingdom.,d Department of Clinical Neuropsychology , Great Ormond Street Hospital for Children NHS Foundation Trust , London , United Kingdom
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Sigmundsdottir L, Longley WA, Tate RL. Computerised cognitive training in acquired brain injury: A systematic review of outcomes using the International Classification of Functioning (ICF). Neuropsychol Rehabil 2016; 26:673-741. [PMID: 26965034 DOI: 10.1080/09602011.2016.1140657] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Computerised cognitive training (CCT) is an increasingly popular intervention for people experiencing cognitive symptoms. This systematic review evaluated the evidence for CCT in adults with acquired brain injury (ABI), focusing on how outcome measures used reflect efficacy across components of the International Classification of Functioning, Disability and Health. Database searches were conducted of studies investigating CCT to treat cognitive symptoms in adult ABI. Scientific quality was rated using the PEDro-P and RoBiNT Scales. Ninety-six studies met the criteria. Most studies examined outcomes using measures of mental functions (93/96, 97%); fewer studies included measures of activities/participation (41/96, 43%) or body structures (8/96, 8%). Only 14 studies (15%) provided Level 1 evidence (randomised controlled trials with a PEDro-P score ≥ 6/10), with these studies suggesting strong evidence for CCT improving processing speed in multiple sclerosis (MS) and moderate evidence for improving memory in MS and brain tumour populations. There is a large body of research examining the efficacy of CCT, but relatively few Level 1 studies and evidence is largely limited to body function outcomes. The routine use of outcome measures of activities/participation would provide more meaningful evidence for the efficacy of CCT. The use of body structure outcome measures (e.g., neuroimaging) is a newly emerging area, with potential to increase understanding of mechanisms of action for CCT.
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Affiliation(s)
- Linda Sigmundsdottir
- a John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Sydney Medical School - Northern, University of Sydney , St Leonards , NSW , Australia.,b Brain Injury Rehabilitation Unit , Liverpool Hospital , Sydney , Australia
| | - Wendy A Longley
- a John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Sydney Medical School - Northern, University of Sydney , St Leonards , NSW , Australia
| | - Robyn L Tate
- a John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Sydney Medical School - Northern, University of Sydney , St Leonards , NSW , Australia
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Chang L, Løhaugen GC, Douet V, Miller EN, Skranes J, Ernst T. Neural correlates of working memory training in HIV patients: study protocol for a randomized controlled trial. Trials 2016; 17:62. [PMID: 26833223 PMCID: PMC4736265 DOI: 10.1186/s13063-016-1160-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 01/07/2016] [Indexed: 12/31/2022] Open
Abstract
Background Potent combined antiretroviral therapy decreased the incidence and severity of HIV-associated neurocognitive disorders (HAND); however, no specific effective pharmacotherapy exists for HAND. Patients with HIV commonly have deficits in working memory and attention, which may negatively impact many other cognitive domains, leading to HAND. Since HAND may lead to loss of independence in activities of daily living and negative emotional well-being, and incur a high economic burden, effective treatments for HAND are urgently needed. This study aims to determine whether adaptive working memory training might improve cognitive functions and neural network efficiency and possibly decrease neuroinflammation. This study also aims to assess whether subjects with the LMX1A-rs4657412 TT(AA) genotype show greater training effects from working memory training than TC(AG) or CC(GG)-carriers. Methods/Design 60 HIV-infected and 60 seronegative control participants will be randomized to a double-blind active-controlled study, using adaptive versus non-adaptive Cogmed Working Memory Training® (CWMT), 20–25 sessions over 5–8 weeks. Each subject will be assessed with near- and far-transfer cognitive tasks, self-reported mood and executive function questionnaires, and blood-oxygenation level-dependent functional MRI during working memory (n-back) and visual attention (ball tracking) tasks, at baseline, 1-month, and 6-months after CWMT. Furthermore, genotyping for LMX1A-rs4657412 will be performed to identify whether subjects with the TT(AA)-genotype show greater gain or neural efficiency after CWMT than those with other genotypes. Lastly, cerebrospinal fluid will be obtained before and after CWMT to explore changes in levels of inflammatory proteins (cytokines and chemokines) and monoamines. Discussion Improving working memory in HIV patients, using CWMT, might slow the progression or delay the onset of HAND. Observation of decreased brain activation or normalized neural networks, using fMRI, after CWMT would lead to a better understanding of how neural networks are modulated by CWMT. Moreover, validating the greater training gain in subjects with the LMX1A-TT(AA) genotype could lead to a personalized approach for future working memory training studies. Demonstrating and understanding the neural correlates of the efficacy of CWMT in HIV patients could lead to a safe adjunctive therapy for HAND, and possibly other brain disorders. Trial registration ClinicalTrial.gov, NCT02602418.
