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Caminiti SP, Bernini S, Bottiroli S, Mitolo M, Manca R, Grillo V, Avenali M, De Icco R, Capellari S, Carlesimo GA, Venneri A, Tassorelli C. Exploring the neural and behavioral correlates of cognitive telerehabilitation in mild cognitive impairment with three distinct approaches. Front Aging Neurosci 2024; 16:1425784. [PMID: 38993694 PMCID: PMC11236534 DOI: 10.3389/fnagi.2024.1425784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 06/10/2024] [Indexed: 07/13/2024] Open
Abstract
Background Currently, the impact of drug therapies on neurodegenerative conditions is limited. Therefore, there is a strong clinical interest in non-pharmacological interventions aimed at preserving functionality, delaying disease progression, reducing disability, and improving quality of life for both patients and their caregivers. This longitudinal multicenter Randomized Controlled Trial (RCT) applies three innovative cognitive telerehabilitation (TR) methods to evaluate their impact on brain functional connectivity reconfigurations and on the overall level of cognitive and everyday functions. Methods We will include 110 participants with mild cognitive impairment (MCI). Fifty-five participants will be randomly assigned to the intervention group who will receive cognitive TR via three approaches, namely: (a) Network-based Cognitive Training (NBCT), (b) Home-based Cognitive Rehabilitation (HomeCoRe), or (c) Semantic Memory Rehabilitation Training (SMRT). The control group (n = 55) will receive an unstructured home-based cognitive stimulation. The rehabilitative program will last either 4 (NBTC) or 6 weeks (HomeCoRe and SMRT), and the control condition will be adapted to each TR intervention. The effects of TR will be tested in terms of Δ connectivity change, obtained from high-density electroencephalogram (HD-EEG) or functional magnetic resonance imaging at rest (rs-fMRI), acquired before (T0) and after (T1) the intervention. All participants will undergo a comprehensive neuropsychological assessment at four time-points: baseline (T0), within 2 weeks (T1), and after 6 (T2) and 12 months (T3) from the end of TR. Discussion The results of this RCT will identify a potential association between improvement in performance induced by individual cognitive TR approaches and modulation of resting-state brain connectivity. The knowledge gained with this study might foster the development of novel TR approaches underpinned by established neural mechanisms to be validated and implemented in clinical practice.Clinical trial registration: [https://classic.clinicaltrials.gov/ct2/show/NCT06278818], identifier [NCT06278818].
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Affiliation(s)
| | | | - Sara Bottiroli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - Micaela Mitolo
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Riccardo Manca
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Department of Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Valentina Grillo
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - Micol Avenali
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - Roberto De Icco
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - Sabina Capellari
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giovanni Augusto Carlesimo
- Department of Systems Medicine, Tor Vergata University, Rome, Italy
- IRCCS S. Lucia Foundation, Rome, Italy
| | - Annalena Venneri
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Department of Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Cristina Tassorelli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
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Qin T, Wang L, Xu H, Liu C, Shao Y, Li F, Wang Y, Jiang J, Lin H. rTMS concurrent with cognitive training rewires AD brain by enhancing GM-WM functional connectivity: a preliminary study. Cereb Cortex 2024; 34:bhad460. [PMID: 38037857 DOI: 10.1093/cercor/bhad460] [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: 06/28/2023] [Revised: 11/03/2023] [Accepted: 11/09/2023] [Indexed: 12/02/2023] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) and cognitive training for patients with Alzheimer's disease (AD) can change functional connectivity (FC) within gray matter (GM). However, the role of white matter (WM) and changes of GM-WM FC under these therapies are still unclear. To clarify this problem, we applied 40 Hz rTMS over angular gyrus (AG) concurrent with cognitive training to 15 mild-moderate AD patients and analyzed the resting-state functional magnetic resonance imaging before and after treatment. Through AG-based FC analysis, corona radiata and superior longitudinal fasciculus (SLF) were identified as activated WM tracts. Compared with the GM results with AG as seed, more GM regions were found with activated WM tracts as seeds. The averaged FC, fractional amplitude of low-frequency fluctuation (fALFF), and regional homogeneity (ReHo) of the above GM regions had stronger clinical correlations (r/P = 0.363/0.048 vs 0.299/0.108, 0.351/0.057 vs 0.267/0.153, 0.420/0.021 vs 0.408/0.025, for FC/fALFF/ReHo, respectively) and better classification performance to distinguish pre-/post-treatment groups (AUC = 0.91 vs 0.88, 0.65 vs 0.63, 0.87 vs 0.82, for FC/fALFF/ReHo, respectively). Our results indicated that rTMS concurrent with cognitive training could rewire brain network by enhancing GM-WM FC in AD, and corona radiata and SLF played an important role in this process.
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Affiliation(s)
- Tong Qin
- Department of Neurology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing 100053, China
| | - Luyao Wang
- School of Life Science, Shanghai University, No. 99 Shangda Road, Baoshan District, Shanghai 200444, China
| | - Huanyu Xu
- School of Communication and Information Engineering, Shanghai University, No. 99 Shangda Road, Baoshan District, Shanghai 200444, China
| | - Chunyan Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing 100053, China
| | - Yuxuan Shao
- Department of Neurology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing 100053, China
| | - Fangjie Li
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, No. 1200 Cailun Road, Pudong New Area, Shanghai 201203, China
| | - Yuping Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing 100053, China
| | - Jiehui Jiang
- School of Life Science, Shanghai University, No. 99 Shangda Road, Baoshan District, Shanghai 200444, China
| | - Hua Lin
- Department of Neurology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing 100053, China
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3
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Verovnik B, Khachatryan E, Šuput D, Van Hulle MM. Effects of risk factors on longitudinal changes in brain structure and function in the progression of AD. Alzheimers Dement 2023; 19:2666-2676. [PMID: 36807765 DOI: 10.1002/alz.12991] [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: 10/21/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 02/20/2023]
Abstract
INTRODUCTION Past research on Alzheimer's disease (AD) has focused on biomarkers, cognition, and neuroimaging as primary predictors of its progression, albeit additional ones have recently gained attention. When turning to the prediction of the progression from one stage to another, one could benefit from the joint assessment of imaging-based biomarkers and risk/protective factors. METHODS We included 86 studies that fulfilled our inclusion criteria. RESULTS Our review summarizes and discusses the results of 30 years of longitudinal research on brain changes assessed with neuroimaging and the risk/protective factors and their effect on AD progression. We group results into four sections: genetic, demographic, cognitive and cardiovascular, and lifestyle factors. DISCUSSION Given the complex nature of AD, including risk factors could prove invaluable for a better understanding of AD progression. Some of these risk factors are modifiable and could be targeted by potential future treatments.
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Affiliation(s)
- Barbara Verovnik
- Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Laboratory for Neuro- and Psychophysiology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Elvira Khachatryan
- Laboratory for Neuro- and Psychophysiology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Dušan Šuput
- Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Center for Clinical Physiology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Marc M Van Hulle
- Laboratory for Neuro- and Psychophysiology, Department of Neurosciences, KU Leuven, Leuven, Belgium
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4
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Filippi M, Spinelli EG, Cividini C, Ghirelli A, Basaia S, Agosta F. The human functional connectome in neurodegenerative diseases: relationship to pathology and clinical progression. Expert Rev Neurother 2023; 23:59-73. [PMID: 36710600 DOI: 10.1080/14737175.2023.2174016] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Neurodegenerative diseases can be considered as 'disconnection syndromes,' in which a communication breakdown prompts cognitive or motor dysfunction. Mathematical models applied to functional resting-state MRI allow for the organization of the brain into nodes and edges, which interact to form the functional brain connectome. AREAS COVERED The authors discuss the recent applications of functional connectomics to neurodegenerative diseases, from preclinical diagnosis, to follow up along with the progressive changes in network organization, to the prediction of the progressive spread of neurodegeneration, to stratification of patients into prognostic groups, and to record responses to treatment. The authors searched PubMed using the terms 'neurodegenerative diseases' AND 'fMRI' AND 'functional connectome' OR 'functional connectivity' AND 'connectomics' OR 'graph metrics' OR 'graph analysis.' The time range covered the past 20 years. EXPERT OPINION Considering the great pathological and phenotypical heterogeneity of neurodegenerative diseases, identifying a common framework to diagnose, monitor and elaborate prognostic models is challenging. Graph analysis can describe the complexity of brain architectural rearrangements supporting the network-based hypothesis as unifying pathogenetic mechanism. Although a multidisciplinary team is needed to overcome the limit of methodologic complexity in clinical application, advanced methodologies are valuable tools to better characterize functional disconnection in neurodegeneration.
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Affiliation(s)
- Massimo Filippi
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy.,Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Edoardo Gioele Spinelli
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Camilla Cividini
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alma Ghirelli
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Silvia Basaia
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Federica Agosta
- Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
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5
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Petrella JR, Michael AM, Qian M, Nwosu A, Sneed J, Goldberg TE, Devanand DP, Doraiswamy PM. Impact of Computerized Cognitive Training on Default Mode Network Connectivity in Subjects at Risk for Alzheimer's Disease: A 78-week Randomized Controlled Trial. J Alzheimers Dis 2023; 91:483-494. [PMID: 36442202 PMCID: PMC9881022 DOI: 10.3233/jad-220946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Mild cognitive impairment (MCI) represents a high risk group for Alzheimer's disease (AD). Computerized Cognitive Games Training (CCT) is an investigational strategy to improve targeted functions in MCI through the modulation of cognitive networks. OBJECTIVE The goal of this study was to examine the effect of CCT versus a non-targeted active brain exercise on functional cognitive networks. METHODS 107 patients with MCI were randomized to CCT or web-based crossword puzzles. Resting-state functional MRI (fMRI) was obtained at baseline and 18 months to evaluate differences in fMRI measured within- and between-network functional connectivity (FC) of the default mode network (DMN) and other large-scale brain networks: the executive control, salience, and sensorimotor networks. RESULTS There were no differences between crosswords and games in the primary outcome, within-network DMN FC across all subjects. However, secondary analyses suggest differential effects on between-network connectivity involving the DMN and SLN, and within-network connectivity of the DMN in subjects with late MCI. Paradoxically, in both cases, there was a decrease in FC for games and an increase for the crosswords control (p < 0.05), accompanied by lesser cognitive decline in the crosswords group. CONCLUSION Results do not support a differential impact on within-network DMN FC between games and crossword puzzle interventions. However, crossword puzzles might result in cognitively beneficial remodeling between the DMN and other networks in more severely impaired MCI subjects, parallel to the observed clinical benefits.
