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Introzzi L, Zonca J, Cabitza F, Cherubini P, Reverberi C. Enhancing human-AI collaboration: The case of colonoscopy. Dig Liver Dis 2024; 56:1131-1139. [PMID: 37940501 DOI: 10.1016/j.dld.2023.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 11/10/2023]
Abstract
Diagnostic errors impact patient health and healthcare costs. Artificial Intelligence (AI) shows promise in mitigating this burden by supporting Medical Doctors in decision-making. However, the mere display of excellent or even superhuman performance by AI in specific tasks does not guarantee a positive impact on medical practice. Effective AI assistance should target the primary causes of human errors and foster effective collaborative decision-making with human experts who remain the ultimate decision-makers. In this narrative review, we apply these principles to the specific scenario of AI assistance during colonoscopy. By unraveling the neurocognitive foundations of the colonoscopy procedure, we identify multiple bottlenecks in perception, attention, and decision-making that contribute to diagnostic errors, shedding light on potential interventions to mitigate them. Furthermore, we explored how existing AI devices fare in clinical practice and whether they achieved an optimal integration with the human decision-maker. We argue that to foster optimal Human-AI collaboration, future research should expand our knowledge of factors influencing AI's impact, establish evidence-based cognitive models, and develop training programs based on them. These efforts will enhance human-AI collaboration, ultimately improving diagnostic accuracy and patient outcomes. The principles illuminated in this review hold more general value, extending their relevance to a wide array of medical procedures and beyond.
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Affiliation(s)
- Luca Introzzi
- Department of Psychology, Università Milano - Bicocca, Milano, Italy
| | - Joshua Zonca
- Department of Psychology, Università Milano - Bicocca, Milano, Italy; Milan Center for Neuroscience, Università Milano - Bicocca, Milano, Italy
| | - Federico Cabitza
- Department of Informatics, Systems and Communication, Università Milano - Bicocca, Milano, Italy; IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
| | - Paolo Cherubini
- Department of Brain and Behavioral Sciences, Università Statale di Pavia, Pavia, Italy
| | - Carlo Reverberi
- Department of Psychology, Università Milano - Bicocca, Milano, Italy; Milan Center for Neuroscience, Università Milano - Bicocca, Milano, Italy.
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Kvist A, Bezuidenhout L, Johansson H, Albrecht F, Moulaee Conradsson D, Franzén E. Validation of fNIRS measurement of executive demand during walking with and without dual-task in younger and older adults and people with Parkinson's disease. Neuroimage Clin 2024; 43:103637. [PMID: 38964222 DOI: 10.1016/j.nicl.2024.103637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 05/28/2024] [Accepted: 06/29/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Walking with a concurrent cognitive task (dual-task walking) can pose a challenge to some populations due to aging or neurodegenerative disease. These tasks require cognitive resources involving the prefrontal cortex and can be studied using functional near-infrared spectroscopy (fNIRS). An important step in understanding fNIRS measures during such walking tasks is validating that measures reflect the demands of the tasks and not confounding sources or movement artifacts. AIM This study aimed to investigate the validity of fNIRS measures of prefrontal cortex activity as an indicator of executive demand during usual walking (single-task) and dual-task walking against clinical and objective measures of motor behavior in young adults, older adults, and people with Parkinson's disease (PD), by evaluating several validation hypotheses. METHODS In total, 133 participants were recruited from younger adults (18-50 years, n = 42), older adults (≥60 years, n = 49) and people with PD (≥60 years, n = 42). Activity in the prefrontal cortex during walking with and without an auditory Stroop task was measured with fNIRS. A combined hemoglobin measure (correlation-based signal improvement, CBSI) was calculated for use in a region of interest analysis in the dorsolateral prefrontal cortex (dlPFC). Pre-registered hypotheses regarding convergent validity, discriminant validity and known group validity were tested. An exploratory analysis of different hemoglobin measures was also performed. RESULTS Increases in dlPFC activity were found from single- to dual-task walking in the younger adults group and from rest to single-task walking in the older adults and PD groups. In line with hypotheses, a positive relationship was found between between dlPFC activity during dual-task walking and dual-task cost in the younger adults group, as well as a positive relationship to step time variability during single-task walking and a negative relationship to walking speed during single-task walking in the PD group. However, several clinical and gait measures lacked a relationship with dlPFC activity. CONCLUSION The fNIRS results point towards the CBSI measure of dlPFC activity being a valid measure of executive demand during both single and dual-task walking. Some relationships between clinical and gait measures and brain activity during walking need further investigation.
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Affiliation(s)
- Alexander Kvist
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.
| | - Lucian Bezuidenhout
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; Department of Health and Rehabilitation Sciences, Division of Physiotherapy, Stellenbosch University, Cape Town, South Africa
| | - Hanna Johansson
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden; Stockholm Sjukhem Foundation, Mariebergsgatan 22, 112 19 Stockholm, Sweden
| | - Franziska Albrecht
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - David Moulaee Conradsson
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Erika Franzén
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden; Stockholm Sjukhem Foundation, Mariebergsgatan 22, 112 19 Stockholm, Sweden
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Wang C, Jin B, Lu A. Effects of Cognitive-Motor and Motor-Motor Dual Tasks on Gait Performance in Older Adults with Sarcopenia. Healthcare (Basel) 2024; 12:1206. [PMID: 38921320 PMCID: PMC11203043 DOI: 10.3390/healthcare12121206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 05/29/2024] [Accepted: 06/13/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND With the advent of global aging, the health of the older population has become a critical public health challenge. The purpose of this study was to investigate the effect of dual-tasking on gait performance in patients with sarcopenia. METHODS Thirty participants with sarcopenia (age: 70.73 ± 4.12 yr, MMSE score: 26.90 ± 3.00), including 14 males and 16 females, were selected according to the diagnostic criteria of the Asian Working Group on Sarcopenia. All participants were instructed to perform the gait test in three modes: single task (ST), cognitive-motor dual task (CMDT), and motor-motor dual task (MMDT). Statistical analyses were performed using one-way ANOVA to evaluate the effects of different task types on gait parameters of the participants. RESULTS (1) Compared with ST walking, gait frequency, step length, and step speed decreased, and the gait cycle and double-support phase increased in patients with sarcopenia during dual-task walking (p < 0.05); (2) Compared with ST walking, gait variability indices such as stride frequency, stride length, and support period significantly increased in patients with sarcopenia during dual-task walking (p < 0.05). CONCLUSIONS The increased difficulty in postural control caused by dual-task interference may reduce the safety of motor strategies in patients with sarcopenia and increase the risk of falls. Future studies should focus on the effects of exercise interventions on multitasking patterns in people with sarcopenia to promote balance function in these populations.
