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Zanto TP, Giannakopoulou A, Gallen CL, Ostrand AE, Younger JW, Anguera-Singla R, Anguera JA, Gazzaley A. Digital rhythm training improves reading fluency in children. Dev Sci 2024; 27:e13473. [PMID: 38193394 DOI: 10.1111/desc.13473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 12/06/2023] [Accepted: 12/11/2023] [Indexed: 01/10/2024]
Abstract
Musical instrument training has been linked to improved academic and cognitive abilities in children, but it remains unclear why this occurs. Moreover, access to instrument training is not always feasible, thereby leaving less fortunate children without opportunity to benefit from such training. Although music-based video games may be more accessible to a broader population, research is lacking regarding their benefits on academic and cognitive performance. To address this gap, we assessed a custom-designed, digital rhythm training game as a proxy for instrument training to evaluate its ability to engender benefits in math and reading abilities. Furthermore, we tested for changes in core cognitive functions related to math and reading to inform how rhythm training may facilitate improved academic abilities. Classrooms of 8-9 year old children were randomized to receive either 6 weeks of rhythm training (N = 32) or classroom instruction as usual (control; N = 21). Compared to the control group, results showed that rhythm training improved reading, but not math, fluency. Assessments of cognition showed that rhythm training also led to improved rhythmic timing and language-based executive function (Stroop task), but not sustained attention, inhibitory control, or working memory. Interestingly, only the improvements in rhythmic timing correlated with improvements in reading ability. Together, these results provide novel evidence that a digital platform may serve as a proxy for musical instrument training to facilitate reading fluency in children, and that such reading improvements are related to enhanced rhythmic timing ability and not other cognitive functions associated with reading performance. RESEARCH HIGHLIGHTS: Digital rhythm training in the classroom can improve reading fluency in 8-9 year old children Improvements in reading fluency were positively correlated with enhanced rhythmic timing ability Alterations in reading fluency were not predicted by changes in other executive functions that support reading A digital platform may be a convenient and cost-effective means to provide musical rhythm training, which in turn, can facilitate academic skills.
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Affiliation(s)
- Theodore P Zanto
- Department of Neurology, University of California-San Francisco, San Francisco, California, USA
- Neuroscape, University of California-San Francisco, San Francisco, California, USA
| | | | - Courtney L Gallen
- Department of Neurology, University of California-San Francisco, San Francisco, California, USA
- Neuroscape, University of California-San Francisco, San Francisco, California, USA
| | - Avery E Ostrand
- Department of Neurology, University of California-San Francisco, San Francisco, California, USA
- Neuroscape, University of California-San Francisco, San Francisco, California, USA
| | - Jessica W Younger
- Department of Neurology, University of California-San Francisco, San Francisco, California, USA
- Neuroscape, University of California-San Francisco, San Francisco, California, USA
| | - Roger Anguera-Singla
- Department of Neurology, University of California-San Francisco, San Francisco, California, USA
- Neuroscape, University of California-San Francisco, San Francisco, California, USA
| | - Joaquin A Anguera
- Department of Neurology, University of California-San Francisco, San Francisco, California, USA
- Neuroscape, University of California-San Francisco, San Francisco, California, USA
- Department of Psychiatry, University of California-San Francisco, San Francisco, California, USA
| | - Adam Gazzaley
- Department of Neurology, University of California-San Francisco, San Francisco, California, USA
- Neuroscape, University of California-San Francisco, San Francisco, California, USA
- Department of Psychiatry, University of California-San Francisco, San Francisco, California, USA
- Department of Physiology, University of California-San Francisco, San Francisco, California, USA
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Becker N, Kim HC, Bright DJ, Williams Iii R, Anguera JA, Arnold EA, Saberi P, Neilands TB, Pollack LM, Tan JY. Acceptability of the LetSync App Wireframes for an mHealth Intervention to Improve HIV Care Engagement and Treatment Among Black Partnered Sexual Minority Men: Findings from In-Depth Qualitative Interviews. JMIR Form Res 2023; 7:e43676. [PMID: 37624634 PMCID: PMC10492169 DOI: 10.2196/43676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 04/15/2023] [Accepted: 04/17/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND HIV disparities continue to be a significant challenge affecting Black sexual minority men in the United States. Inadequate engagement and retention of patients in HIV care has been associated with poor health outcomes. Interventions to improve sustained commitment to HIV care are needed. Mobile health interventions can help facilitate access to and use of HIV health services, particularly among individuals at risk for disengaging with care. OBJECTIVE We designed the LetSync app wireframes for a mobile health intervention using a couple-centered design approach to improve HIV engagement and treatment among Black sexual minority men and their partners. The objective of this study was to gauge future app user interest and elicit feedback to improve the design, development, and usability of the LetSync app. METHODS We conducted in-depth interviews with 24 Black sexual minority men to assess the acceptability of the LetSync app wireframes between May 2020 and January 2021. Participants reviewed the LetSync app wireframes and provided feedback regarding perceived usefulness and interest in future app use and suggestions for improvement. RESULTS Participants indicated interest in the future LetSync app and noted that the wireframes' features were acceptable and usable. In our study, the future LetSync app was frequently referred to as a potential resource that could help facilitate users' engagement in HIV care through the following mechanisms: enable scheduling of appointments and timely reminders for clinic visits; help improve HIV medication adherence; encourage and motivate participants to ask questions to their health care provider and stay engaged in conversations during clinic visits; facilitate effective communication by assisting couples with planning, coordination, and management of daily routines; help participants understand their partner's health needs, including access to and use of health care services; and facilitate participants' ability to improve their relationship skills, partner support, and self-efficacy in managing conflict. In addition to near-universal interest in potential daily app use, study participants indicted that they would recommend the LetSync app to other family members, friends, and people in their social networks who are living with HIV. CONCLUSIONS Our findings revealed considerable interest in future app use for HIV care management, which could possibly increase the chance of the LetSync app being successfully adopted by Black sexual minority men in couples. Owing to its interactive and couple-centered approach, the LetSync app could help improve communication between Black sexual minority men and their partners and health providers. In addition, the LetSync app could provide an acceptable modality for these men to receive support in accessing HIV care services.