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Affiliation(s)
- Jeffrey R. Petrella
- Department of Radiology, Duke University School of Medicine, Durham, NC, USA
| | - Andrew M. Michael
- Duke Institute for Brain Sciences and the Duke Center for the Study of Aging and Human Development, Durham, NC, USA
| | - Min Qian
- Department of Biostatistics, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA
| | - Adaora Nwosu
- Neurocognitive Disorders Program, Department of Psychiatry, Duke University School of Medicine, Durham, NC, USA
| | - Joel Sneed
- Department of Psychology, Queens College, City University of New York, Flushing, NY, USA
- Department of Psychology The Graduate Center, City University of New York, New York, NY, USA
| | - Terry E. Goldberg
- Department of Psychiatry, Columbia University Medical Center, and the New York Psychiatry Institute, New York, NY, USA
| | - Davangere P. Devanand
- Department of Psychiatry, Columbia University Medical Center, and the New York Psychiatry Institute, New York, NY, USA
| | - P. Murali Doraiswamy
- Duke Institute for Brain Sciences and the Duke Center for the Study of Aging and Human Development, Durham, NC, USA
- Neurocognitive Disorders Program, Department of Psychiatry, Duke University School of Medicine, Durham, NC, USA
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6
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Perus L, Busto GU, Mangin JF, Le Bars E, Gabelle A. Effects of preventive interventions on neuroimaging biomarkers in subjects at-risk to develop Alzheimer's disease: A systematic review. Front Aging Neurosci 2022; 14:1014559. [PMID: 36506466 PMCID: PMC9730537 DOI: 10.3389/fnagi.2022.1014559] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/01/2022] [Indexed: 11/25/2022] Open
Abstract
Alzheimer's Disease (AD) is a multifactorial and complex neurodegenerative disorder. Some modifiable risk factors have been associated with an increased risk of appearance of the disease and/or cognitive decline. Preventive clinical trials aiming at reducing one or combined risk factors have been implemented and their potential effects assessed on cognitive trajectories and on AD biomarkers. However, the effect of interventions on surrogate markers, in particular imaging biomarkers, remains poorly understood. We conducted a review of the literature and analyzed 43 interventional studies that included physical exercise, nutrition, cognitive training or multidomain interventions, and assessed various brain imaging biomarkers, to determine the effects of preventive interventions on imaging biomarkers for subjects at-risk to develop AD. Deciphering the global and regional brain effect of each and combined interventions will help to better understand the interplay relationship between multimodal interventions, cognition, surrogate brain markers, and to better design primary and secondary outcomes for future preventive clinical trials. Those studies were pondered using generally-admitted quality criteria to reveal that interventions may affect the brain of patients with cognitive impairment rather than those without cognitive impairment thus indicating that particular care should be taken when selecting individuals for interventions. Additionally, a majority of the studies concurred on the effect of the interventions and particularly onto the frontal brain areas.
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Affiliation(s)
- Lisa Perus
- INM, Univ Montpellier, INSERM, CHU Montpellier, Montpellier, France,Department of Neurology, Memory Resources and Research Center, Gui de Chauliac Hospital, Montpellier, France,Institut d'Imagerie Fonctionnelle Humaine, I2FH, Department of Neuroradiology, Gui de Chauliac Hospital and University of Montpellier, Montpellier, France,CATI, US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France
| | - Germain U. Busto
- INM, Univ Montpellier, INSERM, CHU Montpellier, Montpellier, France,Department of Neurology, Memory Resources and Research Center, Gui de Chauliac Hospital, Montpellier, France,*Correspondence: Germain U. Busto
| | - Jean-François Mangin
- CATI, US52-UAR2031, CEA, ICM, SU, CNRS, INSERM, APHP, Ile de France, France,Université Paris-Saclay, CEA, CNRS, Neurospin, UMR9027 Baobab, Gif-sur-Yvette, France
| | - Emmanuelle Le Bars
- Institut d'Imagerie Fonctionnelle Humaine, I2FH, Department of Neuroradiology, Gui de Chauliac Hospital and University of Montpellier, Montpellier, France
| | - Audrey Gabelle
- INM, Univ Montpellier, INSERM, CHU Montpellier, Montpellier, France,Department of Neurology, Memory Resources and Research Center, Gui de Chauliac Hospital, Montpellier, France
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Abstract
PURPOSE OF REVIEW We review recent work on applications of non-pharmacologic strategies to promote cognitive health in older adulthood and discuss potential network mechanisms, limitations, and considerations for improving intervention uptake and efficacy. RECENT FINDINGS In healthy older adults and patients with mild cognitive impairment, cognitive training produces global and domain-specific cognitive gains, though effect sizes tend to be modest and transfer is variable. Non-invasive brain stimulation has shown moderate success in enhancing cognitive function, though the optimum approach, parameters, and cortical targets require further investigation. Physical activity improves cognitive functions in late life, with emerging trials highlighting key intervention components that may maximize treatment outcomes. Multimodal interventions may be superior to single-component interventions in conferring cognitive gains, although interpretation is limited by modest sample sizes and variability in training components and parameters. Across modalities, individual differences in patient characteristics predict therapeutic response. These interventions may advance cognitive health by modulating functional networks that support core cognitive abilities including the default mode, executive control, and salience networks. Effectiveness of cognitive enhancement strategies may be increased with clinician-led coaching, booster sessions, gamification, integration of multiple intervention modalities, and concrete applications to everyday functioning. Future trials involving rigorous comparisons of training components, parameters, and delivery formats will be essential in establishing the precise approaches needed to maximize cognitive outcomes. Novel studies using patient-level clinical and neuroimaging features to predict individual differences in training gains may inform the development of personalized intervention prescriptions to optimize cognitive health in late life.
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Papaioannou T, Voinescu A, Petrini K, Stanton Fraser D. Efficacy and Moderators of Virtual Reality for Cognitive Training in People with Dementia and Mild Cognitive Impairment: A Systematic Review and Meta-Analysis. J Alzheimers Dis 2022; 88:1341-1370. [PMID: 35811514 DOI: 10.3233/jad-210672] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Mild cognitive impairment (MCI) and dementia result in cognitive decline which can negatively impact everyday functional abilities and quality of life. Virtual reality (VR) interventions could benefit the cognitive abilities of people with MCI and dementia, but evidence is inconclusive. OBJECTIVE To investigate the efficacy of VR training on global and domain-specific cognition, activities of daily living and quality of life. To explore the influence of priori moderators (e.g., immersion type, training type) on the effects of VR training. Adverse effects of VR training were also considered. METHODS A systematic literature search was conducted on all major databases for randomized control trial studies. Two separate meta-analyses were performed on studies with people with MCI and dementia. RESULTS Sixteen studies with people with MCI and four studies with people with dementia were included in each meta-analysis. Results showed moderate to large effects of VR training on global cognition, attention, memory, and construction and motor performance in people with MCI. Immersion and training type were found to be significant moderators of the effect of VR training on global cognition. For people with dementia, results showed moderate to large improvements after VR training on global cognition, memory, and executive function, but a subgroup analysis was not possible. CONCLUSION Our findings suggest that VR training is an effective treatment for both people with MCI and dementia. These results contribute to the establishment of practical guidelines for VR interventions for patients with cognitive decline.
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Affiliation(s)
| | | | - Karin Petrini
- Department of Psychology, University of Bath, Claverton Down, Bath, UK.,Centre for the Analysis of Motion, Entertainment Research and Applications, University of Bath, Claverton Down, Bath, UK
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9
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Functional connectivity as a neural correlate of cognitive rehabilitation programs’ efficacy: A systematic review. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-02989-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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10
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Suárez-Méndez I, Bruña R, López-Sanz D, Montejo P, Montenegro-Peña M, Delgado-Losada ML, Marcos Dolado A, López-Higes R, Maestú F. Cognitive Training Modulates Brain Hypersynchrony in a Population at Risk for Alzheimer's Disease. J Alzheimers Dis 2022; 86:1185-1199. [PMID: 35180120 DOI: 10.3233/jad-215406] [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: 11/15/2022]
Abstract
BACKGROUND Recent studies demonstrated that brain hypersynchrony is an early sign of dysfunction in Alzheimer's disease (AD) that can represent a proxy for clinical progression. Conversely, non-pharmacological interventions, such as cognitive training (COGTR), are associated with cognitive gains that may be underpinned by a neuroprotective effect on brain synchrony. OBJECTIVE To study the potential of COGTR to modulate brain synchrony and to eventually revert the hypersynchrony phenomenon that characterizes preclinical AD. METHODS The effect of COGTR was examined in a sample of healthy controls (HC, n = 41, 22 trained) and individuals with subjective cognitive decline (SCD, n = 49, 24 trained). Magnetoencephalographic (MEG) activity and neuropsychological scores were acquired before and after a ten-week COGTR intervention aimed at improving cognitive function and daily living performance. Functional connectivity (FC) was analyzed using the phase-locking value. A mixed-effects ANOVA model with factors time (pre-intervention/post-intervention), training (trained/non-trained), and diagnosis (HC/SCD) was used to investigate significant changes in FC. RESULTS We found an average increase in alpha-band FC over time, but the effect was different in each group (trained and non-trained). In the trained group (HC and SCD), we report a reduction in the increase in FC within temporo-parietal and temporo-occipital connections. In the trained SCD group, this reduction was stronger and showed a tentative correlation with improved performance in different cognitive tests. CONCLUSION COGTR interventions could mitigate aberrant increases in FC in preclinical AD, promoting brain synchrony normalization in groups at a higher risk of developing dementia.