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Affiliation(s)
| | - Baoming Jin
- School of Physical Education and Sports Science, Soochow University, Suzhou 215006, China;
| | - Aming Lu
- School of Physical Education and Sports Science, Soochow University, Suzhou 215006, China;
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Wards Y, Ehrhardt SE, Garner KG, Mattingley JB, Filmer HL, Dux PE. Stimulating prefrontal cortex facilitates training transfer by increasing representational overlap. Cereb Cortex 2024; 34:bhae209. [PMID: 38771242 DOI: 10.1093/cercor/bhae209] [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: 01/17/2024] [Revised: 04/29/2024] [Accepted: 04/30/2024] [Indexed: 05/22/2024] Open
Abstract
A recent hypothesis characterizes difficulties in multitasking as being the price humans pay for our ability to generalize learning across tasks. The mitigation of these costs through training has been associated with reduced overlap of constituent task representations within frontal, parietal, and subcortical regions. Transcranial direct current stimulation, which can modulate functional brain activity, has shown promise in generalizing performance gains when combined with multitasking training. However, the relationship between combined transcranial direct current stimulation and training protocols with task-associated representational overlap in the brain remains unexplored. Here, we paired prefrontal cortex transcranial direct current stimulation with multitasking training in 178 individuals and collected functional magnetic resonance imaging data pre- and post-training. We found that 1 mA transcranial direct current stimulation applied to the prefrontal cortex paired with multitasking training enhanced training transfer to spatial attention, as assessed via a visual search task. Using machine learning to assess the overlap of neural activity related to the training task in task-relevant brain regions, we found that visual search gains were predicted by changes in classification accuracy in frontal, parietal, and cerebellar regions for participants that received left prefrontal cortex stimulation. These findings demonstrate that prefrontal cortex transcranial direct current stimulation may interact with training-related changes to task representations, facilitating the generalization of learning.
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Affiliation(s)
- Yohan Wards
- School of Psychology, The University of Queensland, McElwain Building, Campbell Road, St Lucia, Queensland 4072, Australia
| | - Shane E Ehrhardt
- School of Psychology, The University of Queensland, McElwain Building, Campbell Road, St Lucia, Queensland 4072, Australia
| | - Kelly G Garner
- School of Psychology, The University of Queensland, McElwain Building, Campbell Road, St Lucia, Queensland 4072, Australia
- Queensland Brain Institute, The University of Queensland, Building 79, Upland Road, St Lucia, Queensland 4072, Australia
- School of Psychology, University of New South Wales, Mathews Building, Gate 11, Botany Street, Randwick, New South Wales 2052, Australia
- School of Psychology, University of Birmingham, Hills Building, Edgbaston Park Rd, Birmingham B15 2TT, United Kingdom
| | - Jason B Mattingley
- School of Psychology, The University of Queensland, McElwain Building, Campbell Road, St Lucia, Queensland 4072, Australia
- Queensland Brain Institute, The University of Queensland, Building 79, Upland Road, St Lucia, Queensland 4072, Australia
- School of Psychology, University of Birmingham, Hills Building, Edgbaston Park Rd, Birmingham B15 2TT, United Kingdom
| | - Hannah L Filmer
- School of Psychology, The University of Queensland, McElwain Building, Campbell Road, St Lucia, Queensland 4072, Australia
| | - Paul E Dux
- School of Psychology, The University of Queensland, McElwain Building, Campbell Road, St Lucia, Queensland 4072, Australia
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Ding Q, Ou Z, Yao S, Wu C, Chen J, Shen J, Lan Y, Xu G. Cortical activation and brain network efficiency during dual tasks: An fNIRS study. Neuroimage 2024; 289:120545. [PMID: 38367652 DOI: 10.1016/j.neuroimage.2024.120545] [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: 08/30/2023] [Revised: 02/10/2024] [Accepted: 02/15/2024] [Indexed: 02/19/2024] Open
Abstract
OBJECTIVE Dual task (DT) is a commonly used paradigm indicative of executive functions. Brain activities during DT walking is usually measured by portable functional near infrared spectroscopy (fNIRS). Previous studies focused on cortical activation in prefrontal cortex and overlooked other brain regions such as sensorimotor cortices. This study is aimed at investigating the modulations of cortical activation and brain network efficiency in multiple brain regions from single to dual tasks with different complexities and their relationships with DT performance. METHODS Forty-two healthy adults [12 males; mean age: 27.7 (SD=6.5) years] participated in this study. Participants performed behavioral tasks with portable fNIRS simultaneous recording. There were three parts of behavioral tasks: cognitive tasks while standing (serial subtraction of 3's and 7's), walking alone and DT (walk while subtraction, including serial subtraction of 3's and 7's). Cognitive cost, walking cost and cost sum (i.e., sum of cognitive and walking costs) were calculated for DT. Cortical activation, local and global network efficiency were calculated for each task. RESULTS The cognitive cost was greater and the walking cost was less during DT with subtraction 3's compared with 7's (P's = 0.032 and 0.019, respectively). Cortical activation and network efficiency were differentially modulated among single and dual tasks (P's < 0.05). Prefrontal activation during DT was positively correlated with DT costs, while network efficiency was negatively correlated with DT costs (P's < 0.05). CONCLUSIONS Our results revealed prefrontal over-activation and reduced network efficiency in individuals with poor DT performance. Our findings suggest that reduced network efficiency could be a possible mechanism contributing to poor DT performance, which is accompanied by compensatory prefrontal over-activation.
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Affiliation(s)
- Qian Ding
- Department of Rehabilitation Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Zitong Ou
- Department of Rehabilitation Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; Department of Rehabilitation Medicine, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Shantong Yao
- Department of Rehabilitation Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Cheng Wu
- Department of Rehabilitation Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China; Department of Rehabilitation Medicine, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jing Chen
- Department of Rehabilitation Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Junhui Shen
- Department of Rehabilitation Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Yue Lan
- Department of Rehabilitation Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China.
| | - Guangqing Xu
- Department of Rehabilitation Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
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Schubert T, Kübler S, Strobach T. A mechanism underlying improved dual-task performance after practice: Reviewing evidence for the memory hypothesis. Psychon Bull Rev 2024:10.3758/s13423-024-02498-0. [PMID: 38530593 DOI: 10.3758/s13423-024-02498-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2024] [Indexed: 03/28/2024]
Abstract
Extensive practice can significantly reduce dual-task costs (i.e., impaired performance under dual-task conditions compared with single-task conditions) and, thus, improve dual-task performance. Among others, these practice effects are attributed to an optimization of executive function skills that are necessary for coordinating tasks that overlap in time. In detail, this optimization of dual-task coordination skills is associated with the efficient instantiation of component task information in working memory at the onset of a dual-task trial. In the present paper, we review empirical findings on three critical predictions of this memory hypothesis. These predictions concern (1) the preconditions for the acquisition and transfer of coordination skills due to practice, (2) the role of task complexity and difficulty, and (3) the impact of age-related decline in working memory capacity on dual-task optimization.
