Effects of non-pharmacological or pharmacological interventions on cognition and brain plasticity of aging individuals

The performance of serious games for enhancing attention in cognitively impaired older adults

Attention, which is the process of noticing the surrounding environment and processing information, is one of the cognitive functions that deteriorate gradually as people grow older. Games that are used for other than entertainment, such as improving attention, are often referred to as serious games. This study examined the effectiveness of serious games on attention among elderly individuals suffering from cognitive impairment. A systematic review and meta-analyses of randomized controlled trials were carried out. A total of 10 trials ultimately met all eligibility criteria of the 559 records retrieved. The synthesis of very low-quality evidence from three trials, as analyzed in a meta-study, indicated that serious games outperform no/passive interventions in enhancing attention in cognitively impaired older adults (P < 0.001). Additionally, findings from two other studies demonstrated that serious games are more effective than traditional cognitive training in boosting attention among cognitively impaired older adults. One study also concluded that serious games are better than traditional exercises in enhancing attention. Serious games can enhance attention in cognitively impaired older adults. However, given the low quality of the evidence, the limited number of participants in most studies, the absence of some comparative studies, and the dearth of studies included in the meta-analyses, the results remain inconclusive. Thus, until the aforementioned limitations are rectified in future research, serious games should serve as a supplement, rather than a replacement, to current interventions.

Effectiveness of a Computerized Home-Based Cognitive Stimulation Program for Treating Cancer-Related Cognitive Impairment

Cancer patients assert that after chemotherapy their cognitive abilities have deteriorated. Cognitive stimulation is the clinical treatment of choice for reversing cognitive decline. The current study describes a computerized home-based cognitive stimulation program in patients who survived breast cancer. It aims to assess safety and effectiveness of cognitive stimulation in the oncology population. A series of 45-min training sessions was completed by the participants. A thorough assessment was performed both before and after the intervention. The mini-Mental Adjustment to Cancer Scale, the Cognitive Assessment for Chemo Fog Research, and the Functionality Assessment Instrument in Cancer Treatment-Cognitive Function served as the main assessment tools. The State-Trait Anxiety Inventory, Beck Depression Inventory, Brief Fatigue Inventory, and Measuring Quality of Life-The World Health Organization data were gathered as secondary outcomes. Home-based cognitive stimulation demonstrated beneficial effects in the oncology population, with no side effects being reported. Cognitive, physical, and emotional improvements were observed, along with decreased interference in daily life activities and a better overall quality of life.

Virtual Reality and Exercise Training Enhance Brain, Cognitive, and Physical Health in Older Adults with Mild Cognitive Impairment

We investigated the effectiveness of virtual-reality-based cognitive training (VRCT) and exercise on the brain, cognitive, physical and activity of older adults with mild cognitive impairment (MCI).

METHODS

This study included 99 participants (70.8 ± 5.4) with MCI in the VRCT, exercise, and control groups. The VRCT consisted of a series of games targeting different brain functions such as executive function, memory, and attention. Twenty-four sessions of VRCT (three days/week) were performed, and each session was 100 min long. Exercise intervention consisted of aerobic and resistance trainings performed in 24 sessions for 60 min (2 times/week for 12 weeks). Global cognitive function was measured using the Mini-Mental State Examination (MMSE) test. Resting-state electroencephalography (EEG) of the neural oscillatory activity in different frequency bands was performed. Physical function was measured using handgrip strength (HGS) and gait speed.

RESULTS

After the intervention period, VRCT significantly improved the MMSE scores (p < 0.05), and the exercise group had significantly improved HGS and MMSE scores (p < 0.05) compared to baseline. One-way analysis of variance (ANOVA) of resting-state EEG showed a decreased theta/beta power ratio (TBR) (p < 0.05) in the central region of the brain in the exercise group compared to the control group. Although not statistically significant, the VRCT group also showed a decreased TBR compared to the control group. The analysis of covariance (ANCOVA) test showed a significant decrease in theta band power in the VRCT group compared to the exercise group and a decrease in delta/alpha ratio in the exercise group compared to the VRCT group.

CONCLUSION

Our findings suggest that VRCT and exercise training enhances brain, cognitive, and physical health in older adults with MCI. Further studies with a larger population sample to identify the effect of VRCT in combination with exercise training are required to yield peak benefits for patients with MCI.