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Affiliation(s)
- Isabel Suárez-Méndez
- Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Center for Biomedical Technology (CTB), Universidad Politécnica de Madrid (UPM), Madrid, Spain.,Departamento de Estructura de la Materia, Física Térmica y Electrónica, Universidad Complutense de Madrid (UCM), Facultad de Ciencias Físicas, Madrid, Spain.,Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid (UCM), Madrid, Spain
| | - Ricardo Bruña
- Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Center for Biomedical Technology (CTB), Universidad Politécnica de Madrid (UPM), Madrid, Spain.,Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid (UCM), Madrid, Spain.,Networking Research Center on Bioengineering, Biomaterials, and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - David López-Sanz
- Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Center for Biomedical Technology (CTB), Universidad Politécnica de Madrid (UPM), Madrid, Spain.,Department of Psychobiology, Faculty of Psychology, Complutense University of Madrid (UCM), Madrid, Spain
| | - Pedro Montejo
- Center for the Prevention of Cognitive Impairment (Madrid Salud), Madrid City Council, Spain
| | - Mercedes Montenegro-Peña
- Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid (UCM), Madrid, Spain.,Center for the Prevention of Cognitive Impairment (Madrid Salud), Madrid City Council, Spain
| | - María Luisa Delgado-Losada
- Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid (UCM), Madrid, Spain
| | | | - Ramón López-Higes
- Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid (UCM), Madrid, Spain
| | - Fernando Maestú
- Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Center for Biomedical Technology (CTB), Universidad Politécnica de Madrid (UPM), Madrid, Spain.,Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid (UCM), Madrid, Spain.,Networking Research Center on Bioengineering, Biomaterials, and Nanomedicine (CIBER-BBN), Madrid, Spain
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Park JE, Gunasekaran TI, Cho YH, Choi SM, Song MK, Cho SH, Kim J, Song HC, Choi KY, Lee JJ, Park ZY, Song WK, Jeong HS, Lee KH, Lee JS, Kim BC. Diagnostic Blood Biomarkers in Alzheimer’s Disease. Biomedicines 2022; 10:biomedicines10010169. [PMID: 35052848 PMCID: PMC8773964 DOI: 10.3390/biomedicines10010169] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/06/2022] [Accepted: 01/10/2022] [Indexed: 11/16/2022] Open
Abstract
Potential biomarkers for Alzheimer’s disease (AD) include amyloid β1–42 (Aβ1–42), t-Tau, p-Tau181, neurofilament light chain (NFL), and neuroimaging biomarkers. Their combined use is useful for diagnosing and monitoring the progress of AD. Therefore, further development of a combination of these biomarkers is essential. We investigated whether plasma NFL/Aβ1–42 can serve as a plasma-based primary screening biomarker reflecting brain neurodegeneration and amyloid pathology in AD for monitoring disease progression and early diagnosis. We measured the NFL and Aβ1–42 concentrations in the CSF and plasma samples and performed correlation analysis to evaluate the utility of these biomarkers in the early diagnosis and monitoring of AD spectrum disease progression. Pearson’s correlation analysis was used to analyse the associations between the fluid biomarkers and neuroimaging data. The study included 136 participants, classified into five groups: 28 cognitively normal individuals, 23 patients with preclinical AD, 22 amyloid-negative patients with amnestic mild cognitive impairment, 32 patients with prodromal AD, and 31 patients with AD dementia. With disease progression, the NFL concentrations increased and Aβ1–42 concentrations decreased. The plasma and CSF NFL/Aβ1–42 were strongly correlated (r = 0.558). Plasma NFL/Aβ1–42 was strongly correlated with hippocampal volume/intracranial volume (r = 0.409). In early AD, plasma NFL/Aβ1–42 was associated with higher diagnostic accuracy than the individual biomarkers. Moreover, in preclinical AD, plasma NFL/Aβ1–42 changed more rapidly than the CSF t-Tau or p-Tau181 concentrations. Our findings highlight the utility of plasma NFL/Aβ1–42 as a non-invasive plasma-based biomarker for early diagnosis and monitoring of AD spectrum disease progression.
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Affiliation(s)
- Jung Eun Park
- Department of Biomedical Science, Chosun University, Gwangju 61452, Korea; (J.E.P.); (T.I.G.); (Y.H.C.); (K.H.L.)
- Department of Integrative Biological Sciences & BK21 FOUR Educational Research Group for Age-Associated Disorder Control Technology, Chosun University, Gwangju 61452, Korea
| | - Tamil Iniyan Gunasekaran
- Department of Biomedical Science, Chosun University, Gwangju 61452, Korea; (J.E.P.); (T.I.G.); (Y.H.C.); (K.H.L.)
- Gwangju Alzheimer’s Disease and Related Dementias Cohort Center, Chosun University, Gwangju 61452, Korea; (K.Y.C.); (J.J.L.)
| | - Yeong Hee Cho
- Department of Biomedical Science, Chosun University, Gwangju 61452, Korea; (J.E.P.); (T.I.G.); (Y.H.C.); (K.H.L.)
- Department of Integrative Biological Sciences & BK21 FOUR Educational Research Group for Age-Associated Disorder Control Technology, Chosun University, Gwangju 61452, Korea
| | - Seong-Min Choi
- Department of Neurology, Chonnam National University Medical School, Gwangju 61469, Korea; (S.-M.C.); (S.H.C.)
- Department of Neurology, Chonnam National University Hospital, Gwangju 61469, Korea;
| | - Min-Kyung Song
- Department of Neurology, Chonnam National University Hospital, Gwangju 61469, Korea;
| | - Soo Hyun Cho
- Department of Neurology, Chonnam National University Medical School, Gwangju 61469, Korea; (S.-M.C.); (S.H.C.)
- Department of Neurology, Chonnam National University Hospital, Gwangju 61469, Korea;
| | - Jahae Kim
- Department of Nuclear Medicine, Chonnam National University Medical School and Hospital, Gwangju 61469, Korea; (J.K.); (H.-C.S.)
| | - Ho-Chun Song
- Department of Nuclear Medicine, Chonnam National University Medical School and Hospital, Gwangju 61469, Korea; (J.K.); (H.-C.S.)
| | - Kyu Yeong Choi
- Gwangju Alzheimer’s Disease and Related Dementias Cohort Center, Chosun University, Gwangju 61452, Korea; (K.Y.C.); (J.J.L.)
| | - Jang Jae Lee
- Gwangju Alzheimer’s Disease and Related Dementias Cohort Center, Chosun University, Gwangju 61452, Korea; (K.Y.C.); (J.J.L.)
| | - Zee-Yong Park
- Laboratory of Functional and Medicinal Proteomics, School of Life Sciences, Gwangju Institute of Science and Technology, Gwangju 61005, Korea;
| | - Woo Keun Song
- Cell Logistics and Silver Health Research Center, School of Life Sciences, Gwangju Institute of Science and Technology, Gwangju 61005, Korea;
| | - Han-Seong Jeong
- Department of Physiology, Chonnam National University Medical School, Hwasun 58128, Korea;
| | - Kun Ho Lee
- Department of Biomedical Science, Chosun University, Gwangju 61452, Korea; (J.E.P.); (T.I.G.); (Y.H.C.); (K.H.L.)
- Gwangju Alzheimer’s Disease and Related Dementias Cohort Center, Chosun University, Gwangju 61452, Korea; (K.Y.C.); (J.J.L.)
- Aging Neuroscience Research Group, Korea Brain Research Institute, Daegu 41062, Korea
| | - Jung Sup Lee
- Department of Biomedical Science, Chosun University, Gwangju 61452, Korea; (J.E.P.); (T.I.G.); (Y.H.C.); (K.H.L.)
- Department of Integrative Biological Sciences & BK21 FOUR Educational Research Group for Age-Associated Disorder Control Technology, Chosun University, Gwangju 61452, Korea
- Correspondence: (J.S.L.); (B.C.K.); Tel.: +82-62-220-6665 (J.S.L.); +82-62-220-6123 (B.C.K.)
| | - Byeong C. Kim
- Department of Neurology, Chonnam National University Medical School, Gwangju 61469, Korea; (S.-M.C.); (S.H.C.)
- Department of Neurology, Chonnam National University Hospital, Gwangju 61469, Korea;
- Correspondence: (J.S.L.); (B.C.K.); Tel.: +82-62-220-6665 (J.S.L.); +82-62-220-6123 (B.C.K.)