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Affiliation(s)
- Torsten Schubert
- Department of Psychology, Martin-Luther University Halle-Wittenberg, Emil-Abderhalden-Str. 26-27, 06108, Halle, Saale, Germany.
| | - Sebastian Kübler
- Department of Psychology, Martin-Luther University Halle-Wittenberg, Emil-Abderhalden-Str. 26-27, 06108, Halle, Saale, Germany
- Humboldt-Universität zu Berlin, Berlin, Germany
| | - Tilo Strobach
- Department of Psychology, Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany.
- ICAN Institute for Cognitive and Affective Neuroscience, Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany.
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Chow GCC, Ha SCW. Positive skill transfer in balance and speed control from balance bike to pedal bike in adults: A multiphase intervention study. PLoS One 2024; 19:e0298142. [PMID: 38422110 PMCID: PMC10903920 DOI: 10.1371/journal.pone.0298142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 01/17/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Learning to cycle can be challenging for adults who did not acquire the necessary skills during childhood. Balance bikes have been used to teach children how to cycle, but it was unclear whether this approach could also be effective for adults. PURPOSE To address this, a multi-phase intervention study was conducted to investigate whether healthy adults could be taught to cycle independently through the use of a balance bike. METHODS In Phase 1, a case-control observational study was conducted in which 13 cyclists and 8 non-cyclists completed balance bike tests. Based on the findings, an 8-session intervention pre- and post-test study was conducted in Phase 2, using an 8 × 20-minute balance bike training programme to improve cycling postural stability and control. Another 11 non-cyclists completed the novel programme. The time taken to complete the balance bike tests was compared before and after the program, while their cycling confidence was recorded in each session. To assess the effectiveness of the programme, participants were invited to cycle on a pedal bike to evaluate their ability to cycle independently. RESULTS The results in Phase 1 showed that cyclists performed better on the balance bike than non-cyclists, with Bayes factor analyses providing evidence of this difference, BF01 = 0.228 in the 15 m sprint test and BF01 = 0.138 in the two-turn curved sprint test. The novel training programme in Phase 2 demonstrated remarkable effectiveness in improving their balance bike riding performance, as evidenced by the Bayes factor for completion times in the repeated measures being BF01 < 0.001. All participants were able to cycle independently with confidence after the programme. CONCLUSIONS This study sheds light on the idea that it's never too late for adults to learn how to ride a bike. It provides evidence that healthy adults can learn to ride independently with the help of a balance bike, a tool that's commonly used for teaching children. The study identifies five key principles for effective balance bike training in adults, including focusing on riding speed, gliding to turn, building cycling confidence, engaging high motor skills, and using a dual-task approach. Our evidence-based training programme offers a safe, enjoyable, and effective way for adults to develop the skills and confidence they need to ride, even if they've never ridden before.
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Affiliation(s)
- Gary C. C. Chow
- Department of Health and Physical Education, The Education University of Hong Kong, Ting Kok, Hong Kong
| | - Sophia C. W. Ha
- Department of Health and Physical Education, The Education University of Hong Kong, Ting Kok, Hong Kong
- School of Health and Sports Science, Regent College London, London, United Kingdom
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Strobach T. Practice effects on dual-task order coordination and its sequential adjustment. Psychon Bull Rev 2024:10.3758/s13423-024-02476-6. [PMID: 38409499 DOI: 10.3758/s13423-024-02476-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2024] [Indexed: 02/28/2024]
Abstract
When the performance of two tasks overlaps in time, performance impairments in one or both tasks are common. Various theoretical explanations for how component tasks are controlled in dual-task situations have been advanced. However, less attention has been paid to the issue of how two temporally overlapping tasks are appropriately coordinated in terms of their order. The current study focuses on two specific aspects of this task-order coordination: (1) the potential effects of practice on task-order coordination performance and (2) its relationships with cognitive meta-control mechanisms that adjust this coordination. These aspects were investigated in a visual-auditory dual-task combination with randomly changing task orders across trials after four sessions of dual-task practice (N = 24) and single-task practice (N = 24). The results demonstrated that task-order coordination improves during dual-task practice, and in contrast to the effects of single-task practice. Practice, on the other hand, did not show substantial evidence of an effect on the adjustment of task-order coordination. This practice-related dissociation is consistent with the assumption that (1) task-order coordination and (2) its sequential adjustment are separable sets of processes.
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Affiliation(s)
- Tilo Strobach
- Department of Psychology, Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany.
- ICAN Institute for Cognitive and Affective Neuroscience, Medical School Hamburg, Am Kaiserkai 1, 20457, Hamburg, Germany.
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Wu J, Qiu P, Lv S, Chen M, Li Y. The effects of cognitive-motor dual-task training on athletes' cognition and motor performance. Front Psychol 2024; 15:1284787. [PMID: 38390413 PMCID: PMC10881661 DOI: 10.3389/fpsyg.2024.1284787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/29/2024] [Indexed: 02/24/2024] Open
Abstract
Background Cognitive-Motor Dual Task (CMDT) training has been widely utilized in rehabilitation and sports practice. However, whether CMDT training can better enhance athletes' cognitive-motor performance compared to traditional single-task (ST) training remains unclear. Method A systematic review that complied with PRISMA was carried out (Prospero registration number: CRD42023443594). The electronic databases used for the systematic literature search from the beginning through 13 June 2023, included Web of Science, Embase, PubMed, and the Cochrane Library. After obtaining the initial literature, two researchers independently assessed it based on inclusion and exclusion criteria. Finally, the included literature was analyzed to compare the differences between ST training and CMDT training. Results After screening 2,094 articles, we included 10 acute studies and 7 chronic studies. Conclusion This systematic review shows that athletes typically show a degradation of performance in CMDT situations as opposed to ST when evaluated transversally. However, this performance decline is notably reduced following longitudinal training in CMDT, indicating the effectiveness of sustained CMDT training in enhancing cognitive-motor performance under dual-task conditions. Our study provides new insights into the application of CMDT in the field of sports training. Practitioners can utilize CMDT to assess athletic skill levels or optimize cognitive-motor performance of athletes, taking into account the specific needs of each sport. Systematic review registration https://www.crd.york.ac.uk/prospero, identifier CRD42023443594.