Neurodegenerative Diseases: Implications of Environmental and Climatic Influences on Neurotransmitters and Neuronal Hormones Activities

Neurodegenerative and neuronal-related diseases are major public health concerns. Human vulnerability to neurodegenerative diseases (NDDs) increases with age. Neuronal hormones and neurotransmitters are major determinant factors regulating brain structure and functions. The implications of environmental and climatic changes emerged recently as influence factors on numerous diseases. However, the complex interaction of neurotransmitters and neuronal hormones and their depletion under environmental and climatic influences on NDDs are not well established in the literature. In this review, we aim to explore the connection between the environmental and climatic factors to NDDs and to highlight the available and potential therapeutic interventions that could use to improve the quality of life and reduce susceptibility to NDDs.

Herbal drugs and natural bioactive products as potential therapeutics: A review on pro-cognitives and brain boosters perspectives

Memory, one of the most vital aspects of the human brain, is necessary for the effective survival of an individual. 'Memory' can be defined in various ways but in an overall view, memory is the retention of the information that the brain grasps. Different factors are responsible for the disbalance in the brain's hippocampus region and the acetylcholine level, which masters the memory and cognitive functions. Plants are a source of pharmacologically potent drug molecules of high efficacy. Recently herbal medicine has evolved rapidly, gaining great acceptance worldwide due to their natural origin and fewer side effects. In this review, the authors have discussed the mechanisms and pharmacological action of herbal bioactive compounds to boost memory. Moreover, this review presents an update of different herbs and natural products that could act as memory enhancers and how they can be potentially utilized in the near future for the treatment of severe brain disorders. In addition, the authors also discuss the differences in biological activity of the same herb and emphasize the requirement for a higher standardization in cultivation methods and plant processing. The demand for further studies evaluating the interactions of herbal drugs is mentioned.

Working Memory Training Effects on White Matter Integrity in Young and Older Adults

OBJECTIVES

Working memory is essential for daily life skills like reading comprehension, reasoning, and problem-solving. Healthy aging of the brain goes along with working memory decline that can affect older people's independence in everyday life. Interventions in the form of cognitive training are a promising tool for delaying age-related working memory decline, yet the underlying structural plasticity of white matter is hardly studied.

METHODS

We conducted a longitudinal diffusion tensor imaging study to investigate the effects of an intensive four-week adaptive working memory training on white matter integrity quantified by global and tract-wise mean diffusivity. We compared diffusivity measures of fiber tracts that are associated with working memory of 32 young and 20 older participants that were randomly assigned to a working memory training group or an active control group.

RESULTS

The behavioral analysis showed an increase in working memory performance after the four-week adaptive working memory training. The neuroanatomical analysis revealed a decrease in mean diffusivity in the working memory training group after the training intervention in the right inferior longitudinal fasciculus for the older adults. There was also a decrease in mean diffusivity in the working memory training group in the right superior longitudinal fasciculus for the older and young participants after the intervention.

CONCLUSION

This study shows that older people can benefit from working memory training by improving their working memory performance that is also reflected in terms of improved white matter integrity in the superior longitudinal fasciculus and the inferior longitudinal fasciculus, where the first is an essential component of the frontoparietal network known to be essential in working memory.

An update on magnetic resonance imaging markers in AD

The purpose of the present review is to provide an update of the available recent scientific literature on the use of magnetic resonance imaging (MRI) in Alzheimer's disease (AD). MRI is playing an increasingly important role in the characterization of the AD signatures, which can be useful in both the diagnostic process and monitoring of disease progression. Furthermore, this technique is unique in assessing brain structure and function and provides a deep understanding of in vivo evolution of cerebral pathology. In the reviewing process, we established a priori criteria and we thoroughly searched the very recent scientific literature (January 2018-March 2020) for relevant articles on this topic. In summary, we selected 73 articles out of 1654 publications retrieved from PubMed. Based on this selection, this review summarizes the recent application of MRI in clinical trials, defining the predementia stages of AD, the clinical utility of MRI, proposal of novel biomarkers and brain regions of interest, and assessing the relationship between MRI and cognitive features, risk and protective factors of AD. Finally, the value of a multiparametric approach in clinical and preclinical stages of AD is discussed.