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12
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Changes in Brain Volume Resulting from Cognitive Intervention by Means of the Feuerstein Instrumental Enrichment Program in Older Adults with Mild Cognitive Impairment (MCI): A Pilot Study. Brain Sci 2021; 11:brainsci11121637. [PMID: 34942939 PMCID: PMC8699159 DOI: 10.3390/brainsci11121637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/24/2021] [Accepted: 12/09/2021] [Indexed: 11/24/2022] Open
Abstract
There is increasing interest in identifying biological and imaging markers for the early detection of neurocognitive decline. In addition, non-pharmacological strategies, including physical exercise and cognitive interventions, may be beneficial for those developing cognitive impairment. The Feuerstein Instrumental Enrichment (FIE) Program is a cognitive intervention based on structural cognitive modifiability and the mediated learning experience (MLE) and aims to promote problem-solving strategies and metacognitive abilities. The FIE program uses a variety of instruments to enhance the cognitive capacity of the individual as a result of mediation. A specific version of the FIE program was developed for the cognitive enhancement of older adults, focusing on strengthening orientation skills, categorization skills, deductive reasoning, and memory. We performed a prospective interventional pilot observational study on older subjects with MCI who participated in 30 mediated FIE sessions (two sessions weekly for 15 weeks). Of the 23 subjects who completed the study, there was a significant improvement in memory on the NeuroTrax cognitive assessment battery. Complete sets of anatomical MRI data for voxel-based morphometry, taken at the beginning and the end of the study, were obtained from 16 participants (mean age 83.5 years). Voxel-based morphometry showed an interesting and unexpected increase in grey matter (GM) in the anterolateral occipital border and the middle cingulate cortex. These initial findings of our pilot study support the design of randomized trials to evaluate the effect of cognitive training using the FIE program on brain volumes and cognitive function.
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13
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Kletzel SL, Sood P, Negm A, Heyn PC, Krishnan S, Machtinger J, Hu X, Devos H. Effectiveness of Brain Gaming in Older Adults With Cognitive Impairments: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2021; 22:2281-2288.e5. [PMID: 34146517 PMCID: PMC8628430 DOI: 10.1016/j.jamda.2021.05.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 05/17/2021] [Accepted: 05/19/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This systematic review and meta-analysis evaluates the evidence from randomized clinical trials (RCTs) that designed brain gaming interventions to improve cognitive functions of older adults with cognitive impairments, including mild cognitive impairments and dementia. DESIGN Systematic review and meta-analysis. SETTING AND PARTICIPANTS N/A. MEASURES N/A. METHODS Data sources-relevant randomized control trials (RCTs) were identified by a systematic search of databases including Medline, PubMed, PsycINFO, Embase, CINAHL, Web of Science, and Cochrane. RCTs were selected first based on title and abstract review and then on full-text review by independent reviewers using predefined eligibility criteria. Risk of bias (RoB) was assessed using the Cochrane RoB tool and funnel plots. The primary outcome variable was the composite score of global cognitive function. RESULTS A total of 909 participants with mild cognitive impairment or dementia from 16 RCTs were included in the systematic review. The study quality was modest, and the RoB assessment showed bias in blinding the participants and personnel. Funnel plots showed no evidence of publication bias. The meta-analysis of 14 RCTs revealed no superior effect of brain gaming compared to other interventions on global cognitive function (pooled standardized mean difference = 0.08, 95% confidence interval -0.24, 0.41, P = .61, I2 = 77%). Likewise, no superior effects were found on the cognitive domains of memory, executive function, visuospatial skills, and language. CONCLUSION AND IMPLICATIONS The findings of this meta-analysis suggest that brain gaming compared with the control intervention does not show significant improvement in standardized tests of cognitive function. Because of considerable heterogeneity in sample size, gaming platform, cognitive status, study design, assessment tools, and training prescription, we cannot confidently refute the premise that brain gaming is an effective cognitive training approach for older adults with cognitive impairments. Recommendations for future research are included.
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Affiliation(s)
- Sandra L Kletzel
- The Department of Veterans Affairs (VA), Center for Innovation in Complex Chronic Healthcare & Research Service, Edward Hines Jr VA Hospital, Hines, IL, USA
| | - Pallavi Sood
- Department of Aging and Geriatric Research, Institute of Aging, University of Florida, Gainesville, FL, USA.
| | - Ahmed Negm
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Patricia C Heyn
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Shilpa Krishnan
- Department of Rehabilitation Medicine, Division of Physical Therapy, Emory University, School of Medicine, Atlanta, GA, USA
| | - Joseph Machtinger
- Department of Neurology, School of medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Xiaolei Hu
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Hannes Devos
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA
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14
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Yuan Q, Qi W, Xue C, Ge H, Hu G, Chen S, Xu W, Song Y, Zhang X, Xiao C, Chen J. Convergent Functional Changes of Default Mode Network in Mild Cognitive Impairment Using Activation Likelihood Estimation. Front Aging Neurosci 2021; 13:708687. [PMID: 34675797 PMCID: PMC8525543 DOI: 10.3389/fnagi.2021.708687] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 08/30/2021] [Indexed: 12/13/2022] Open
Abstract
Background: Mild cognitive impairment (MCI) represents a transitional state between normal aging and dementia disorders, especially Alzheimer's disease (AD). The disruption of the default mode network (DMN) is often considered to be a potential biomarker for the progression from MCI to AD. The purpose of this study was to assess MRI-specific changes of DMN in MCI patients by elucidating the convergence of brain regions with abnormal DMN function. Methods: We systematically searched PubMed, Ovid, and Web of science for relevant articles. We identified neuroimaging studies by using amplitude of low frequency fluctuation /fractional amplitude of low frequency fluctuation (ALFF/fALFF), regional homogeneity (ReHo), and functional connectivity (FC) in MCI patients. Based on the activation likelihood estimation (ALE) algorithm, we carried out connectivity modeling of coordination-based meta-analysis and functional meta-analysis. Results: In total, this meta-analysis includes 39 articles on functional neuroimaging studies. Using computer software analysis, we discovered that DMN changes in patients with MCI mainly occur in bilateral inferior frontal lobe, right medial frontal lobe, left inferior parietal lobe, bilateral precuneus, bilateral temporal lobe, and parahippocampal gyrus (PHG). Conclusions: Herein, we confirmed the presence of DMN-specific damage in MCI, which is helpful in revealing pathology of MCI and further explore mechanisms of conversion from MCI to AD. Therefore, we provide a new specific target and direction for delaying conversion from MCI to AD.
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Affiliation(s)
- Qianqian Yuan
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenzhang Qi
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chen Xue
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Honglin Ge
- Department of Neurosurgery, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Guanjie Hu
- Department of Neurosurgery, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Shanshan Chen
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenwen Xu
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yu Song
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - XuLian Zhang
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chaoyong Xiao
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Department of Neurosurgery, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Jiu Chen
- Department of Neurosurgery, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China.,Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Fourth Clinical College of Nanjing Medical University, Nanjing, China
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15
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Kujawa K, Zurek G, Kwiatkowska A, Olejniczak R, Żurek A. Assessment of Language Functions in Patients With Disorders of Consciousness Using an Alternative Communication Tool. Front Neurol 2021; 12:684362. [PMID: 34354661 PMCID: PMC8329337 DOI: 10.3389/fneur.2021.684362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/24/2021] [Indexed: 11/13/2022] Open
Abstract
This study aimed to describe the percentage of tasks involving language functions that were completed by patients diagnosed with disorders of consciousness, as observed during neurorehabilitation conducted for different periods of time using an alternative communication tool. The project involved six participants, who were observed for 1 month, 6 months, and 1 year. The patients were asked to solve tasks involving language functions with the use of an eye-controlled device. The language functions were evaluated on the basis of the average number of tasks performed by the patients, which was 70.45% for the whole subject group. It is not entirely clear what determined the changes in language functions during the research. It is crucial that patients performed the presented tasks even though their state of consciousness, as confirmed through medical documentation (unresponsive wakefulness syndrome), did not suggest the possibility of establishing any contact with them.
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Affiliation(s)
- Katarzyna Kujawa
- Department of Biostructure University School of Physical Education in Wroclaw, Wroclaw, Poland
- Neurorehabilitation Clinic, Wroclaw, Poland
| | - Grzegorz Zurek
- Department of Biostructure University School of Physical Education in Wroclaw, Wroclaw, Poland
| | | | | | - Alina Żurek
- Institute of Psychology, University of Wroclaw, Wroclaw, Poland
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16
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Nguyen L, Murphy K, Andrews G. A Game a Day Keeps Cognitive Decline Away? A Systematic Review and Meta-Analysis of Commercially-Available Brain Training Programs in Healthy and Cognitively Impaired Older Adults. Neuropsychol Rev 2021; 32:601-630. [PMID: 34251578 DOI: 10.1007/s11065-021-09515-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/15/2021] [Indexed: 12/31/2022]
Abstract
The rising prevalence rates of age-related cognitive impairment are a worldwide public concern, bringing about a surge in the number of "brain training" programs commercially available to the general public. Numerous companies advertise that their products improve memory and protect against cognitive decline, though researchers have voiced concerns regarding the validity of such claims. To address this issue, the current meta-analytic investigation examined evidence from 43 studies (encompassing 2,636 participants) to evaluate the efficacy of commercial training programs within two separate populations: healthy older adults and older adults with mild cognitive-impairment (MCI). Seven programs were identified: BrainGymmer, BrainHQ, CogMed, CogniFit, Dakim, Lumosity, and MyBrainTrainer. Analyses yielded small, significant near-transfer effects for both healthy and MCI samples. Far-transfer was not observed for the MCI sample, whereas a small, significant effect was found for subjective but not objective measures of far-transfer in the healthy sample. Analyses of individual domains (combining near-and far-transfer outcomes) yielded significant transfer to executive-functioning, memory, and processing-speed in healthy older adults. After adjusting for publication bias, only the effect size for processing speed remained significant. Transfer to attention, objective everyday functioning, fluid-intelligence, and visuospatial domains was not significant. Thus, whilst "brain training" may be suitable for enjoyment and entertainment purposes, there is currently insufficient empirical evidence to support that such training can improve memory, general cognition, or everyday functioning. This area of research is still in its infancy and warrants further investigation to provide more substantial evidence regarding the efficacy of this rapidly expanding industry.