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Affiliation(s)
- Junyu Wu
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Peng Qiu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Shuaibing Lv
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Mingxian Chen
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Youqiang Li
- School of Physical Education, Shanghai University of Sport, Shanghai, China
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Vicente C, Fernandes S, Romão A, Fernandes JB. Current trends in psychotherapies and psychosocial interventions for people with dementia: a scoping review of randomized controlled trials. Front Psychiatry 2024; 15:1286475. [PMID: 38317762 PMCID: PMC10838973 DOI: 10.3389/fpsyt.2024.1286475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/09/2024] [Indexed: 02/07/2024] Open
Abstract
An outcome of dementia is a progressive decline in cognitive function. Implementing psychotherapies and psychosocial interventions is crucial for bolstering cognitive abilities, promoting independence, and elevating the quality of life for individuals with dementia. This review aims to identify current trends in psychotherapies and psychosocial interventions for people with dementia. A Scoping review was developed based on the framework proposed by Arksey and O'Malley. The literature search was conducted on electronic databases, including Scopus, Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, Nursing & Allied Health Collection, and MedicLatina. Executed in June 2023, the search focused on articles published in English, Portuguese, and Spanish between 2013 and 2023. Through this search, 1409 articles were initially identified. After selecting and analyzing the reports, sixteen trials were included in this review. Eight distinct categories were identified, covering different strategies. These categories run from computerized game-based cognitive training and reminiscence therapy to compensatory and restorative strategies, memory and attention training, calculation training, dual-task training, counseling, and personalized goal attainment. The findings of this scoping review highlight the diverse landscape of psychotherapies and psychosocial interventions for people with dementia.
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Affiliation(s)
- Célia Vicente
- Department of Nursing, Hospital Garcia de Orta, Almada, Portugal
- Nurs Lab, Caparica, Almada, Portugal
| | - Sónia Fernandes
- Nurs Lab, Caparica, Almada, Portugal
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Caparica, Almada, Portugal
| | - Ana Romão
- Nurs Lab, Caparica, Almada, Portugal
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Caparica, Almada, Portugal
| | - Júlio Belo Fernandes
- Nurs Lab, Caparica, Almada, Portugal
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Caparica, Almada, Portugal
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Chen IC, Chuang IC, Chang KC, Chang CH, Wu CY. Dual task measures in older adults with and without cognitive impairment: response to simultaneous cognitive-exercise training and minimal clinically important difference estimates. BMC Geriatr 2023; 23:663. [PMID: 37845603 PMCID: PMC10580601 DOI: 10.1186/s12877-023-04390-3] [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: 02/09/2023] [Accepted: 10/06/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Responsiveness and minimal clinically important difference (MCID) are critical indices to understand whether observed improvement represents a meaningful improvement after intervention. Although simultaneous cognitive-exercise training (SCET; e.g., performing memory tasks while cycling) has been suggested to enhance the cognitive function of older adults, responsiveness and MCID have not been established. Hence, we aimed to estimate responsiveness and MCIDs of two dual task performance involving cognition and hand function in older adults with and without cognitive impairment and to compare the differences in responsiveness and MCIDs of the two dual task performance between older adults with and without cognitive impairment. METHODS A total of 106 older adults completed the Montreal Cognitive Assessment and two dual tasks before and after SCET. One dual task was a combination of Serial Sevens Test and Box and Block Test (BBT), and the other included frequency discrimination and BBT. We used effect size and standardized response mean to indicate responsiveness and used anchor- and distribution-based approaches to estimating MCID ranges. When conducting data analysis, all participants were classified into two cognitive groups, cognitively healthy (Montreal Cognitive Assessment ≥ 26) and cognitively impaired (Montreal Cognitive Assessment < 26) groups, based on the scores of the Montreal Cognitive Assessment before SCET. RESULTS In the cognitively healthy group, Serial Seven Test performance when tasked with BBT and BBT performance when tasked with Serial Seven Test were responsive to SCET (effect size = 0.18-0.29; standardized response mean = 0.25-0.37). MCIDs of Serial Seven Test performance when tasked with BBT ranged 2.09-2.36, and MCIDs of BBT performance when tasked with Serial Seven Test ranged 3.77-5.85. In the cognitively impaired group, only frequency discrimination performance when tasked with BBT was responsive to SCET (effect size = 0.37; standardized response mean = 0.47). MCIDs of frequency discrimination performance when tasked with BBT ranged 1.47-2.18, and MCIDs of BBT performance when tasked with frequency discrimination ranged 1.13-7.62. CONCLUSIONS Current findings suggest that a change in Serial Seven Test performance when tasked with BBT between 2.09 and 2.36 corrected number (correct responses - incorrect responses) should be considered a meaningful change for older adults who are cognitively healthy, and a change in frequency discrimination performance when tasked with BBT between 1.47 and 2.18 corrected number (correct responses - incorrect responses) should be considered a meaningful change for older adults who are cognitively impaired. Clinical practitioners may use these established MCIDs of dual tasks involving cognition and hand function to interpret changes following SCET for older adults with and without cognitive impairment. TRIAL REGISTRATION NCT04689776, 30/12/2020.
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Affiliation(s)
- I-Chen Chen
- Department of Occupational Therapy, College of Nursing and Health Sciences, Da-Yeh University, Changhua, Taiwan
| | - I-Ching Chuang
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, No.259, Wunhua 1st Rd., Gueishan Township, Taoyuan, 333, Taiwan.
- Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
| | - Ku-Chou Chang
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chih-Hung Chang
- Program in Occupational Therapy, School of Medicine, Washington University , St. Louis, MO, USA
- Department of Medicine, School of Medicine, Washington University , St. Louis, MO, USA
- Department of Orthopedic Surgery, School of Medicine, Washington University , St. Louis, MO, USA
| | - Ching-Yi Wu
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, No.259, Wunhua 1st Rd., Gueishan Township, Taoyuan, 333, Taiwan
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
- Department of Physical Medicine and Rehabilitation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
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12
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Yagci G, Metin G, Erel S, Erbahceci F. Dual Task Performance in Adolescents With Idiopathic Scoliosis. Percept Mot Skills 2023; 130:1889-1900. [PMID: 37282549 DOI: 10.1177/00315125231182276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Daily life activities commonly include many combinations of dual tasks. Although dual task ability has been studied in healthy young adults, dual task performance in adolescents with idiopathic scoliosis (IS) has not been explored. Our objective in this study was to investigate dual task performance in adolescents with IS. We paired 33 adolescents diagnosed with IS and 33 healthy control participants (age range: 11-17 years) and administered to both groups the Stroop Color and Word test as a measure of cognitive ability, and both the Expanded Timed Up and Go (ETUG) test and the Tandem Gait test as measures of motor tasks. During the motor tasks, we had participants spell five-letter words in reverse and count down by seven from a randomly presented number between 50 and 100 to assess their dual task (cognitive-motor) performance. All cognitive, motor, and dual cognitive-motor test scores differed significantly between the IS and healthy control groups. The time taken to complete all these tasks was longer for participants with IS compared with controls (p < .05). These results revealed diminished performances on dual cognitive-motor tasks among adolescents with IS when compared to peers without IS. Dual task performance is a new research paradigm in the scoliosis rehabilitation field, and it should be further investigated in future studies.