Hacking the Brain: Dimensions of Cognitive Enhancement

In an increasingly complex information society, demands for cognitive functioning are growing steadily. In recent years, numerous strategies to augment brain function have been proposed. Evidence for their efficacy (or lack thereof) and side effects has prompted discussions about ethical, societal, and medical implications. In the public debate, cognitive enhancement is often seen as a monolithic phenomenon. On a closer look, however, cognitive enhancement turns out to be a multifaceted concept: There is not one cognitive enhancer that augments brain function per se, but a great variety of interventions that can be clustered into biochemical, physical, and behavioral enhancement strategies. These cognitive enhancers differ in their mode of action, the cognitive domain they target, the time scale they work on, their availability and side effects, and how they differentially affect different groups of subjects. Here we disentangle the dimensions of cognitive enhancement, review prominent examples of cognitive enhancers that differ across these dimensions, and thereby provide a framework for both theoretical discussions and empirical research.

How does physical activity and different models of exercise training affect oxidative parameters and memory?

The present study investigated the chronic effects of different physical exercise and physical activity models on cognitive function, cholinergic activity, and oxidative stress markers in the cerebral cortex and hippocampus. Eighty 60-day old C57BL/6 mice were divided into the following five groups: Sedentary (SED), moderate-intensity continuous training (MICT), high-intensity interval training (HIIT), resistance training (RT), and physical activity (RW, for "running wheel"). Cognitive function (recognition and spatial memory), oxidative stress parameters, and acetylcholinesterase (AChE) activity in the cerebral cortex and hippocampus were evaluated. MICT mice exhibited enhanced recognition memory compared to SED mice (p = .046) and other exercised groups (HIIT: p < .001; RW: p = .003; RT: p < .001). The RT group showed better spatial memory compared to the SED (p = .004), MICT (p = .019), and RW (p = .003) groups. RW, MICT, HIIT, and RT training models reduced nitrites in the hippocampus compared to the SED group. RT led to a significant increase in both lipid peroxidation (p = .01) and reactive oxygen species (ROS) (p < .001) levels compared to the SED group in the hippocampus. MICT promoted an increase in catalase (CAT) activity (p = .002), while superoxide dismutase (SOD) activity was diminished by RT compared to MICT and HIIT (p = .008). In the cerebral cortex, RT increased ROS levels, but exhibited the lowest lipid peroxidation level among the groups (p < .001). The RW group showed an activity-induced increase in lipid peroxidation level compared to the SED group, and the highest level of CAT activity among all groups (p < .001). AChE activity was higher in the RT group compared to the SED, MICT, and RW groups (p = .039) in the cerebral cortex. In summary, nitrite levels in the hippocampus were decreased in all intervention groups regardless of activity or exercise model. Likewise, MICT improved recognition memory besides increasing CAT activity. We conclude that the MICT and RT protocols seem to act as oxidative stress regulators and non-pharmacological strategies to improve cognitive function.

Development and validation of Cognitive Training Intervention for Alzheimer's disease (CTI-AD): A picture-based interventional program

Introduction

Alzheimer’s disease is a gradual and progressive disorder which cripples the person’s functionality due to cognitive decline. Many clinicopathological and pharmacological therapy has the potential to slow down the progression of the disease but has limited efficacy. One complimentary approach that has emerged is cognitive training interventions which have shown synergistic effect with the drug therapy. Nevertheless, many cognitive interventions lack on specificities of the intervention due to which its efficacy gets scrutinized.

Objective

To describe the foundation, content, and development of Cognitive Training Intervention for Alzheimer’s disease (CTI-AD) along with the treatment feasibility based on a pilot study.

Materials and methods

A culture-specific picture-based eight weeks cognitive training manual was developed based on extensive review and focused group discussions. It was standardized on 63 older participants (48 healthy controls (HC); 15 early Alzheimer’s disease cases).