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Affiliation(s)
- L Chang
- Department of Medicine, John A. Burns School of Medicine, The Queen's Medical Center, University of Hawaii at Manoa, 1356 Lusitana Street, 7th Floor UH Tower, Honolulu, HI, USA.
| | - G C Løhaugen
- Department of Pediatrics, Sørlandet Hospital, Arendal, Norway. .,Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
| | - V Douet
- Department of Medicine, John A. Burns School of Medicine, The Queen's Medical Center, University of Hawaii at Manoa, 1356 Lusitana Street, 7th Floor UH Tower, Honolulu, HI, USA.
| | - E N Miller
- UCLA Psychiatry and Biobehavioral Sciences, Los Angeles, CA, USA.
| | - J Skranes
- Department of Pediatrics, Sørlandet Hospital, Arendal, Norway. .,Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
| | - T Ernst
- Department of Medicine, John A. Burns School of Medicine, The Queen's Medical Center, University of Hawaii at Manoa, 1356 Lusitana Street, 7th Floor UH Tower, Honolulu, HI, USA.
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Stephens JA, Williamson KNC, Berryhill ME. Cognitive Rehabilitation After Traumatic Brain Injury: A Reference for Occupational Therapists. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2015; 35:5-22. [PMID: 26623474 DOI: 10.1177/1539449214561765] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Nearly 1.7 million Americans sustain a traumatic brain injury (TBI) each year. These injuries can result in physical, emotional, and cognitive consequences. While many individuals receive cognitive rehabilitation from occupational therapists (OTs), the interdisciplinary nature of TBI research makes it difficult to remain up-to-date on relevant findings. We conducted a literature review to identify and summarize interdisciplinary evidence-based practice targeting cognitive rehabilitation for civilian adults with TBI. Our review summarizes TBI background, and our cognitive remediation section focuses on the findings from 37 recent (since 2006) empirical articles directly related to cognitive rehabilitation for individuals (i.e., excluding special populations such as veterans or athletes). This manuscript is offered as a tool for OTs engaged in cognitive rehabilitation and as a means to highlight arenas where more empirical, interdisciplinary research is needed.
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van de Ven RM, Schmand B, Groet E, Veltman DJ, Murre JMJ. The effect of computer-based cognitive flexibility training on recovery of executive function after stroke: rationale, design and methods of the TAPASS study. BMC Neurol 2015; 15:144. [PMID: 26286548 PMCID: PMC4545547 DOI: 10.1186/s12883-015-0397-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 07/31/2015] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Stroke survivors frequently suffer from executive impairments even in the chronic phase after stroke, and there is a need for improved rehabilitation of these functions. One way of improving current rehabilitation treatment may be by online cognitive training. Based on a review of the effectiveness of computer-based cognitive training in healthy elderly, we concluded that cognitive flexibility may be a key element for an effective training, which results in improvements not merely on trained tasks but also in untrained tasks (i.e., far transfer). The aim of the current study was to track the behavioral and neural effects of computer-based cognitive flexibility training after stroke. We expected that executive functioning would improve after the cognitive flexibility training, and that neural activity and connectivity would normalize towards what is seen in healthy elderly. METHODS/DESIGN The design was a multicenter, double blind, randomized controlled trial (RCT) with three groups: an experimental intervention group, an active control group who did a mock training, and a waiting list control group. Stroke patients (3 months to 5 years post-stroke) with cognitive complaints were included. Training consisted of 58 half-hour sessions spread over 12 weeks. The primary study outcome was objective executive function. Secondary measures were improvement on training tasks, cognitive flexibility, objective cognitive functioning in other domains than the executive domain, subjective cognitive and everyday life functioning, and neural correlates assessed by both structural and resting-state functional Magnetic Resonance Imaging. The three groups were compared at baseline, after six and twelve weeks of training, and four weeks after the end of the training. Furthermore, they were compared to healthy elderly who received the same training. DISCUSSION The cognitive flexibility training consisted of several factors deemed important for effects that go beyond improvement on merely the training task themselves. Due to the presence of two control groups, the effects of the training could be compared with spontaneous recovery and with the effects of a mock training. This study provides insight into the potential of online cognitive flexibility training after stroke. We also compared its results with the effectiveness of the same training in healthy elderly. TRIAL REGISTRATION The Netherlands National Trial Register NTR5174. Registered 22 May 2015.