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Affiliation(s)
- Lan Nguyen
- School of Applied Psychology, Griffith University, Griffith University, Gold Coast, QLD 4222, Australia.
| | - Karen Murphy
- School of Applied Psychology, Griffith University, Griffith University, Gold Coast, QLD 4222, Australia
| | - Glenda Andrews
- School of Applied Psychology, Griffith University, Griffith University, Gold Coast, QLD 4222, Australia
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17
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Bertolino N, Procissi D, Disterhoft JF, Weiss C. Detection of memory- and learning-related brain connectivity changes following trace eyeblink-conditioning using resting-state functional magnetic resonance imaging in the awake rabbit. J Comp Neurol 2021; 529:1597-1606. [PMID: 32975314 DOI: 10.1002/cne.25042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/12/2020] [Accepted: 09/12/2020] [Indexed: 12/13/2022]
Abstract
Animal imaging studies have the potential to further establish resting-state fMRI (rs-fMRI) and enable its validation for clinical use. The rabbit subjects used in this work are an ideal model system for studying learning and behavior and are also an excellent established test subject for awake scanning given their natural tolerance for restraint. We found that analysis of rs-fMRI conducted on a cohort of rabbits undergoing eyeblink conditioning can reveal functional brain connectivity changes associated with learning, and that rs-fMRI can be used to capture differences between subjects with different levels of cognitive performance. rs-fMRI sessions were conducted on a cohort of rabbits before and after trace eyeblink conditioning. MRI results were analyzed using independent component analysis (ICA) and network analysis. Behavioral data were collected with standard methods using an infrared reflective sensor aimed at the cornea to detect blinks. Behavioral results were analyzed, and a median split was used to create two groups of rabbits based on their performance. The cohort of rabbits undergoing eyeblink conditioning exhibited increased functional connectivity in the cingulate cortex, retrosplenial cortex, and thalamus consistent with brain reorganization associated with increased learning. Differences in the striatum and right cerebellum were also identified between rabbits in the top or bottom halves of the group as measured by the behavioral assay. Thus, rs-fMRI can provide not only a tool to detect and monitor functional brain changes associated with learning, but also to discriminate between different levels of cognitive performance.
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Affiliation(s)
- Nicola Bertolino
- Department of Radiology, Northwestern University, Chicago, Illinois, USA
| | - Daniele Procissi
- Department of Radiology, Northwestern University, Chicago, Illinois, USA
| | - John F Disterhoft
- Department of Physiology, Northwestern University, Chicago, Illinois, USA
| | - Craig Weiss
- Department of Physiology, Northwestern University, Chicago, Illinois, USA
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18
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The Effect of Cognitive Intervention on Cognitive Function in Older Adults With Alzheimer's Disease: A Systematic Review and Meta-Analysis. Neuropsychol Rev 2021; 32:247-273. [PMID: 33893905 DOI: 10.1007/s11065-021-09486-4] [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] [Received: 06/18/2019] [Accepted: 02/11/2021] [Indexed: 10/21/2022]
Abstract
Cognitive intervention includes cognitive stimulation, cognitive training, and cognitive rehabilitation. This systematic review was performed to re-assess the efficacy of cognitive intervention for the patients with Alzheimer's disease (AD). Twenty studies (2012 participants) were eventually included. For global cognitive function, the combined mean difference (MD) in eight studies was 1.67 (95% Confidence Interval: 0.45, 2.89, p = 0.007; Q = 33.28, df = 8, p < 0.0001, τ2 = 2.17, I2 = 76%) for the short term. The pooled standardized mean difference (SMD) of six RCTs was 1.61 (95% Confidence Interval: 0.65, 2.56, p = 0.0009; Q = 127.66, df = 6, p < 0.00001, τ2 = 1.56, I2 = 95%) for the medium term. The pooled SMD of seven studies was 0.79 (95% Confidence Interval: 0.33, 1.25, p = 0.0008; Q = 35.10, df = 7, p < 0.0001, τ2 = 0.33, I2 = 80%) for the long term. For depression, the pooled SMD of two trials was -0.48 (95% Confidence Interval: -0.71, -0.24; p < 0.0001, I2 = 4%) for the short term. Cognitive training may show obvious improvements in global cognitive function whether after short, medium, or long-term interventions and in depression after short term intervention. However, the positive effect of the intervention on general cognitive function or depression did not seem to persist after intervention ended. There is still a lack of reliable and consistent conclusions relevant to the effect of cognitive stimulation and cognitive rehabilitation on observed outcomes, cognitive training for memory or other non-cognitive outcomes. PROSPERO registration number: CRD42019121768.
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19
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Lasaponara S, Marson F, Doricchi F, Cavallo M. A Scoping Review of Cognitive Training in Neurodegenerative Diseases via Computerized and Virtual Reality Tools: What We Know So Far. Brain Sci 2021; 11:528. [PMID: 33919244 PMCID: PMC8143131 DOI: 10.3390/brainsci11050528] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/17/2021] [Accepted: 04/19/2021] [Indexed: 11/17/2022] Open
Abstract
Most prevalent neurodegenerative diseases such as Alzheimer's disease, frontotemporal dementia, Parkinson's disease and multiple sclerosis are heterogeneous in their clinical profiles and underlying pathophysiology, although they typically share the presence of cognitive impairment that worsens significantly during the course of the disease. Viable pharmacological options for cognitive symptoms in these clinical conditions are currently lacking. In recent years, several studies have started to apply Computerized Cognitive Training (CCT) and Virtual Reality (VR) tools to try and contrast patients' cognitive decay over time. However, no in-depth literature review of the contribution of these promising therapeutic options across main neurodegenerative diseases has been conducted yet. The present paper reports the state-of-the-art of CCT and VR studies targeting cognitive impairment in most common neurodegenerative conditions. Our twofold aim is to point out the scientific evidence available so far and to support health professionals to consider these promising therapeutic tools when planning rehabilitative interventions, especially when the access to regular and frequent hospital consultations is not easy to be provided.
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Affiliation(s)
- Stefano Lasaponara
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (S.L.); (F.D.)
- Department of Human Sciences, LUMSA University, 00193 Rome, Italy
| | - Fabio Marson
- Research Institute for Neuroscience, Education and Didactics, Fondazione Patrizio Paoletti, 06081 Assisi, Italy;
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
| | - Fabrizio Doricchi
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (S.L.); (F.D.)
- Department of Neuropsychology, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Marco Cavallo
- Faculty of Psychology, eCampus University, 22060 Novedrate, Italy
- Clinical Psychology Service, Saint George Foundation, 12030 Cavallermaggiore, Italy
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20
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Reynolds GO, Willment K, Gale SA. Mindfulness and Cognitive Training Interventions in Mild Cognitive Impairment: Impact on Cognition and Mood. Am J Med 2021; 134:444-455. [PMID: 33385339 DOI: 10.1016/j.amjmed.2020.10.041] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 10/26/2020] [Accepted: 10/28/2020] [Indexed: 12/29/2022]
Abstract
With the lack of disease-modifying pharmacologic treatments for mild cognitive impairment and dementia, there has been an increasing clinical and research focus on nonpharmacological interventions for these disorders. Many treatment approaches, such as mindfulness and cognitive training, aim to mitigate or delay cognitive decline, particularly in early disease stages, while also offering potential benefits for mood and quality of life. In this review, we highlight the potential of mindfulness and cognitive training to improve cognition and mood in mild cognitive impairment. Emerging research suggests that these approaches are feasible and safe in this population, with preliminary evidence of positive effects on aspects of cognition (attention, psychomotor function, memory, executive function), depression, and anxiety, though some findings have been unclear or limited by methodological weaknesses. Even so, mindfulness and cognitive training warrant inclusion as current treatments for adults with mild cognitive impairment, even if there is need for additional research to clarify treatment outcomes and questions related to dose, mechanisms, and transfer and longevity of treatment effects.
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Affiliation(s)
| | - Kim Willment
- Department of Neurology, Brigham and Women's Hospital, Boston, Mass
| | - Seth A Gale
- Department of Neurology, Brigham and Women's Hospital, Boston, Mass
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21
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Cao Y, Yang H, Zhou Z, Cheng Z, Zhao X. Abnormal Default-Mode Network Homogeneity in Patients With Mild Cognitive Impairment in Chinese Communities. Front Neurol 2021; 11:569806. [PMID: 33643176 PMCID: PMC7905225 DOI: 10.3389/fneur.2020.569806] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 12/23/2020] [Indexed: 11/15/2022] Open
Abstract
Background and Objective: Current evidence suggests that abnormalities within the default-mode network (DMN) play a key role in the broad-scale cognitive problems that characterize mild cognitive impairment (MCI). However, little is known about the alterations of DMN network homogeneity (NH) in MCI. Methods: Resting-state functional magnetic resonance imaging scans (rs-fMRI) were collected from 38 MCI patients and 69 healthy controls matched for age, gender, and education. NH approach was employed to analyze the imaging dataset. Cognitive performance was measured with the Chinese version of Alzheimer's disease assessment scale-Cognitive subscale (ADAS-Cog). Results: Two groups have no significant differences between demographic factors. And mean ADAS-Cog score in MCI was 12.02. MCI patients had significantly lower NH values than controls in the right anterior cingulate cortex and significantly higher NH values in the ventral medial prefrontal cortex(vmPFC) than those in healthy controls. No significant correlations were found between abnormal NH values and ADAS-Cog in the patients. Conclusions: These findings provide further evidence that abnormal NH of the DMN exists in MCI, and highlight the significance of DMN in the pathophysiology of cognitive problems occurring in MCI.