Results

All the tasks were progressive in nature and were found effective in discriminating the cognitive performance of early Alzheimer’s disease and HC throughout the intervention period. Moreover, it also improved early Alzheimer’s disease performance on the memory (HC: 1st week/8th week = 21.6 ± 5.7/57.3 ± 19.0; early Alzheimer’s disease: 1st week/8th week = 48.5 ± 22.9/60.5 ± 21.8); attention (HC: 1st week/8th week = 90.2 ± 18.0/196.9 ± 28.0; early Alzheimer’s disease: 1st week/8th week = 216.6 ± 78.2/286.8 ± 87.0) and language (HC: 1st week/8th week = 29.8 ± 9.4/115.3 ± 31.1; early Alzheimer’s disease: 1st week/8th week = 211.8 ± 68.4/270.4 ± 104.9) domains, respectively, from the baseline level.

Conclusion

The current manual (CTI-AD) is one of the first promising non-pharmacological program developed nationally with a strong theoretical base to cater to the tertiary needs of the older adults with early Alzheimer’s disease.

Effects of Different Cognitive Trainings on Amnestic Mild Cognitive Impairment in the Elderly: A One-Year Longitudinal Functional Magnetic Resonance Imaging (MRI) Study

BACKGROUND Cognitive training has been focused on the interventions of amnestic mild cognitive impairment (aMCI) in recent years, with poor understanding. MATERIAL AND METHODS The study participants with aMCI were screened in a previous intervention trial. Functional magnetic resonance imaging (fMRI) was adopted to investigate effects of single-domain cognitive training (SDCT) and multi-domain cognitive training (MDCT) on aMCI and to explore potential mechanisms. RESULTS There were significant differences in the grey matter volume of the middle frontal gyrus, superior parietal lobule, inferior temporal gyrus, fusiform gyrus, and ventral V3 between the MDCT/SDCT group and the control group (P<0.05). Regional homogeneity (ReHo) increased significantly in the right and left inferior frontal gyrus as well as in the left and right precentral gyrus after intervention in the MDCT group and the SDCT group. ReHo increased significantly in the right and left lingual gyrus of the MDCT group and the control group. ReHo reduced significantly in the right middle temporal gyrus of the MDCT group but increased significantly in the left middle temporal gyrus in the SDCT group and the control group. The voxel of grey matter in the precuneus was positively related to the language scores on RBANS (Repeatable Battery for the Assessment of Neuropsychological Status), and amygdala, fusiform gyrus, and hippocampus also had a positive relationship with delayed memory scores in RBANS of the MDCT group. In the MDCT group, the attention and reasoning scores were also positively related to the ReHo of middle temporal gyrus. CONCLUSIONS Both MDCT and SDCT may improve the aMCI at brain functional and structural levels; however, the MDCT group exhibited higher ReHo values in middle temporal gyrus and superior occipital gyrus. Also, it was confirmed that MDCT leads to better results than SDCT, showing a significant correlation of cognitive functions such as attention, memory, reasoning, and visual-spatial ability.

Chronic intermittent exposure to ayahuasca during aging does not affect memory in mice

The Quechua term ayahuasca refers to a beverage obtained from decoctions of the liana Banisteriopsis caapi with leaves of Psychotria viridis. The ritualistic use of ayahuasca is becoming a global phenomenon, with some individuals using this beverage throughout life, including in old age. Cognitive impairment is a common manifestation during aging. There are conflicting reports on the ability of some ayahuasca compounds to exert neuroprotective or neurotoxic effects that could improve or impair learning and memory. Animal models provide a relevant and accessible means of investigating the behavioral effects of ayahuasca without the environmental conditions associated with the ritualistic use of the beverage. In this study, we investigated the influence of chronic ayahuasca exposure throughout aging on the spatial reference and habituation memories of mice. Twenty-eight male c57bl/6 mice (6 months old) received ayahuasca or water (1.5 mL/kg, orally) twice a week for 12 months and were tested in the Morris water maze (MWM), open field and elevated plus maze (EPM) tasks before and after treatment. During aging, there was significant impairment in the evocation (but not acquisition) of spatial reference memory and in habituation to the open field. There was also a decrease in locomotor activity in the open field and EPM tests, whereas the anxiety parameters were unaltered. Ayahuasca treatment did not alter any of these parameters associated with aging. These findings indicate that chronic exposure to ayahuasca during aging did not affect memory in mice.