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Affiliation(s)
- Renate M van de Ven
- Department of Psychology, University of Amsterdam, Weesperplein 4, 1018, XA, Amsterdam, The Netherlands.
| | - Ben Schmand
- Department of Psychology, University of Amsterdam, Weesperplein 4, 1018, XA, Amsterdam, The Netherlands.
| | - Erny Groet
- Heliomare Research and Development, Relweg 51, 1949, EC, Wijk aan Zee, The Netherlands.
| | - Dick J Veltman
- Department of Psychiatry, VU University medical center, De Boelelaan 1117, 1081, HZ, Amsterdam, The Netherlands.
| | - Jaap M J Murre
- Department of Psychology, University of Amsterdam, Weesperplein 4, 1018, XA, Amsterdam, The Netherlands.
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Longaud-Valès A, Chevignard M, Dufour C, Grill J, Puget S, Sainte-Rose C, Valteau-Couanet D, Dellatolas G. Assessment of executive functioning in children and young adults treated for frontal lobe tumours using ecologically valid tests. Neuropsychol Rehabil 2015; 26:558-83. [DOI: 10.1080/09602011.2015.1048253] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Cassanelli PM, Cladouchos ML, Fernández Macedo G, Sifonios L, Giaccardi LI, Gutiérrez ML, Gravielle MC, Wikinski S. Working memory training triggers delayed chromatin remodeling in the mouse corticostriatothalamic circuit. Prog Neuropsychopharmacol Biol Psychiatry 2015; 60:93-103. [PMID: 25724761 DOI: 10.1016/j.pnpbp.2015.02.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 02/05/2015] [Accepted: 02/16/2015] [Indexed: 01/10/2023]
Abstract
Working memory is a cognitive function serving goal-oriented behavior. In the last decade, working memory training has been shown to improve performance and its efficacy for the treatment of several neuropsychiatric disorders has begun to be examined. Neuroimaging studies have contributed to elucidate the brain areas involved but little is known about the underlying cellular events. A growing body of evidence has provided a link between working memory and relatively long-lasting epigenetic changes. However, the effects elicited by working memory training at the epigenetic level remain unknown. In this study we establish an animal model of working memory training and explore the changes in histone H3 acetylation (H3K9,14Ac) and histone H3 dimethylation on lysine 27 (H3K27Me2) triggered by the procedure in the brain regions of the corticostriatothalamic circuit (prelimbic/infralimbic cortex (PrL/IL), dorsomedial striatum (DMSt) and dorsomedial thalamus (DMTh)). Mice trained on a spontaneous alternation task showed improved alternation scores when tested with a retention interval that disrupts the performance of untrained animals. We then determined the involvement of the brain areas of the corticostriatothalamic circuit in working memory training by measuring the marker of neuronal activation c-fos. We observed increased c-fos levels in PrL/IL and DMSt in trained mice 90min after training. These animals also presented lower immunoreactivity for H3K9,14Ac in DMSt 24h but not 90min after the procedure. Increases in H3K27Me2, a repressive chromatin mark, were found in the DMSt and DMTh 24h after the task. Altogether, we present a mouse model to study the cellular underpinnings of working memory training and provide evidence indicating delayed chromatin remodeling towards repression triggered by the procedure.