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Affiliation(s)
- Yuping Cao
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders, Changsha, China.,China National Technology Institute on Mental Disorders, Changsha, China.,Hunan Technology Institute of Psychiatry, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Huan Yang
- Mental Health Institute, The Second Xiangya Hospital, Central South University, Changsha, China.,China National Clinical Research Center on Mental Disorders, Changsha, China.,China National Technology Institute on Mental Disorders, Changsha, China.,Hunan Technology Institute of Psychiatry, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Zhenhe Zhou
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, China
| | - Zaohuo Cheng
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, China
| | - Xingfu Zhao
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, China
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22
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The effects of cognitive training on the topological properties of brain structural network among community-dwelling older adults. J Clin Neurosci 2020; 83:77-82. [PMID: 33341367 DOI: 10.1016/j.jocn.2020.11.024] [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] [Received: 07/06/2020] [Revised: 09/27/2020] [Accepted: 11/23/2020] [Indexed: 11/21/2022]
Abstract
Increased number of neuroimaging studies has revealed association between age-related cognitive decline and alterations in the architecture of brain networks, while trials consistently confirmed benefits following cognitive training in the elderly. As a consequence, the present study aimed to investigate the potential moderating role of topological properties in brain structural network on training benefits. Among 32 community-dwelling older adults, 18 were randomly assigned to the training group to receive 24 sessions of multi-domain cognitive training (MDCT) over 12 weeks, and 14 to the control group. At baseline and 12-month follow-up, diffusion tensor imaging was acquired to construct the brain structural network, and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the Visual Reasoning Test (VRT) were performed to assess cognitive functions. Compared with controls, participants received MDCT achieved significant larger gain in terms of delayed memory with a trend of better global cognitive function. In addition, Sigma coefficient of small-worldness were reduced in the MDCT group relative to the control group. Correlation between changes in Sigma and in delayed memory index were found among controls, however, not among older adults received MDCT. Our results demonstrated the modulating effects of cognitive training on the small-world architecture of brain structural network. And the present study suggested a trade-off mechanism underlying the benefits of cognitive training among aged people, where brain sacrificed its cost-effectiveness of network wiring for better cognitive functions.
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Abstract
AbstractThe prospect of improving or maintaining cognitive functioning has provoked a steadily increasing number of cognitive training interventions over the last years, especially for clinical and elderly populations. However, there are discrepancies between the findings of the studies. One of the reasons behind these heterogeneous findings is that there are vast inter-individual differences in how people benefit from the training and in the extent that training-related gains are transferred to other untrained tasks and domains. In this paper, we address the value of incorporating neural measures to cognitive training studies in order to fully understand the mechanisms leading to inter-individual differences in training gains and their generalizability to other tasks. Our perspective is that it is necessary to collect multimodal neural measures in the pre- and post-training phase, which can enable us to understand the factors contributing to successful training outcomes. More importantly, this understanding can enable us to predict who will benefit from different types of interventions, thereby allowing the development of individually tailored intervention programs.
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Wang J, Gu Y, Dong W, Zhao M, Tian J, Sun T, Yu X, Ouyang G, Wang H. Lower Small-Worldness of Intrinsic Brain Networks Facilitates the Cognitive Protection of Intellectual Engagement in Elderly People Without Dementia: A Near-Infrared Spectroscopy Study. Am J Geriatr Psychiatry 2020; 28:722-731. [PMID: 32173205 DOI: 10.1016/j.jagp.2020.02.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 02/04/2020] [Accepted: 02/14/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Lifetime intellectual engagement may be associated with cognitive ability late in life. However, the current evidence on whether cognitive activities will improve and/or maintain cognitive function is heterogeneous. Drawing on knowledge of the brain's intrinsic small-world organization which combines regional specialization and efficient global information transfer, we aimed to explore that whether individual differences in the small-worldness of resting-state functional connectivity (rsFC) networks would explain the variability in the strength of the association between intellectual engagement and cognitive functioning. METHODS Sixty-five elderly people without dementia were enrolled and scanned with a 52-channel near-infrared spectroscopy system. The number, frequency, and participation hours of intellectual activities were investigated to measure intellectual engagement. Global cognition was assessed by the Montreal Cognitive Assessment. The general linear models and the simple slope analysis were employed to measure the modulatory role of network properties. RESULTS The small-worldness of the brain network emerged as a moderator of the association between intellectual engagement and cognition. Exclusively among elderly people with lower small-worldness, greater intellectual engagement, including the frequency and participation hours of activities, was associated with greater global cognitive function. Furthermore, we observed that elderly people with lower small-worldness exhibited decreased rsFC across the bilateral frontopolar areas and increased rsFC across the bilateral parietal cortex. CONCLUSION The individual differences in the small-worldness of rsFC networks might explain the varying strength of the association between intellectual engagement and cognitive functioning. Our findings imply that the intrinsic small-worldness of the brain network might be a potential neurobiological contributor that interacts with the intellectual engagement in enhancing the cognitive ability in late life.
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Affiliation(s)
- Jing Wang
- Peking University Institute of Mental Health (Sixth Hospital) (JW, WD, MZ, JT, TS, XY, HW), Beijing, China; National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health (Peking University) (JW, WD, MZ, JT, TS, XY HW), Beijing, China; Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia (JW, MZ, TS, XY, HW), Beijing, China
| | - Yue Gu
- Key Laboratory of Computer Vision and System (Ministry of Education), School of Computer Science and Engineering, Tianjin University of Technology (YG), Tianjin, China
| | - Wentian Dong
- Peking University Institute of Mental Health (Sixth Hospital) (JW, WD, MZ, JT, TS, XY, HW), Beijing, China; National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health (Peking University) (JW, WD, MZ, JT, TS, XY HW), Beijing, China
| | - Mei Zhao
- Peking University Institute of Mental Health (Sixth Hospital) (JW, WD, MZ, JT, TS, XY, HW), Beijing, China; National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health (Peking University) (JW, WD, MZ, JT, TS, XY HW), Beijing, China; Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia (JW, MZ, TS, XY, HW), Beijing, China; Department of Psychiatry, University of Melbourne (MZ), Melbourne, Australia
| | - Ju Tian
- Peking University Institute of Mental Health (Sixth Hospital) (JW, WD, MZ, JT, TS, XY, HW), Beijing, China; National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health (Peking University) (JW, WD, MZ, JT, TS, XY HW), Beijing, China
| | - Tingting Sun
- Peking University Institute of Mental Health (Sixth Hospital) (JW, WD, MZ, JT, TS, XY, HW), Beijing, China; National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health (Peking University) (JW, WD, MZ, JT, TS, XY HW), Beijing, China; Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia (JW, MZ, TS, XY, HW), Beijing, China
| | - Xin Yu
- Peking University Institute of Mental Health (Sixth Hospital) (JW, WD, MZ, JT, TS, XY, HW), Beijing, China; National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health (Peking University) (JW, WD, MZ, JT, TS, XY HW), Beijing, China; Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia (JW, MZ, TS, XY, HW), Beijing, China
| | - Gaoxiang Ouyang
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University (GO), Beijing, China
| | - Huali Wang
- Peking University Institute of Mental Health (Sixth Hospital) (JW, WD, MZ, JT, TS, XY, HW), Beijing, China; National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health (Peking University) (JW, WD, MZ, JT, TS, XY HW), Beijing, China; Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia (JW, MZ, TS, XY, HW), Beijing, China.
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The Effects of Cognitive Training on Brain Network Activity and Connectivity in Aging and Neurodegenerative Diseases: a Systematic Review. Neuropsychol Rev 2020; 30:267-286. [PMID: 32529356 PMCID: PMC7305076 DOI: 10.1007/s11065-020-09440-w] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 05/03/2020] [Indexed: 12/12/2022]
Abstract
Cognitive training (CT) is an increasingly popular, non-pharmacological intervention for improving cognitive functioning in neurodegenerative diseases and healthy aging. Although meta-analyses support the efficacy of CT in improving cognitive functioning, the neural mechanisms underlying the effects of CT are still unclear. We performed a systematic review of literature in the PubMed, Embase and PsycINFO databases on controlled CT trials (N > 20) in aging and neurodegenerative diseases with pre- and post-training functional MRI outcomes up to November 23rd 2018 (PROSPERO registration number CRD42019103662). Twenty articles were eligible for our systematic review. We distinguished between multi-domain and single-domain CT. CT induced both increases and decreases in task-related functional activation, possibly indicative of an inverted U-shaped curve association between regional brain activity and task performance. Functional connectivity within ‘cognitive’ brain networks was consistently reported to increase after CT while a minority of studies additionally reported increased segregation of frontoparietal and default mode brain networks. Although we acknowledge the large heterogeneity in type of CT, imaging methodology, in-scanner task paradigm and analysis methods between studies, we propose a working model of the effects of CT on brain activity and connectivity in the context of current knowledge on compensatory mechanisms that are associated with aging and neurodegenerative diseases.