The effects of an extensive exercise programme on the progression of Mild Cognitive Impairment (MCI): study protocol for a randomised controlled trial

Background

Exercise interventions to prevent dementia and delay cognitive decline have gained considerable attention in recent years. Human and animal studies have demonstrated that regular physical activity targets brain function by increasing cognitive reserve. There is also evidence of structural changes caused by exercise in preventing or delaying the genesis of neurodegeneration. Although initial studies indicate enhanced cognitive performance in patients with mild cognitive impairment (MCI) following an exercise intervention, little is known about the effect of an extensive, controlled and regular exercise regimen on the neuropathology of patients with MCI. This study aims to determine the effects of an extensive exercise programme on the progression of MCI.

Methods/design

This randomised controlled clinical intervention study will take place across three European sites. Seventy-five previously sedentary patients with a clinical diagnosis of MCI will be recruited at each site. Participants will be randomised to one of three groups. One group will receive a standardised 1-year extensive aerobic exercise intervention (3 units of 45 min/week). The second group will complete stretching and toning (non-aerobic) exercise (3 units of 45 min/week) and the third group will act as the control group. Change in all outcomes will be measured at baseline (T0), after six months (T1) and after 12 months (T2). The primary outcome, cognitive performance, will be determined by a neuropsychological test battery (CogState battery, Trail Making Test and Verbal fluency). Secondary outcomes include Montreal Cognitive Assessment (MoCA), cardiovascular fitness, physical activity, structural changes of the brain, quality of life measures and measures of frailty. Furthermore, outcome variables will be related to genetic variations on genes related to neurogenesis and epigenetic changes in these genes caused by the exercise intervention programme.

Discussion

The results will add new insights into the prevailing notion that exercise may slow the rate of cognitive decline in MCI.

Trial registration

ClinicalTrials.gov NCT02913053

Cognitive training and Bacopa monnieri: Evidence for a combined intervention to alleviate age associated cognitive decline

As the elderly population grows the impact of age associated cognitive decline as well as neurodegenerative diseases such as Alzheimer's disease and dementia will increase. Ageing is associated with consistent impairments in cognitive processes (e.g., processing speed, memory, executive function and learning) important for work, well-being, life satisfaction and overall participation in society. Recently, there has been increased effort to conduct research examining methods to improve cognitive function in older citizens. Cognitive training has been shown to improve performance in some cognitive domains; including memory, processing speed, executive function and attention in older adults. These cognitive changes are thought to be related to improvements in brain connectivity and neural circuitry. Bacopa monnieri has also been shown to improve specific domains of cognition, sensitive to age associated cognitive decline (particularly processing speed and memory). These Bacopa monnieri dependent improvements may be due to the increase in specific neuro-molecular mechanisms implicated in the enhancement of neural connections in the brain (i.e. synaptogenesis). In particular, a number of animal studies have shown Bacopa monnieri consumption upregulates calcium dependent kinases in the synapse and post-synaptic cell, crucial for strengthening and growing connections between neurons. These effects have been shown to occur in areas important for cognitive processes, such as the hippocampus. As Bacopa monnieri has shown neuro-molecular mechanisms that encourage synaptogenesis, while cognitive training enhances brain connectivity, Bacopa monnieri supplementation could theoretically enhance and strengthen synaptic changes acquired through cognitive training. Therefore, the current paper hypothesises that the combination of these two interventions could improve cognitive outcomes, over and above the effects of administrating these interventions independently, as an effective treatment to ameliorate age associated cognitive decline.

Protective effects of resveratrol on aging-induced cognitive impairment in rats

Resveratrol, a polyphenol phytoalexine, has been shown to play a neuroprotective role in the neurodegenerative process in Alzheimer's disease (AD) and improve memory function in dementia. However, the in vivo effect of resveratrol in normal aging models of learning and memory has not yet been evaluated. Therefore, the present neurobehavioral study was undertaken to evaluate the effect of resveratrol on cognitive impairment induced by aging in passive avoidance and Morris water maze (MWM) tests. Male Wistar albino rats were divided into four groups: young control (4month), young resveratrol (4month+RESV), old control (24month) and old resveratrol (24month+RESV). Resveratrol (50mg/kg/day) was given to the 4month+RESV and 24month+RESV groups orally for 12weeks. There was no significant difference between the groups for the first day of latency, while in aged rats, the second day of latency was significantly shortened compared to the young group in the passive avoidance test (p<0.05). Additionally, in the MWM test, the results showed a decrease in the time spent in the escape platform's quadrant in the probe test in aged rats (p<0.05). The administration of resveratrol at 50mg/kg/day increased the retention scores in the passive avoidance test and the time spent in the escape platform's quadrant in the MWM task (p<0.05). Furthermore resveratrol attenuated the protein levels of TNFα and IL1β in the 24-month group. These findings indicate that aging impairs emotional and spatial learning-memory and resveratrol reverses the effect of age-related learning and memory impairment. The results of this study suggest that resveratrol is effective in preventing cognitive deficit in aged rats by inhibiting the production of inflammatory cytokines.