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Affiliation(s)
- Pablo Martín Cassanelli
- Instituto de Investigaciones Farmacológicas (UBA-CONICET), Junín 956, 5th Floor, C1113AAD Ciudad Autónoma de Buenos Aires, Argentina.
| | - María Laura Cladouchos
- Instituto de Investigaciones Farmacológicas (UBA-CONICET), Junín 956, 5th Floor, C1113AAD Ciudad Autónoma de Buenos Aires, Argentina
| | - Georgina Fernández Macedo
- Instituto de Investigaciones Farmacológicas (UBA-CONICET), Junín 956, 5th Floor, C1113AAD Ciudad Autónoma de Buenos Aires, Argentina
| | - Laura Sifonios
- Instituto de Investigaciones Farmacológicas (UBA-CONICET), Junín 956, 5th Floor, C1113AAD Ciudad Autónoma de Buenos Aires, Argentina
| | - Laura Inés Giaccardi
- Instituto de Investigaciones Farmacológicas (UBA-CONICET), Junín 956, 5th Floor, C1113AAD Ciudad Autónoma de Buenos Aires, Argentina
| | - María Laura Gutiérrez
- Instituto de Investigaciones Farmacológicas (UBA-CONICET), Junín 956, 5th Floor, C1113AAD Ciudad Autónoma de Buenos Aires, Argentina
| | - María Clara Gravielle
- Instituto de Investigaciones Farmacológicas (UBA-CONICET), Junín 956, 5th Floor, C1113AAD Ciudad Autónoma de Buenos Aires, Argentina
| | - Silvia Wikinski
- Instituto de Investigaciones Farmacológicas (UBA-CONICET), Junín 956, 5th Floor, C1113AAD Ciudad Autónoma de Buenos Aires, Argentina; 1ª Cátedra de Farmacología, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, C1121ABG Ciudad Autónoma de Buenos Aires, Argentina
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Dores AR, Barbosa F, Carvalho IP, Almeida I, Guerreiro S, da Rocha BM, de Sousa L, Castro-Caldas A. Study of behavioural and neural bases of visuo-spatial working memory with an fMRI paradigm based on an n-back task. J Neuropsychol 2015; 11:122-134. [DOI: 10.1111/jnp.12076] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 05/04/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Artemisa R. Dores
- Department of Biomedical Sciences; Institute of Biomedical Sciences Abel Salazar; University of Porto (ICBAS-UP); Portugal
- Psychosocial Rehabilitation Lab; School of Allied Health Technologies; Polytechnic Institute of Porto/Faculty of Psychology and Educational Sciences; University of Porto; Portugal
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology; Faculty of Psychology and Educational Sciences; University of Porto (FPCEUP); Portugal
| | - Irene P. Carvalho
- Department of Clinical Neurosciences and Mental Health; School of Medicine; University of Porto (FMUP); Portugal
| | - Isabel Almeida
- Neuropsychological Rehabilitation Group; Gaia Vocational Rehabilitation Centre; Vila Nova de Gaia Portugal
| | - Sandra Guerreiro
- Neuropsychological Rehabilitation Group; Gaia Vocational Rehabilitation Centre; Vila Nova de Gaia Portugal
| | | | - Liliana de Sousa
- Department of Biomedical Sciences; Institute of Biomedical Sciences Abel Salazar; University of Porto (ICBAS-UP); Portugal
| | - Alexandre Castro-Caldas
- Centre for Interdisciplinary Research in Health - Universidade Catolica Portuguesa; Portugal
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Li K, Alonso J, Chadha N, Pulido J. Does Generalization Occur Following Computer-Based Cognitive Retraining?-An Exploratory Study. Occup Ther Health Care 2015; 29:283-296. [PMID: 25993264 DOI: 10.3109/07380577.2015.1010246] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Computer-based cognitive retraining (CBCR) intervention has gained great popularity in recent years. This study aimed to investigate the occurrence of skill generalization to daily living task for individuals with acquired brain injury (ABI) after completion of eight modules of a commercially available CBCR program, the Parrot Software. The study investigated changes in individuals' global cognition as measured by the Montreal Cognitive Assessment, and changes in individuals' performance during a medication-box sorting task, a novel instrumental activity of daily living. The medication-box sorting task resembled real life medication management with daily prescribed and over-the-counter medications. Twelve individuals with ABI from a community-based program completed the study. Results indicated that CBCR intervention brought about improvement in global cognition, but the improvement did not appear in any particular cognitive domain. Additionally, the gains in global cognition failed to enhance performance in the medication-box sorting task. This exploratory study demonstrated that while CBCR may be a promising intervention for improving global cognition in individuals with ABI, additional intervention might be needed for generalization to occur to a novel daily task. Future studies should look for the ultimate therapeutic outcome from CBCR interventions or include interventions that could bridge the gap between CBCR intervention and performance improvement in daily living occupations.