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Li X, Zhang J, Li XD, Cui W, Su R. Neurofeedback Training for Brain Functional Connectivity Improvement in Mild Cognitive Impairment. J Med Biol Eng 2020. [DOI: 10.1007/s40846-020-00531-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Kallio EL, Hietanen M, Kautiainen H, Pitkälä KH. Neuropsychological outcome of cognitive training in mild to moderate dementia: A randomized controlled trial. Neuropsychol Rehabil 2020; 31:935-953. [PMID: 32295483 DOI: 10.1080/09602011.2020.1749674] [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
Effectiveness of a 12-week cognitive training (CT) programme for community-dwelling patients with dementia was evaluated on various cognitive functions (attention, memory, executive functions and reasoning) and psychological well-being (PWB). A single-blind randomized controlled trial was conducted in adult day care centres in Helsinki, Finland. Participants (N = 147) were older individuals with mild to moderate dementia living at home and attending day care (mean age 83 years, 72% female, 63% at mild stage of dementia). The intervention group (n = 76) received systematic CT for 45 min twice a week while the control group (n = 71) attended day care as usual. The cognitive and psychological outcomes were measured at baseline, and followed up at 3 and 9 months. No differences between the two groups in changes of any of the cognitive functions, or PWB over time were found. We observed a positive trend at 3 months in the change for PWB favouring the intervention group, but no significant interaction effect was found (p = .079; d = -0.31). Thus, systematic CT appears to have no effect on neuropsychological outcomes of cognitive functioning and PWB in older adults who already have dementia.
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Affiliation(s)
- Eeva-Liisa Kallio
- Department of General Practice and Primary Health Care, University of Helsinki, and Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland.,Clinical Neurosciences, Neuropsychology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Marja Hietanen
- Clinical Neurosciences, Neuropsychology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hannu Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki, and Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
| | - Kaisu H Pitkälä
- Department of General Practice and Primary Health Care, University of Helsinki, and Unit of Primary Health Care, Helsinki University Hospital, Helsinki, Finland
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Cai C, Huang C, Yang C, Zhang X, Peng Y, Zhao W, Hong X, Ren F, Hong D, Xiao Y, Yan J. Altered Patterns of Phase Position Connectivity in Default Mode Subnetwork of Subjective Cognitive Decline and Amnestic Mild Cognitive Impairment. Front Neurosci 2020; 14:185. [PMID: 32265623 PMCID: PMC7099636 DOI: 10.3389/fnins.2020.00185] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 02/19/2020] [Indexed: 01/19/2023] Open
Abstract
Alzheimer’s disease (AD), which most commonly occurs in the elder, is a chronic neurodegenerative disease with no agreed drugs or treatment protocols at present. Amnestic mild cognitive impairment (aMCI), earlier than AD onset and later than subjective cognitive decline (SCD) onset, has a serious probability of converting into AD. The SCD, which can last for decades, subjectively complains of decline impairment in memory. Distinct altered patterns of default mode network (DMN) subnetworks connected to the whole brain are perceived as prominent hallmarks of the early stages of AD. Nevertheless, the aberrant phase position connectivity (PPC) connected to the whole brain in DMN subnetworks remains unknown. Here, we hypothesized that there exist distinct variations of PPC in DMN subnetworks connected to the whole brain for patients with SCD and aMCI, which might be acted as discriminatory neuroimaging biomarkers. We recruited 27 healthy controls (HC), 20 SCD and 28 aMCI subjects, respectively, to explore aberrant patterns of PPC in DMN subnetworks connected to the whole brain. In anterior DMN (aDMN), SCD group exhibited aberrant PPC in the regions of right superior cerebellum lobule (SCL), right superior frontal gyrus of medial part (SFGMP), and left fusiform gyrus (FG) in comparison of HC group, by contrast, no prominent difference was found in aMCI group. It is important to note that aMCI group showed increased PPC in the right SFGMP in comparison with SCD group. For posterior DMN (pDMN), SCD group showed decreased PPC in the left superior parietal lobule (SPL) and right superior frontal gyrus (SFG) compared to HC group. It is noteworthy that aMCI group showed decreased PPC in the left middle frontal gyrus of orbital part (MFGOP) and right SFG compared to HC group, yet increased PPC was found in the left superior temporal gyrus of temporal pole (STGTP). Additionally, aMCI group exhibited decreased PPC in the left MFGOP compared to SCD group. Collectively, our results have shown that the aberrant regions of PPC observed in DMN are related to cognitive function, and it might also be served as impressible neuroimaging biomarkers for timely intervention before AD occurs.
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Affiliation(s)
- Chunting Cai
- School of Informatics, Xiamen University, Xiamen, China
| | - Chenxi Huang
- School of Informatics, Xiamen University, Xiamen, China
| | - Chenhui Yang
- School of Informatics, Xiamen University, Xiamen, China
| | - Xiaodong Zhang
- Department of Ultrasound, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Yonghong Peng
- Department of Computing and Mathematics, Manchester Metropolitan University, Manchester, United Kingdom
| | - Wenbing Zhao
- Department of Electrical Engineering and Computer Science, Cleveland State University, Cleveland, OH, United States
| | - Xin Hong
- School of Informatics, Xiamen University, Xiamen, China
| | - Fujia Ren
- School of Informatics, Xiamen University, Xiamen, China
| | - Dan Hong
- School of Informatics, Xiamen University, Xiamen, China
| | - Yutian Xiao
- School of Informatics, Xiamen University, Xiamen, China
| | - Jiqiang Yan
- School of Informatics, Xiamen University, Xiamen, China
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Si S, Wang B, Liu X, Yu C, Ding C, Zhao H. Brain Network Modeling Based on Mutual Information and Graph Theory for Predicting the Connection Mechanism in the Progression of Alzheimer's Disease. ENTROPY (BASEL, SWITZERLAND) 2019; 21:E300. [PMID: 33267015 PMCID: PMC7514781 DOI: 10.3390/e21030300] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 03/14/2019] [Accepted: 03/14/2019] [Indexed: 12/21/2022]
Abstract
Alzheimer's disease (AD) is a progressive disease that causes problems of cognitive and memory functions decline. Patients with AD usually lose their ability to manage their daily life. Exploring the progression of the brain from normal controls (NC) to AD is an essential part of human research. Although connection changes have been found in the progression, the connection mechanism that drives these changes remains incompletely understood. The purpose of this study is to explore the connection changes in brain networks in the process from NC to AD, and uncovers the underlying connection mechanism that shapes the topologies of AD brain networks. In particular, we propose a mutual information brain network model (MINM) from the perspective of graph theory to achieve our aim. MINM concerns the question of estimating the connection probability between two cortical regions with the consideration of both the mutual information of their observed network topologies and their Euclidean distance in anatomical space. In addition, MINM considers establishing and deleting connections, simultaneously, during the networks modeling from the stage of NC to AD. Experiments show that MINM is sufficient to capture an impressive range of topological properties of real brain networks such as characteristic path length, network efficiency, and transitivity, and it also provides an excellent fit to the real brain networks in degree distribution compared to experiential models. Thus, we anticipate that MINM may explain the connection mechanism for the formation of the brain network organization in AD patients.
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Affiliation(s)
| | - Bin Wang
- School of Computer Science and Engineering, Northeastern University, Shenyang 110169, China
| | - Xiao Liu
- School of Computer Science and Engineering, Northeastern University, Shenyang 110169, China
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Mudar RA, Nguyen LT, Eroh J, Chiang HS, Rackley A, Chapman SB. Event-related neural oscillation changes following reasoning training in individuals with Mild Cognitive Impairment. Brain Res 2019; 1704:229-240. [PMID: 30342001 DOI: 10.1016/j.brainres.2018.10.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 09/17/2018] [Accepted: 10/16/2018] [Indexed: 10/28/2022]
Abstract
Emerging evidence suggests cognitive training programs targeting higher-order reasoning may strengthen not only cognitive, but also neural functions in individuals with Mild Cognitive Impairment (MCI). However, research on direct measures of training-induced neural changes, derivable from electroencephalography (EEG), is limited. The current pilot study examined effects of Gist Reasoning training (n = 16) compared to New Learning training (n = 16) in older adults with amnestic MCI on measures of event-related neural oscillations (theta and alpha band power) corresponding to Go/NoGo tasks during basic and superordinate semantic categorization. EEG data were recorded while participants performed the Go/NoGo task pre- and post-training, and power in theta and alpha frequency bands was examined. Both groups were comparable at pre-training on all measures and both groups showed greater event-related theta synchronization post-training. Furthermore, the Gist Reasoning group had enhanced event-related desynchronization in low-frequency alpha band (8-10 Hz) on response inhibition (NoGo) trials and high-frequency alpha band (11-13 Hz) on response execution (Go) trials during superordinate categorization, relative to the New Learning group. These findings suggest that Gist Reasoning training in MCI impacted neural processing linked to strategic processing of Go and NoGo trials during the more complex superordinate categorization task. Targeting higher-order top-down cognitive processing seems to better harness residual neuroplastic potential in MCI. ClinicalTrials.gov ID: NCT02588209.