Age-dependent effects of esculetin on mood-related behavior and cognition from stressed mice are associated with restoring brain antioxidant status

Dietary antioxidants might exert an important role in the aging process by relieving oxidative damage, a likely cause of age-associated brain dysfunctions. This study aims to investigate the influence of esculetin (6,7-dihydroxycoumarin), a naturally occurring antioxidant in the diet, on mood-related behaviors and cognitive function and its relation with age and brain oxidative damage. Behavioral tests were employed in 11-, 17- and 22-month-old male C57BL/6J mice upon an oral 35day-esculetin treatment (25mg/kg). Activity of antioxidant enzymes, GSH and GSSG levels, GSH/GSSG ratio, and mitochondrial function were analyzed in brain cortex at the end of treatment in order to assess the oxidative status related to mouse behavior. Esculetin treatment attenuated the increased immobility time and enhanced the diminished climbing time in the forced swim task elicited by acute restraint stress (ARS) in the 11- and 17-month-old mice versus their counterpart controls. Furthermore, ARS caused an impairment of contextual memory in the step-through passive avoidance both in mature adult and aged mice which was partially reversed by esculetin only in the 11-month-old mice. Esculetin was effective to prevent the ARS-induced oxidative stress mostly in mature adult mice by restoring antioxidant enzyme activities, augmenting the GSH/GSSG ratio and increasing cytochrome c oxidase (COX) activity in cortex. Modulation of the mood-related behavior and cognitive function upon esculetin treatment in a mouse model of ARS depends on age and is partly due to the enhancement of redox status and levels of COX activity in cortex.

Cognitive training can reduce the rate of cognitive aging: a neuroimaging cohort study

BACKGROUND

The neural mechanisms underlying the restorative effects of cognitive training on aging brains remain unclear. To address this issue, we examined the relationship between changes in spontaneous brain activity and cognitive performance that occur after cognitive training.

METHODS

Participants were older adults who were part of a randomized control trial within a larger longitudinal cognitive training study. We conducted single-domain and multi-domain cognitive training in two respective intervention groups. Participants were trained for 1 h, twice a week, for 12 weeks. Cognition was assessed in all participants and magnetic resonance images were obtained at baseline and 1 year after training. To assess spontaneous fluctuations in brain activity, we acquired resting-state fMRI data. Two indices-functional entropy and time-domain entropy-were used to measure the effects of training. Functional entropy increases with aging, and indicates disruptions in functional conectivity. Time-domain entropy decreases with aging, and indicates structural alterations in the brain and blood-flow reduction.

RESULTS

Seventy participants completed the study: 26 in the multi-domain cognitive training group (70.38 ± 3.30 yrs), 27 in single-domain group (70.48 ± 3.93 yrs), and 17 in a control group (68.59 ± 3.24 yrs). Functional entropy increased significantly less in the multi-domain (p = 0.047) and single-domain groups (p = 9.51 × 10(-4)) compared with the control group. In the multi-domain group, this was true in the paracentral lobule (p = 0.004, Bonferroni corrected p < 0.05). Time-domain entropy also improved with training. Compared with controls, time-domain entropy in the multi-domain group decreased less in the inferior frontal gyrus pars opercularis (p = 3.59 × 10(-4)), the medial part of superior frontal gyrus (p = 1.17 × 10(-5)), and the thalamus (p = 4.72 × 10(-5)), while that in the single-domain group decreased less in the cuneus (p = 2.58 × 10(-4), Bonferroni corrected p < 0.05). Additionally, changes in regional entropy for some regions such as hippocampus significantly correlated with improvements in cognitive performance.