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Affiliation(s)
- Kitsum Li
- Department of Occupational Therapy, School of Health and Natural Sciences, Dominican University of California, San Rafael, CA, USA
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Spencer-Smith M, Klingberg T. Benefits of a working memory training program for inattention in daily life: a systematic review and meta-analysis. PLoS One 2015; 10:e0119522. [PMID: 25793607 PMCID: PMC4368783 DOI: 10.1371/journal.pone.0119522] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 01/23/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Many common disorders across the lifespan feature impaired working memory (WM). Reported benefits of a WM training program include improving inattention in daily life, but this has not been evaluated in a meta-analysis. This study aimed to evaluate whether one WM training method has benefits for inattention in daily life by conducting a systematic review and meta-analysis. METHODS We searched Medline and PsycINFO, relevant journals and contacted authors for studies with an intervention and control group reporting post-training estimates of inattention in daily life. To reduce the influence of different WM training methods on the findings, the review was restricted to trials evaluating the Cogmed method. A meta-analysis calculated the pooled standardised difference in means (SMD) between intervention and control groups. RESULTS A total of 622 studies were identified and 12 studies with 13 group comparisons met inclusion criteria. The meta-analysis showed a significant training effect on inattention in daily life, SMD=-0.47, 95% CI -0.65, -0.29, p<.00001. Subgroup analyses showed this significant effect was observed in groups of children and adults as well as users with and without ADHD, and in studies using control groups that were active and non-adaptive, wait-list and passive as well as studies using specific or general measures. Seven of the studies reported follow-up assessment and a meta-analysis showed persisting training benefits for inattention in daily life, SMD=-0.33, 95% CI -0.57 -0.09, p=.006. Additional meta-analyses confirmed improvements after training on visuospatial WM, SMD=0.66, 95% CI 0.43, 0.89, p<.00001, and verbal WM tasks, SMD=0.40, 95% CI 0.18, 0.62, p=.0004. CONCLUSIONS Benefits of a WM training program generalise to improvements in everyday functioning. Initial evidence shows that the Cogmed method has significant benefits for inattention in daily life with a clinically relevant effect size.