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Affiliation(s)
- Gozde Yagci
- Faculty of Physical Therapy and Rehabilitation, Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Türkiye
| | - Gulnihal Metin
- Faculty of Physical Therapy and Rehabilitation, Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Türkiye
| | - Suat Erel
- Faculty of Physical Therapy and Rehabilitation, Department of Physiotherapy and Rehabilitation, Pamukkale University, Denizli, Türkiye
| | - Fatih Erbahceci
- Faculty of Physical Therapy and Rehabilitation, Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Türkiye
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13
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Xiao Y, Yang T, Shang H. The Impact of Motor-Cognitive Dual-Task Training on Physical and Cognitive Functions in Parkinson’s Disease. Brain Sci 2023; 13:brainsci13030437. [PMID: 36979247 PMCID: PMC10046387 DOI: 10.3390/brainsci13030437] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 02/15/2023] [Accepted: 02/20/2023] [Indexed: 03/08/2023] Open
Abstract
Rehabilitation is a high-potential approach to improving physical and cognitive functions in Parkinson’s disease (PD). Dual-task training innovatively combines motor and cognitive rehabilitation in a comprehensive module. Patients perform motor and cognitive tasks at the same time in dual-task training. The previous studies of dual-task training in PD had high heterogeneity and achieved controversial results. In the current review, we aim to summarize the current evidence of the effect of dual-task training on motor and cognitive functions in PD patients to support the clinical practice of dual-task training. In addition, we also discuss the current opinions regarding the mechanism underlying the interaction between motor and cognitive training. In conclusion, dual-task training is suitable for PD patients with varied disease duration to improve their motor function. Dual-task training can improve motor symptoms, single-task gait speed, single-task steep length, balance, and objective experience of freezing of gait in PD. The improvement in cognitive function after dual-task training is mild.
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14
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Froger G, Blättler C, Bonnardel N. L’acquisition de l’expertise ou l’abandon progressif du renforcement des processus génériques. PSYCHOLOGIE FRANCAISE 2023. [DOI: 10.1016/j.psfr.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
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15
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Wisniewski T, Masurkar AV. Gait dysfunction in Alzheimer disease. HANDBOOK OF CLINICAL NEUROLOGY 2023; 196:267-274. [PMID: 37620073 DOI: 10.1016/b978-0-323-98817-9.00013-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
Alzheimer's disease (AD) is the most common cause of age-associated dementia and will exponentially rise in prevalence in the coming decades, supporting the parallel development of the early stage detection and disease-modifying strategies. While primarily considered as a cognitive disorder, AD also features motor symptoms, primarily gait dysfunction. Such gait abnormalities can be phenotyped across classic clinical syndromes as well as by quantitative kinematic assessments to address subtle dysfunction at preclinical and prodromal stages. As such, certain measures of gait can predict the future cognitive and functional decline. Moreover, cross-sectional and longitudinal studies have associated gait abnormalities with imaging, biofluid, and genetic markers of AD across all stages. This suggests that gait assessment is an important tool in the clinical assessment of patients across the AD spectrum, especially to help identify at-risk individuals.
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Affiliation(s)
- Thomas Wisniewski
- Department of Neurology, NYU School of Medicine, New York, NY, United States; Department of Pathology, NYU School of Medicine, New York, NY, United States; Department of Psychiatry, NYU School of Medicine, New York, NY, United States; Division of Cognitive Neurology, Center for Cognitive Neurology, NYU School of Medicine, New York, NY, United States.
| | - Arjun V Masurkar
- Department of Neurology, NYU School of Medicine, New York, NY, United States; Division of Cognitive Neurology, Center for Cognitive Neurology, NYU School of Medicine, New York, NY, United States
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16
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Wang Q, Dai W, Xu S, Zhu S, Sui Y, Kan C, Shen Y, Zhu Y, Guo C, Wang T. Brain activation of the PFC during dual-task walking in stroke patients: A systematic review and meta-analysis of functional near-infrared spectroscopy studies. Front Neurosci 2023; 17:1111274. [PMID: 36875661 PMCID: PMC9980909 DOI: 10.3389/fnins.2023.1111274] [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: 11/29/2022] [Accepted: 01/30/2023] [Indexed: 02/18/2023] Open
Abstract
Background Dual-task walking is a good paradigm to measure the walking ability of stroke patients in daily life. It allows for a better observation of brain activation under dual-task walking to assess the impact of the different tasks on the patient when combining with functional near-infrared spectroscopy (fNIRS). This review aims to summarize the cortical change of the prefrontal cortex (PFC) detected in single-task and dual-task walking in stroke patients. Methods Six databases (Medline, Embase, PubMed, Web of Science, CINAHL, and Cochrane Library) were systematically searched for relevant studies, from inception to August 2022. Studies that measured the brain activation of single-task and dual-task walking in stroke patients were included. The main outcome of the study was PFC activity measured using fNIRS. In addition, a subgroup analysis was also performed for study characteristics based on HbO to analyze the different effects of disease duration and the type of dual task. Results Ten articles were included in the final review, and nine articles were included in the quantitative meta-analysis. The primary analysis showed more significant PFC activation in stroke patients performing dual-task walking than single-task walking (SMD = 0.340, P = 0.02, I 2 = 7.853%, 95% CI = 0.054-0.626). The secondary analysis showed a significant difference in PFC activation when performing dual-task walking and single-task walking in chronic patients (SMD = 0.369, P = 0.038, I 2 = 13.692%, 95% CI = 0.020-0.717), but not in subacute patients (SMD = 0.203, P = 0.419, I 2 = 0%, 95% CI = -0.289-0.696). In addition, performing walking combining serial subtraction (SMD = 0.516, P < 0.001, I 2 = 0%, 95% CI = 0.239-0.794), obstacle crossing (SMD = 0.564, P = 0.002, I 2 = 0%, 95% CI = 0.205-0.903), or a verbal task (SMD = 0.654, P = 0.009, I 2 = 0%, 95% CI = 0.164-1.137) had more PFC activation than single-task walking, while performing the n-back task did not show significant differentiation (SMD = 0.203, P = 0.419, I 2 = 0%, 95% CI = -0.289-0.696). Conclusions Different dual-task paradigms produce different levels of dual-task interference in stroke patients with different disease durations, and it is important to choose the matching dual-task type in relation to the walking ability and cognitive ability of the patient, in order to better improve the assessment and training effects. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier: CRD42022356699.