CONCLUSIONS

Cognitive training can induce plastic changes in neural functional connectivity of healthy older people, and these changes may underlie the positive effect of cognitive training.

TRIAL REGISTRATION

ChiCTR-TRC-08000732 (Date of registration: 5th November, 2008).

Cognitive training with and without additional physical activity in healthy older adults: cognitive effects, neurobiological mechanisms, and prediction of training success

Data is inconsistent concerning the question whether cognitive-physical training (CPT) yields stronger cognitive gains than cognitive training (CT). Effects of additional counseling, neurobiological mechanisms, and predictors have scarcely been studied. Healthy older adults were trained with CT (n = 20), CPT (n = 25), or CPT with counseling (CPT+C; n = 23). Cognition, physical fitness, BDNF, IGF-1, and VEGF were assessed at pre- and post-test. No interaction effects were found except for one effect showing that CPT+C led to stronger gains in verbal fluency than CPT (p = 0.03). However, this superiority could not be assigned to additional physical training gains. Low baseline cognitive performance and BDNF, not carrying apoE4, gains in physical fitness and the moderation of gains in physical fitness × gains in BDNF predicted training success. Although all types of interventions seem successful to enhance cognition, our data do not support the hypotheses that CPT shows superior CT gains compared to CT or that CPT+C adds merit to CPT. However, as CPT leads to additional gains in physical fitness which in turn is known to have positive impact on cognition in the long-term, CPT seems more beneficial. Training success can partly be predicted by neuropsychological, neurobiological, and genetic parameters. Unique Identifier: WHO ICTRP (http://www.who.int/ictrp); ID: DRKS00005194.

Beneficial effects of multisensory and cognitive stimulation in institutionalized elderly: 12-months follow-up

We previously demonstrated the beneficial effects of a multisensory and cognitive stimulation program, consisting of 48 sessions, twice a week, to improve the cognition of elderly subjects living either in long-term care institutions (institutionalized – I) or in communities with their families (noninstitutionalized – NI). In the present study, we evaluated these subjects after the end of the intervention and compared the rate of age-related cognitive decline of those living in an enriched community environment (NI group, n=15, 74.1±3.9 years old) with those living in the impoverished environment of long-term care institutions (I group, n=20, 75.1±6.8 years old). Both groups participated fully in our stimulation program. Over 1 year, we conducted revaluations at five time points (2 months, 4 months, 6 months, 8 months, and 12 months) after the completion of the intervention. Both elderly groups were evaluated with the mini-mental state examination and selected language tests. Progressive cognitive decline was observed in both groups over the period. Indeed, it took only 4–6 months after the end of the stimulation program for significant reductions in language test scores to become apparent. However, earlier reductions in test scores were mainly associated with I group, and linguistic prosody test scores were significantly affected by institutionalization and time, two variables that interacted and reduced these scores. Moreover, I group reduced the Montréal cognitive assessment battery language tests scores 4 months before NI group. It remains to be investigated what mechanisms may explain the earlier and more intense language losses in institutionalized elderly.

Screening and personalizing nootropic drugs and cognitive modulator regimens in silico

The go-to cognitive enhancers of today are those that are widely available rather than optimal for the user, including drugs typically prescribed for treatment of ADHD (e.g., methylphenidate) and sleep disturbances such as narcolepsy (modafinil). While highly effective in their intended therapeutic role, performance gains in healthy populations are modest at best and profoundly inconsistent across subgroups and individuals. We propose a method for in silico screening of possible novel cognitive enhancers followed by high-throughput in vivo and in vitro validation. The proposed method uses gene expression data to evaluate the the collection of activated or suppressed signaling pathways in tissues or neurons of the cognitively enhanced brain. An algorithm maps expression data onto signaling pathways and quantifies their individual activation strength. The collective pathways and their activation form what we term the signaling pathway cloud, a biological fingerprint of cognitive enhancement (or any other condition of interest). Drugs can then be screened and ranked based on their ability to minimize, mimic, or exaggerate pathway activation or suppression within that cloud. Using this approach, one may predict the efficacy of many drugs that may enhance various aspects of cognition before costly preclinical studies and clinical trials are undertaken.