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Affiliation(s)
- Megan Spencer-Smith
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Torkel Klingberg
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Des Roches CA, Balachandran I, Ascenso EM, Tripodis Y, Kiran S. Effectiveness of an impairment-based individualized rehabilitation program using an iPad-based software platform. Front Hum Neurosci 2015; 8:1015. [PMID: 25601831 PMCID: PMC4283612 DOI: 10.3389/fnhum.2014.01015] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 12/01/2014] [Indexed: 11/13/2022] Open
Abstract
The delivery of tablet-based rehabilitation for individuals with post-stroke aphasia is relatively new, therefore, this study examined the effectiveness of an iPad-based therapy to demonstrate improvement in specific therapy tasks and how the tasks affect overall language and cognitive skills. Fifty-one individuals with aphasia due to a stroke or traumatic brain injury (TBI) were recruited to use an iPad-based software platform, Constant Therapy, for a 10 week therapy program. Participants were split into an experimental (N = 42) and control (N = 9) group. Both experimental and control participants received a 1 h clinic session with a clinician once a week, the experimental participants additionally practiced the therapy at home. Participants did not differ in the duration of the therapy and both groups of participants showed improvement over time in the tasks used for the therapy. However, experimental participants used the application more often and showed greater changes in accuracy and latency on the tasks than the control participants; experimental participants' severity level at baseline as measured by standardized tests of language and cognitive skills were a factor in improvement on the tasks. Subgroups of task co-improvement appear to occur between different language tasks, between different cognitive tasks, and across both domains. Finally, experimental participants showed more significant and positive changes due to therapy in their standardized tests than control participants. These results provide preliminary evidence for the usefulness of a tablet-based platform to deliver tailored language and cognitive therapy to individuals with aphasia.
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Affiliation(s)
- Carrie A. Des Roches
- Aphasia Research Laboratory, Speech, Language, and Hearing Sciences, Sargent College, Boston UniversityBoston, MA, USA
| | - Isabel Balachandran
- Aphasia Research Laboratory, Speech, Language, and Hearing Sciences, Sargent College, Boston UniversityBoston, MA, USA
| | - Elsa M. Ascenso
- Aphasia Research Laboratory, Speech, Language, and Hearing Sciences, Sargent College, Boston UniversityBoston, MA, USA
| | - Yorghos Tripodis
- Department of Biostatistics, School of Public Health, Boston UniversityBoston, MA, USA
| | - Swathi Kiran
- Aphasia Research Laboratory, Speech, Language, and Hearing Sciences, Sargent College, Boston UniversityBoston, MA, USA
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Hellgren L, Samuelsson K, Lundqvist A, Börsbo B. Computerized Training of Working Memory for Patients with Acquired Brain Injury. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/ojtr.2015.32007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Spreij LA, Visser-Meily JMA, van Heugten CM, Nijboer TCW. Novel insights into the rehabilitation of memory post acquired brain injury: a systematic review. Front Hum Neurosci 2014; 8:993. [PMID: 25566021 PMCID: PMC4267268 DOI: 10.3389/fnhum.2014.00993] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 11/22/2014] [Indexed: 11/24/2022] Open
Abstract
Objective: Acquired Brain Injury (ABI) frequently results in memory impairment causing significant disabilities in daily life and is therefore a critical target for cognitive rehabilitation. Current understanding of brain plasticity has led to novel insights in remediation-oriented approaches for the rehabilitation of memory deficits. We will describe 3 of these approaches that have emerged in the last decade: Virtual Reality (VR) training, Computer-Based Cognitive Retraining (CBCR) and Non-Invasive Brain Stimulation (NBS) and evaluate its effectiveness. Methods: A systematic literature search was completed in regard to studies evaluating interventions aiming to improve the memory function after ABI. Information concerning study content and reported effectiveness were extracted. Quality of the studies and methods were evaluated. Results: A total of 786 studies were identified, 15 studies met the inclusion criteria. Three of those studies represent the VR technique, 7 studies represent CBCR and 5 studies NBS. All 3 studies found a significant improvement of the memory function after VR-based training, however these studies are considered preliminary. All 7 studies have shown that CBCR can be effective in improving memory function in patients suffering from ABI. Four studies of the 5 did not find significant improvement of the memory function after the use of NBS in ABI patients. Conclusion: On the basis of this review, CBCR is considered the most promising novel approach of the last decade because of the positive results in improving memory function post ABI. The number of studies representing VR were limited and the methodological quality low, therefore the results should be considered preliminary. The studies representing NBS did not detect evidence for the use of NBS in improving memory function.