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Affiliation(s)
- Qinglei Wang
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, China
| | - Wenjun Dai
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Sheng Xu
- Department of Rehabilitation, Changzhou Dean Hospital, Changzhou, China
| | - Shizhe Zhu
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, China
| | - Youxin Sui
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, China
| | - Chaojie Kan
- School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, China.,Department of Rehabilitation, Changzhou Dean Hospital, Changzhou, China
| | - Ying Shen
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yi Zhu
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Chuan Guo
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Tong Wang
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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17
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Khan MJ, Kannan P, Wong TWL, Fong KNK, Winser SJ. A Systematic Review Exploring the Theories Underlying the Improvement of Balance and Reduction in Falls Following Dual-Task Training among Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16890. [PMID: 36554771 PMCID: PMC9778940 DOI: 10.3390/ijerph192416890] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Balance impairment causes frequent falls in older adults, and preventing falls remains challenging. Dual-task (DT) training reduces falls by improving balance, but the precise theory is not fully understood. This review aims to explore the theories underlying the effectiveness of DT in improving balance and reducing falls in older adults. METHODS Eleven electronic databases were searched from database inception to June 2022. Two reviewers independently performed study screening and data extraction. The risk of bias (RoB) in the included studies was assessed using the Cochrane Collaboration RoB 2 tool. RESULTS The searches yielded 1478 citations, of which 30 studies met the inclusion criteria and were included in the review. Twenty-two of the 30 included studies utilized the motor-cognitive type of DT for training, while six used motor-motor and two utilized cognitive-cognitive DT. The included studies reported 20 different theories to explain the effectiveness of DT for improving balance and reducing falls in older adults. The predominant theory identified in the included studies was attention theory (n = 14). Overall, 26 studies reported improved balance and five studies found a reduction in fall incidence following DT training. Balance and falls improved significantly in 15 motor-cognitive DT intervention studies. CONCLUSION Attention shifting between two tasks is reported to occur following DT training. Motor-cognitive DT training improves balance and reduces fall incidence in older adults by shifting attention based on the difficulty and priority of a task from the motor to the cognitive task.
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18
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Research progress in the application of motor-cognitive dual task training in rehabilitation of walking function in stroke patients. JOURNAL OF NEURORESTORATOLOGY 2022. [DOI: 10.1016/j.jnrt.2022.100028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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19
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McPhee AM, Cheung TCK, Schmuckler MA. Dual-task interference as a function of varying motor and cognitive demands. Front Psychol 2022; 13:952245. [PMID: 36248521 PMCID: PMC9558828 DOI: 10.3389/fpsyg.2022.952245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
Multitasking is a critical feature of our daily lives. Using a dual-task paradigm, this experiment explored adults’ abilities to simultaneously engage in everyday motor and cognitive activities, counting while walking, under conditions varying the difficulty of each of these tasks. Motor difficulty was manipulated by having participants walk forward versus backward, and cognitive difficulty was manipulated by having participants count forward versus backward, employing either a serial 2 s or serial 3 s task. All of these manipulations were performed in single-task conditions (walk only, count only) and dual-task conditions (walk and count simultaneously). Both motor performance variables (cycle time, stride length, walking velocity) and cognitive variables (counting fluency, counting accuracy) were assessed in these conditions. Analyses of single-task conditions revealed that both motor and cognitive manipulations predictably influenced performance. Analyses of dual-task performance revealed influences of motor and cognitive factors on both motor and cognitive performance. Most centrally, dual-task costs (normalized difference between single- and dual-task conditions) for motor variables revealed that such costs occurred primarily for temporal or spatiotemporal gait parameters (cycle time, walking velocity) and were driven by cognitive manipulations. Dual-task cost analyses for cognitive measures revealed negative dual-task costs, or dual-task benefits, for cognitive performance. Finally, the effects of dual-task manipulations were correlated for motor and cognitive measures, indicating dual-task performance as a significant individual difference variable. These findings are discussed with reference to theories of attentional allocation, as well as the possible role of auditory–motor entrainment in dual-task conditions.
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20
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Sui SX, Hendy AM, Teo WP, Moran JT, Nuzum ND, Pasco JA. A Review of the Measurement of the Neurology of Gait in Cognitive Dysfunction or Dementia, Focusing on the Application of fNIRS during Dual-Task Gait Assessment. Brain Sci 2022; 12:brainsci12080968. [PMID: 35892409 PMCID: PMC9331540 DOI: 10.3390/brainsci12080968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/16/2022] [Accepted: 07/20/2022] [Indexed: 12/07/2022] Open
Abstract
Poor motor function or physical performance is a predictor of cognitive decline. Additionally, slow gait speed is associated with poor cognitive performance, with gait disturbances being a risk factor for dementia. Parallel declines in muscular and cognitive performance (resulting in cognitive frailty) might be driven primarily by muscle deterioration, but bidirectional pathways involving muscle–brain crosstalk through the central and peripheral nervous systems are likely to exist. Following screening, early-stage parallel declines may be manageable and modifiable through simple interventions. Gait–brain relationships in dementia and the underlying mechanisms are not fully understood; therefore, the current authors critically reviewed the literature on the gait–brain relationship and the underlying mechanisms and the feasibility/accuracy of assessment tools in order to identify research gaps. The authors suggest that dual-task gait is involved in concurrent cognitive and motor activities, reflecting how the brain allocates resources when gait is challenged by an additional task and that poor performance on dual-task gait is a predictor of dementia onset. Thus, tools or protocols that allow the identification of subtle disease- or disorder-related changes in gait are highly desirable to improve diagnosis. Functional near-infrared spectroscopy (fNIRS) is a non-invasive, cost-effective, safe, simple, portable, and non-motion-sensitive neuroimaging technique, widely used in studies of clinical populations such as people suffering from Alzheimer’s disease, depression, and other chronic neurological disorders. If fNIRS can help researchers to better understand gait disturbance, then fNIRS could form the basis of a cost-effective means of identifying people at risk of cognitive dysfunction and dementia. The major research gap identified in this review relates to the role of the central/peripheral nervous system when performing dual tasks.
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Affiliation(s)
- Sophia X. Sui
- Instiute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC 3216, Australia; (J.T.M.); (J.A.P.)
- Correspondence: ; Tel.: +61-3-4215-3306-53306; Fax: +61-3-4215-3491
| | - Ashlee M. Hendy
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3216, Australia; (A.M.H.); (N.D.N.)
| | - Wei-Peng Teo
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore 308232, Singapore;
| | - Joshua T. Moran
- Instiute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC 3216, Australia; (J.T.M.); (J.A.P.)
| | - Nathan D. Nuzum
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3216, Australia; (A.M.H.); (N.D.N.)
| | - Julie A. Pasco
- Instiute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC 3216, Australia; (J.T.M.); (J.A.P.)