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Affiliation(s)
- Raksha A Mudar
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, IL, United States; Neuroscience Program, University of Illinois at Urbana-Champaign, Champaign, IL, United States.
| | - Lydia T Nguyen
- Neuroscience Program, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Justin Eroh
- Center for BrainHealth, The University of Texas at Dallas, Dallas, TX, United States
| | - Hsueh-Sheng Chiang
- Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Audette Rackley
- Center for BrainHealth, The University of Texas at Dallas, Dallas, TX, United States
| | - Sandra B Chapman
- Center for BrainHealth, The University of Texas at Dallas, Dallas, TX, United States
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Eyler LT, Elman JA, Hatton SN, Gough S, Mischel AK, Hagler DJ, Franz CE, Docherty A, Fennema-Notestine C, Gillespie N, Gustavson D, Lyons MJ, Neale MC, Panizzon MS, Dale AM, Kremen WS. Resting State Abnormalities of the Default Mode Network in Mild Cognitive Impairment: A Systematic Review and Meta-Analysis. J Alzheimers Dis 2019; 70:107-120. [PMID: 31177210 PMCID: PMC6697380 DOI: 10.3233/jad-180847] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Large-scale brain networks such as the default mode network (DMN) are often disrupted in Alzheimer's disease (AD). Numerous studies have examined DMN functional connectivity in those with mild cognitive impairment (MCI), a presumed AD precursor, to discover a biomarker of AD risk. Prior reviews were qualitative or limited in scope or approach. OBJECTIVE We aimed to systematically and quantitatively review DMN resting state fMRI studies comparing MCI and healthy comparison (HC) groups. METHODS PubMed was searched for relevant articles. Study characteristics were abstracted and the number of studies showing no group difference or hyper- versus hypo-connnectivity in MCI was tallied. A voxel-wise (ES-SDM) meta-analysis was conducted to identify regional group differences. RESULTS Qualitatively, our review of 57 MCI versus HC comparisons suggests substantial inconsistency; 9 showed no group difference, 8 showed MCI > HC and 22 showed HC > MCI across the brain, and 18 showed regionally-mixed directions of effect. The meta-analysis of 31 studies revealed areas of significant hypo- and hyper-connectivity in MCI, including hypoconnectivity in the posterior cingulate cortex/precuneus (z = -3.1, p < 0.0001). Very few individual studies, however, showed patterns resembling the meta-analytic results. Methodological differences did not appear to explain inconsistencies. CONCLUSIONS The pattern of altered resting DMN function or connectivity in MCI is complex and variable across studies. To date, no index of DMN connectivity qualifies as a useful biomarker of MCI or risk for AD. Refinements to MCI diagnosis, including other biological markers, or longitudinal studies of progression to AD, might identify DMN alterations predictive of AD risk.
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Affiliation(s)
- Lisa T. Eyler
- Department of Psychiatry, University of California San Diego
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System
| | - Jeremy A. Elman
- Department of Psychiatry, University of California San Diego
| | - Sean N Hatton
- Department of Psychiatry, University of California San Diego
- Department of Neurosciences, University of California San Diego
| | - Sarah Gough
- Department of Psychiatry, University of California San Diego
| | - Anna K. Mischel
- Department of Psychiatry, University of California San Diego
| | | | - Carol E. Franz
- Department of Psychiatry, University of California San Diego
| | - Anna Docherty
- Departments of Psychiatry & Human Genetics, University of Utah School of Medicine
| | - Christine Fennema-Notestine
- Department of Psychiatry, University of California San Diego
- Department of Radiology, University of California San Diego
| | - Nathan Gillespie
- Departments of Psychiatry and Human and Molecular Genetics, Virginia Commonwealth University
| | | | | | - Michael C. Neale
- Departments of Psychiatry and Human and Molecular Genetics, Virginia Commonwealth University
| | | | - Anders M. Dale
- Department of Neurosciences, University of California San Diego
- Department of Radiology, University of California San Diego
| | - William S. Kremen
- Department of Psychiatry, University of California San Diego
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System
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A randomized controlled trial of combined executive function and memory training on the cognitive and noncognitive function of individuals with mild cognitive impairment: Study rationale and protocol design. ALZHEIMERS & DEMENTIA-TRANSLATIONAL RESEARCH & CLINICAL INTERVENTIONS 2018; 4:556-564. [PMID: 30386820 PMCID: PMC6205116 DOI: 10.1016/j.trci.2018.09.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction Cognitive training has attracted considerable attention as a safe, economical, and scalable nonpharmacologic intervention in patients with mild cognitive impairment (MCI). However, no study has yet placed sufficient emphasis on the training of executive function. The present study aimed to evaluate whether memory training combined with executive training could lead to improved cognitive and noncognitive performance in patients with MCI. Furthermore, we will explore the neural correlates underlying the changed performances. Methods The proposed study is a randomized controlled trial that will include 120 patients with MCI. The eligible patients will be randomized to either an intervention group or a waitlist control group. The intervention group will receive computerized combined training (executive function and memory) for 96 sessions for more than 24 weeks. The control group will receive no intervention during the research period. Behavior data collection and a magnetic resonance imaging/electroencephalogram/near-infrared spectroscopy scan will be performed at baseline and after 24 weeks of intervention. Results The study is currently ongoing. Recruitment began in July 2017 and will conclude in December 2018. Discussion If combined training results in positive changes to cognitive function and noncognitive function in patients with MCI, this might represent a new approach to delay the cognitive decline or even provide a potential method for dementia prevention. Furthermore, the evaluation of any training-related structural changes or functional changes will help to reveal the mechanisms underlying the combined cognitive training. Trial registration This study was registered with Clinicaltrials.gov (Identifier: NCT03232047, August 18, 2017).
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Sherman DS, Mauser J, Nuno M, Sherzai D. The Efficacy of Cognitive Intervention in Mild Cognitive Impairment (MCI): a Meta-Analysis of Outcomes on Neuropsychological Measures. Neuropsychol Rev 2017; 27:440-484. [PMID: 29282641 PMCID: PMC5754430 DOI: 10.1007/s11065-017-9363-3] [Citation(s) in RCA: 146] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 11/05/2017] [Indexed: 12/12/2022]
Abstract
Cognitive training in MCI may stimulate pre-existing neural reserves or recruit neural circuitry as “compensatory scaffolding” prompting neuroplastic reorganization to meet task demands (Reuter-Lorenz & Park, 2014). However, existing systematic reviews and meta-analytic studies exploring the benefits of cognitive interventions in MCI have been mixed. An updated examination regarding the efficacy of cognitive intervention in MCI is needed given improvements in adherence to MCI diagnostic criteria in subject selection, better defined interventions and strategies applied, increased use of neuropsychological measures pre- and post-intervention, as well as identification of moderator variables which may influence treatment. As such, this meta-analytic review was conducted to examine the efficacy of cognitive intervention in individuals diagnosed with mild cognitive impairment (MCI) versus MCI controls based on performance of neuropsychological outcome measures in randomized controlled trials (RCT). RCT studies published from January 1995 to June 2017 were obtained through source databases of MEDLINE-R, PubMed, Healthstar, Global Health, PSYCH-INFO, and Health and Psychological Instruments using search parameters for MCI diagnostic category (mild cognitive impairment, MCI, pre-Alzheimer’s disease, early cognitive decline, early onset Alzheimer’s disease, and preclinical Alzheimer’s disease) and the intervention or training conducted (intervention, training, stimulation, rehabilitation, or treatment). Other inclusion and exclusion criteria included subject selection based on established MCI criteria, RCT design in an outpatient setting, MCI controls (active or passive), and outcomes based on objective neuropsychological measures. From the 1199 abstracts identified, 26 articles met inclusion criteria for the meta-analyses completed across eleven (11) countries; 92.31% of which have been published within the past 7 years. A series of meta-analyses were performed to examine the effects of cognitive intervention by cognitive domain, type of training, and intervention content (cognitive domain targeted). We found significant, moderate effects for multicomponent training (Hedges’ g observed = 0.398; CI [0.164, 0.631]; Z = 3.337; p = 0.001; Q = 55.511; df = 15; p = 0.000; I2 = 72.978%; τ2 = 0.146) as well as multidomain-focused strategies (Hedges’ g = 0.230; 95% CI [0.108, 0.352]; Z = 3.692; p < 0.001; Q = 12.713; df = 12; p = 0.390; I2 = 5.612; τ2 = 0.003). The effects for other interventions explored by cognitive domain, training type, or intervention content were indeterminate due to concerns for heterogeneity, bias, and small cell sizes. In addition, subgroup and meta-regression analyses were conducted with the moderators of MCI category, mode of intervention, training type, intervention content, program duration (total hours), type of control group (active or passive), post-intervention follow-up assessment period, and control for repeat administration. We found significant overall effects for intervention content with memory focused interventions appearing to be more effective than multidomain approaches. There was no evidence of an influence on outcomes for the other covariates examined. Overall, these findings suggest individuals with MCI who received multicomponent training or interventions targeting multiple domains (including lifestyle changes) were apt to display an improvement on outcome measures of cognition post-intervention. As such, multicomponent and multidomain forms of intervention may prompt recruitment of alternate neural processes as well as support primary networks to meet task demands simultaneously. In addition, interventions with memory and multidomain forms of content appear to be particularly helpful, with memory-based approaches possibly being more effective than multidomain methods. Other factors, such as program duration, appear to have less of an influence on intervention outcomes. Given this, although the creation of new primary network paths appears strained in MCI, interventions with memory-based or multidomain forms of content may facilitate partial activation of compensatory scaffolding and neuroplastic reorganization. The positive benefit of memory-based strategies may also reflect transfer effects indicative of compensatory network activation and the multiple-pathways involved in memory processes. Limitations of this review are similar to other meta-analysis in MCI, including a modest number studies, small sample sizes, multiple forms of interventions and types of training applied (some overlapping), and, while greatly improved in our view, a large diversity of instruments used to measure outcome. This is apt to have contributed to the presence of heterogeneity and publication bias precluding a more definitive determination of the outcomes observed.
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Affiliation(s)
- Dale S Sherman
- Cedars-Sinai Medical Center, 444 S. San Vicente Blvd, Suite 103, Los Angeles, CA, 90048, USA. .,University of Southern California, Los Angeles, CA, USA.
| | - Justin Mauser
- Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Miriam Nuno
- University of California, Davis, Davis, CA, USA
| | - Dean Sherzai
- Loma Linda University Health, 11370 Anderson Street B100, Loma Linda, CA, 92354, USA
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