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Affiliation(s)
- Lauriane A Spreij
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University Utrecht, Netherlands
| | - Johanna M A Visser-Meily
- Brain Center Rudolf Magnus, Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht, and De Hoogstraat Rehabilitation Utrecht, Netherlands
| | - Caroline M van Heugten
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University Maastricht, Netherlands
| | - Tanja C W Nijboer
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University Utrecht, Netherlands ; Brain Center Rudolf Magnus, Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht, and De Hoogstraat Rehabilitation Utrecht, Netherlands
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Martin KJ, Lincoln N, das Nair R, Kneebone I. Group-based memory rehabilitation for people with multiple sclerosis: Subgroup analysis of the ReMiND trial. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2014. [DOI: 10.12968/ijtr.2014.21.12.590] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Kristy-Jane Martin
- Research associate, Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, UK
| | - Nadina Lincoln
- Professor of clinical psychology, Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, UK
| | - Roshan das Nair
- Consultant clinical psychologist and associate professor, Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, UK
| | - Ian Kneebone
- Professor in clinical psychology, Clinical and Health Psychology Research Initiative, University of Western Sydney, Australia
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das Nair R, Martin KJ, Sinclair EJ. A meta-synthesis of qualitative research on perceptions of people with long-term neurological conditions about group-based memory rehabilitation. Neuropsychol Rehabil 2014; 25:479-502. [DOI: 10.1080/09602011.2014.971820] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Holmes J, Gathercole SE. Taking working memory training from the laboratory into schools. EDUCATIONAL PSYCHOLOGY 2014; 34:440-450. [PMID: 26494933 PMCID: PMC4579053 DOI: 10.1080/01443410.2013.797338] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Revised: 04/11/2013] [Indexed: 05/20/2023]
Abstract
Working memory skills have been shown to be enhanced by adaptive training in several randomised controlled trials. Here, two field trials were conducted in which teachers administered working memory training to their own pupils in school. Twenty-two children aged 8-9 years participated in Trial 1. In Trial 2, 50 children aged 9-11 years with the lowest academic performance completed training. They were matched with a group of 50 children who were not trained. Following training, children in Trial 1 improved significantly in both trained and untrained working memory tasks, with effect sizes comparable to those reported in research studies. Improvements on the trained tasks in Trial 2 were comparable, and training was associated with significantly greater progress at school across the academic year in maths and English. These findings indicate that teacher-administered training leads to generalised and robust gains in working memory and educationally significant gains in academic performance.
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Affiliation(s)
- Joni Holmes
- MRC, Cognition and Brain Sciences Unit, Cambridge, UK
- Corresponding author.
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INCOG Recommendations for Management of Cognition Following Traumatic Brain Injury, Part V. J Head Trauma Rehabil 2014; 29:369-86. [DOI: 10.1097/htr.0000000000000069] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Flak MM, Hernes SS, Skranes J, Løhaugen GCC. The Memory Aid study: protocol for a randomized controlled clinical trial evaluating the effect of computer-based working memory training in elderly patients with mild cognitive impairment (MCI). Trials 2014; 15:156. [PMID: 24886034 PMCID: PMC4016674 DOI: 10.1186/1745-6215-15-156] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 04/08/2014] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Mild cognitive impairment (MCI) is a condition characterized by memory problems that are more severe than the normal cognitive changes due to aging, but less severe than dementia. Reduced working memory (WM) is regarded as one of the core symptoms of an MCI condition. Recent studies have indicated that WM can be improved through computer-based training. The objective of this study is to evaluate if WM training is effective in improving cognitive function in elderly patients with MCI, and if cognitive training induces structural changes in the white and gray matter of the brain, as assessed by structural MRI. METHODS/DESIGNS The proposed study is a blinded, randomized, controlled trail that will include 90 elderly patients diagnosed with MCI at a hospital-based memory clinic. The participants will be randomized to either a training program or a placebo version of the program. The intervention is computerized WM training performed for 45 minutes of 25 sessions over 5 weeks. The placebo version is identical in duration but is non-adaptive in the difficulty level of the tasks. Neuropsychological assessment and structural MRI will be performed before and 1 month after training, and at a 5-month folllow-up. DISCUSSION If computer-based training results in positive changes to memory functions in patients with MCI this may represent a new, cost-effective treatment for MCI. Secondly, evaluation of any training-induced structural changes to gray or white matter will improve the current understanding of the mechanisms behind effective cognitive interventions in patients with MCI. TRIAL REGISTRATION ClinicalTrials.gov NCT01991405. November 18, 2013.