- Department of Medicine—Western Campus, The University of Melbourne, St Albans, VIC 3010, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
- Barwon Health, University Hospital Geelong, Geelong, VIC 3220, Australia
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21
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von Bastian CC, Reinhartz A, Udale RC, Grégoire S, Essounni M, Belleville S, Strobach T. Mechanisms of processing speed training and transfer effects across the adult lifespan: protocol of a multi-site cognitive training study. BMC Psychol 2022; 10:168. [PMID: 35804410 PMCID: PMC9270821 DOI: 10.1186/s40359-022-00877-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 06/29/2022] [Indexed: 11/10/2022] Open
Abstract
Background In recent years, cognitive training has gained popularity as a cost-effective and accessible intervention aiming at compensating for or even counteracting age-related cognitive declines during adulthood. Whereas the evidence for the effectiveness of cognitive training in general is inconsistent, processing speed training has been a notable successful exception, showing promising generalized benefits in untrained tasks and everyday cognitive functioning. The goal of this study is to investigate why and when processing speed training can lead to transfer across the adult lifespan. Specifically, we will test (1) whether training-induced changes in the rate of evidence accumulation underpin transfer to cognitive performance in untrained contexts, and (2) whether these transfer effects increase with stronger attentional control demands of the training tasks. Methods We will employ a multi-site, longitudinal, double-blinded and actively controlled study design with a target sample size of N = 400 adult participants between 18 and 85 years old. Participants will be randomly assigned to one of three processing speed training interventions with varying attentional control demands (choice reaction time, switching, or dual tasks) which will be compared to an active control group training simple reaction time tasks with minimal attentional control demands. All groups will complete 10 home-based training sessions comprising three tasks. Training gains, near transfer to the untrained tasks of the other groups, and far transfer to working memory, inhibitory control, reasoning, and everyday cognitive functioning will be assessed in the laboratory directly before, immediately after, and three months after training (i.e., pretest, posttest, and follow-up, respectively). We will estimate the rate of evidence accumulation (drift rate) with diffusion modeling and conduct latent-change score modeling for hypothesis testing. Discussion This study will contribute to identifying the cognitive processes that change when training speeded tasks with varying attentional control demands across the adult lifespan. A better understanding of how processing speed training affects specific cognitive mechanisms will enable researchers to maximize the effectiveness of cognitive training in producing broad transfer to psychologically meaningful everyday life outcomes. Trial registration Open Science Framework Registries, registration https://doi.org/10.17605/OSF.IO/J5G7E; date of registration: 9 May 2022.
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Affiliation(s)
- Claudia C von Bastian
- Department of Psychology, University of Sheffield, 1 Vicar Lane, Sheffield, S1 2LT, UK.
| | | | - Robert C Udale
- Department of Psychology, University of Sheffield, 1 Vicar Lane, Sheffield, S1 2LT, UK
| | - Stéphanie Grégoire
- Centre de Recherche de L'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, Canada
| | - Mehdi Essounni
- Centre de Recherche de L'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, Canada
| | - Sylvie Belleville
- Centre de Recherche de L'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, Canada.,Université de Montréal (UdeM), Montréal, Canada
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22
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Szameitat AJ. Inter-Individual Differences in Executive Functions Predict Multitasking Performance - Implications for the Central Attentional Bottleneck. Front Psychol 2022; 13:778966. [PMID: 35645928 PMCID: PMC9131123 DOI: 10.3389/fpsyg.2022.778966] [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: 09/17/2021] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Human multitasking suffers from a central attentional bottleneck preventing parallel performance of central mental operations, leading to profound deferments in task performance. While previous research assumed that the deferment is caused by a mere waiting time (refractory period), we show that the bottleneck requires executive functions (EF; active scheduling account) accounting for a profound part of the deferment. Three participant groups with EF impairments (dyslexics, highly neurotics, deprived smokers) showed worse multitasking performance than respective control groups. Three further groups with EF improvements (video-gamers, bilinguals, coffee consumers) showed improved multitasking. Finally, three groups performed a dual-task and different measures of EF (reading span, rotation span, symmetry span) and showed significant correlations between multitasking performance and working memory capacity. Demands on EF during multitasking may cause more errors, mental fatigue and stress, with parts of the population being considerably more prone to this.
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Affiliation(s)
- André J. Szameitat
- Center for Cognitive Neuroscience (CCN), Division of Psychology, Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom
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23
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Fabio RA, Andricciola F, Caprì T. Visual-motor attention in children with ADHD: The role of automatic and controlled processes. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 123:104193. [PMID: 35149332 DOI: 10.1016/j.ridd.2022.104193] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 01/17/2022] [Accepted: 02/03/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND there are evidence that children with ADHD exhibit a deficit both in automatic and controlled processes. AIMS the present study aimed to examine the visual-motor attention and the influence of cognitive load through a dual task paradigm in children with ADHD compared with typical developing children (TD). METHODS AND PROCEDURES 113 children with ADHD: 40 with subtype inattentive (ADHD- I group), 16 with subtype hyperactive (ADHD-H group), 57 with subtype combined (ADHD-C group), and 113 TD children (TD group) were recruited. We used a dual-task paradigm in which the primary task was a figure-tracing test whereas the second task was a digit span test. A figure-tracing test was used to evaluate visual motor attention. Based on the length and intersection of the lines, the figures of the primary task were categorized into simple and complex. OUTCOMES AND RESULTS the ADHD groups compared to the TD group showed a worse accuracy of performance in both condition with and without cognitive load. CONCLUSIONS AND IMPLICATIONS The findings were discussed in light of the relationship between automatic and controlled processes involved in the visual-motor attention.
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Affiliation(s)
- Rosa Angela Fabio
- Department of Clinical and Experimental Medicine, University of Messina, Via Bivona, 98122, Messina, Italy
| | - Federica Andricciola
- Department of Clinical and Experimental Medicine, University of Messina, Via Bivona, 98122, Messina, Italy
| | - Tindara Caprì
- Department of Life and Health Sciences, Link Campus University, Via del Casale di S. Pio V, 44, 00165, Rome, Italy; Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), 98164, Messina, Italy.
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24
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Yuzlu V, Oguz S, Timurtas E, Aykutoglu E, Polat MG. The Effect of 2 Different Dual-Task Balance Training Methods on Balance and Gait in Older Adults: A Randomized Controlled Trial. Phys Ther 2022; 102:6481184. [PMID: 34972869 DOI: 10.1093/ptj/pzab298] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 08/21/2021] [Accepted: 11/09/2021] [Indexed: 02/09/2023]
Abstract
OBJECTIVE The purpose of this study was to compare the effects of integrated and consecutive cognitive dual-task balance training in older adults on balance, fear of falling, and gait performance. METHODS Fifty-eight participants (age >65 years) were randomly assigned to an integrated dual-task training group (IDTT) (n = 29) and consecutive dual-task training group (CDTT) (n = 29). Balance exercises and cognitive tasks were performed simultaneously by the IDTT group and consecutively by the CDTT group for 8 weeks. Balance was assessed using the Berg Balance Scale as a primary outcome measure and the Timed "Up & Go" Test (TUG) (standard-cognitive), fear of falling was assessed using the Tinetti Falls Efficacy Scale, and gait speed was assessed using the 10-Meter Walk Test (10MWT) (under single-task and dual-task conditions). All tests were performed before and after the training. RESULTS There was no difference in group-time interaction in the Berg Balance Scale, TUG-standard, 10MWT-single task, and 10MWT-dual task tests. Group-time interaction was different in the TUG-cognitive and Tinetti Falls Efficacy Scale scores. Also, the effect of time was significantly different in all scales except for the 10MWT-single task in both groups. CONCLUSION At the end of the 8-week training period, the impact of integrated and consecutive dual-task balance training on balance and gait performance in older adults was not statistically significantly different. This study suggests that consecutive dual-task balance training can be used as an alternative method to increase balance performance and gait speed in older adults who cannot perform integrated dual-task activities. IMPACT There were no significant differences between the effects of the 2 dual-task training methods on balance and gait speed, suggesting that the consecutive dual-task balance training method can be used to improve the balance and gait of older adults. CDTT can be performed safely and considered as an alternative method for use in many rehabilitation training programs with older adults who cannot perform simultaneous activities.
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Affiliation(s)
- Volkan Yuzlu
- Darussafaka OYH Physical Therapy and Rehabilitation Center, Maltepe\Istanbul, Turkey
| | - Semra Oguz
- Marmara University Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Istanbul, Turkey
| | - Eren Timurtas
- Marmara University Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Istanbul, Turkey
| | - Elcin Aykutoglu
- Darussafaka OYH Physical Therapy and Rehabilitation Center, Maltepe\Istanbul, Turkey
| | - M Gulden Polat
- Marmara University Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Istanbul, Turkey
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Musslick S, Cohen JD. Rationalizing constraints on the capacity for cognitive control. Trends Cogn Sci 2021; 25:757-775. [PMID: 34332856 DOI: 10.1016/j.tics.2021.06.001] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 06/02/2021] [Accepted: 06/02/2021] [Indexed: 12/16/2022]
Abstract
Humans are remarkably limited in: (i) how many control-dependent tasks they can execute simultaneously, and (ii) how intensely they can focus on a single task. These limitations are universal assumptions of most theories of cognition. Yet, a rationale for why humans are subject to these constraints remains elusive. This feature review draws on recent insights from psychology, neuroscience, and machine learning, to suggest that constraints on cognitive control may result from a rational adaptation to fundamental, computational dilemmas in neural architectures. The reviewed literature implies that limitations in multitasking may result from a trade-off between learning efficacy and processing efficiency and that limitations in the intensity of commitment to a single task may reflect a trade-off between cognitive stability and flexibility.
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Affiliation(s)
- Sebastian Musslick
- Princeton Neuroscience Institute, Princeton University, Princeton, NJ 08544, USA.
| | - Jonathan D Cohen
- Princeton Neuroscience Institute, Princeton University, Princeton, NJ 08544, USA; Department of Psychology, Princeton University, Princeton, NJ 08544, USA
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Eigsti IM, Irvine CA. Verbal mediation of theory of mind in verbal adolescents with autism spectrum disorder. LANGUAGE ACQUISITION 2021; 28:195-213. [PMID: 35548704 PMCID: PMC9090211 DOI: 10.1080/10489223.2021.1877705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 01/12/2021] [Indexed: 06/15/2023]
Abstract
This study tests the role of verbal mediation during theory of mind processing in autism spectrum disorder (ASD). Adolescents with ASD or typical development completed a false belief task while simultaneously performing a verbal or nonverbal load task. There was no group difference in false belief accuracy; however, under verbal load, the ASD group was relatively less efficient, with slower reaction times, in false belief compared to true belief trials. Faster false belief task performance under verbal but not nonverbal load was associated with pragmatic language ability for the ASD group only. Results were consistent with the theory that there are two (implicit, nonverbal and explicit, verbal) processes that support cognitive reasoning about other people's minds (Apperly & Butterfill, 2009), and that people with ASD rely more on the explicit system. Verbal mediation may be critical for false belief understanding in individuals with ASD, but not typical development.
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Strobach T, Huestegge L. Structuralist Mental Representation of Dual-action Demands: Mechanisms of Improved Dual-task Performance after Practice in Older Adults. Exp Aging Res 2021; 47:109-130. [PMID: 33446078 DOI: 10.1080/0361073x.2021.1873053] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Aim: The present study was designed to investigate how behavioral (dual-action) demands in dual tasks are mentally represented in older adults and how these representations might contribute to the practice-related improvement of dual-task performance. Three different theoretical representation accounts were empirically tested: a structuralist account, a holistic account, and a contextual change account. The first account assumes that component tasks remain structurally intact when combined with another task while the second account assumes that dual-action requirements in dual tasks are represented holistically and entirely distinct from its component (single-action) requirements. The final account assumes that a change in context (e.g., from single to dual requirement) might generally impede response retrieval, similar to repeating a response when the task context switches. Methods: To address this issue of dual-action representations in older adults, we assessed trial-by-trial effects in a single/dual switch paradigm (involving a randomized mix of single- and dual-task trials within blocks). In detail, we re-analyzed a large set of practice data involving seven sessions, in which an auditory-vocal task was combined with a visual-manual task. Results: At the end of practice, the current results were largely consistent with the structuralist account. Conclusions: We conclude that dual-action requirements in the present dual-task setting are mentally represented in a predominantly structuralist fashion at the end of practice in older adults. The results are discussed in the context of other theories on practice-related mechanisms of improved dual-task performance in this age group.
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Affiliation(s)
- Tilo Strobach
- Department of Psychology, MSH Medical School , Hamburg, Germany
| | - Lynn Huestegge
- Department of Psychology, University of Würzburg , Würzburg, Germany
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Is Training with the N-Back Task More Effective Than with Other Tasks? N-Back vs. Dichotic Listening vs. Simple Listening. JOURNAL OF COGNITIVE ENHANCEMENT 2020. [DOI: 10.1007/s41465-020-00202-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AbstractCognitive training most commonly uses computerized tasks that stimulate simultaneous cognitive processing in two modalities, such as a dual n-back task with visual and auditive stimuli, or on two receptive channels, such as a listening task with dichotically presented stimuli. The present study was designed to compare a dual n-back task and a dichotic listening (DL) task with an active control condition (a simple listening task) and a no-training control condition for their impact on cognitive performance, daily life memory, and mindfulness. One hundred thirty healthy adults aged 18–55 years were randomly assigned to one of the four conditions. The training consisted of twenty 15-min sessions spread across 4 weeks. The results indicated some improvement on episodic memory tasks and a trend for enhanced performance in an untrained working memory (WM) span task following cognitive training relative to the no-training control group. However, the only differential training effects were found for the DL training in increasing choice reaction performance and a trend for self-reported mindfulness. Transfer to measures of fluid intelligence and memory in daily life did not emerge. Additionally, we found links between self-efficacy and n-back training performance and between emotion regulation and training motivation. Our results contribute to the field of WM training by demonstrating that our listening tasks are comparable in effect to a dual n-back task in slightly improving memory. The possibility of improving attentional control and mindfulness through dichotic listening training is promising and deserves further consideration.
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