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Affiliation(s)
- Marianne M Flak
- Department of Medicine, Geriatric Unity, The Memory Clinic, Sørlandet Hospital, Arendal, Norway
- Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - Susanne S Hernes
- Department of Medicine, Geriatric Unity, The Memory Clinic, Sørlandet Hospital, Arendal, Norway
| | - Jon Skranes
- Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
- Department of Laboratory Medicine, Children’s and Women’s Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gro CC Løhaugen
- Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
- Department of Laboratory Medicine, Children’s and Women’s Health, Norwegian University of Science and Technology, Trondheim, Norway
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Abstract
OBJECTIVE In this review of the Cogmed training program, we discuss its theoretical foundations, materials, the intervention program, use of coaches, customer support, and research support. METHOD This review was conducted by means of first-hand exploration of the Cogmed training program in conjunction with a critical synthesis of existing empirical literature. RESULTS We conclude that Cogmed has the potential to help individuals improve working memory capabilities and focused attention. CONCLUSION More research is needed to demonstrate if these changes in working memory and focused attention are enduring and generalizable.
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Mitzner TL, McBride SE, Barg-Walkow LH, Rogers WA. Self-Management of Wellness and Illness in an Aging Population. ACTA ACUST UNITED AC 2013. [DOI: 10.1177/1557234x13492979] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this chapter, we review the last 10 years of literature on self-management of illnesses (acute/episodic and chronic) and wellness (e.g., health promotion). We focus on health self-management in the context of an aging population, wherein middle-aged adults are more likely to be managing wellness activities and older adults are often managing both maintenance of health and chronic illnesses. The critical issues related to self-management of health are discussed, including those imposed by health care demands and those stemming from individual differences in general abilities (e.g., motor, perception, cognition) and socioemotional characteristics. The dynamic relationship between theory and practice is highlighted. Health care demands reflect the nature of the illness or wellness activity and include managing comorbidities, symptoms, and medications; engaging in health promotion activities (e.g., exercise, diet); the required use of health technologies; the need for health-related information; and coordination of the care network. Individual differences in motor, perceptual, and cognitive abilities, as well as in the severity and complexity of the illness and the consequent demands, also impact how a person self-manages health. Cognitive abilities, such as decision making, knowledge, literacy (i.e., general, health, and e-health literacy), and numeracy are particularly implicated in the process of managing one’s own health and are especially important in the context of an aging population; therefore we give these cognitive abilities special attention in this chapter. Socioemotional characteristics, and attitudes and beliefs about one’s health, impact an individual’s self-management of health as well, impacting his or her motivation and goal-setting behaviors. Moreover, we discuss literature on interventions that have been used to improve self-management of health, and we examine the potential for technology. We conclude with guidelines for technology design and instruction, and discuss emerging themes.
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Rehabilitation of executive function and social cognition impairments after brain injury. Curr Opin Neurol 2013; 25:656-61. [PMID: 23108251 DOI: 10.1097/wco.0b013e3283594872] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Brain injury is a major cause of long-term disability. Executive and social cognition sequelae are associated with poor outcome. This review examines recent evidence on the efficacy of rehabilitation in these areas. RECENT FINDINGS Accumulating evidence shows that interventions that work with patients on developing insight and strategies to offset executive impairments can produce significant benefits. Training of specific capacities, such as working memory, holds some promise, but more needs to be known about effect generalization. Evidence on social cognition rehabilitation following brain injury is sparse. Although there are some encouraging early results, more information on the clinical significance of change for everyday function is required. SUMMARY Rehabilitation in these areas is inherently difficult but vital if outcomes are to improve. Significant gains have been reported, and further work applying appropriate methods is urgently required.
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