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Affiliation(s)
- Nozipho Becker
- Office for Inclusive Excellence, Colorado State University, Fort Collins, CO, United States
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Hyunjin C Kim
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Darius J Bright
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Robert Williams Iii
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Joaquin A Anguera
- Neuroscape, Department of Neurology, University of California San Francisco, San Francisco, CA, United States
| | - Emily A Arnold
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Parya Saberi
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Torsten B Neilands
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Lance M Pollack
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Judy Y Tan
- Center for AIDS Prevention Studies, Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
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Younger JW, O’Laughlin KD, Anguera JA, Bunge SA, Ferrer EE, Hoeft F, McCandliss BD, Mishra J, Rosenberg-Lee M, Gazzaley A, Uncapher MR. Better together: novel methods for measuring and modeling development of executive function diversity while accounting for unity. Front Hum Neurosci 2023; 17:1195013. [PMID: 37554411 PMCID: PMC10405287 DOI: 10.3389/fnhum.2023.1195013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/28/2023] [Indexed: 08/10/2023] Open
Abstract
INTRODUCTION Executive functions (EFs) are linked to positive outcomes across the lifespan. Yet, methodological challenges have prevented precise understanding of the developmental trajectory of their organization. METHODS We introduce novel methods to address challenges for both measuring and modeling EFs using an accelerated longitudinal design with a large, diverse sample of students in middle childhood (N = 1,286; ages 8 to 14). We used eight adaptive assessments hypothesized to measure three EFs, working memory, context monitoring, and interference resolution. We deployed adaptive assessments to equate EF challenge across ages and a data-driven, network analytic approach to reveal the evolving diversity of EFs while simultaneously accounting for their unity. RESULTS AND DISCUSSION Using this methodological paradigm shift brought new precision and clarity to the development of these EFs, showing these eight tasks are organized into three stable components by age 10, but refinement of composition of these components continues through at least age 14.
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Affiliation(s)
- Jessica Wise Younger
- Neuroscape, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Kristine D. O’Laughlin
- Neuroscape, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Joaquin A. Anguera
- Neuroscape, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Silvia A. Bunge
- Department of Psychology & Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, United States
| | - Emilio E. Ferrer
- Department of Psychology, University of California, Davis, Davis, CA, United States
| | - Fumiko Hoeft
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
- Department of Psychological Sciences and Brain Imaging Research Center (BIRC), University of Connecticut, Storrs, CT, United States
| | - Bruce D. McCandliss
- Graduate School of Education, Stanford University, Stanford, CA, United States
| | - Jyoti Mishra
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
- Neural Engineering & Translation Labs, University of California San Diego, La Jolla, CA, United States
| | | | - Adam Gazzaley
- Neuroscape, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Department of Psychiatry and Physiology, University of California, San Francisco, San Francisco, CA, United States
| | - Melina R. Uncapher
- Neuroscape, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Advanced Education Research and Development Fund, Oakland, CA, United States
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Simon AJ, Gallen CL, Ziegler DA, Mishra J, Marco EJ, Anguera JA, Gazzaley A. Quantifying attention span across the lifespan. Front Cognit 2023; 2:1207428. [PMID: 37920687 PMCID: PMC10621754 DOI: 10.3389/fcogn.2023.1207428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Introduction Studies examining sustained attention abilities typically utilize metrics that quantify performance on vigilance tasks, such as response time and response time variability. However, approaches that assess the duration that an individual can maintain their attention over time are lacking. Methods Here we developed an objective attention span metric that quantified the maximum amount of time that a participant continuously maintained an optimal "in the zone" sustained attention state while performing a continuous performance task. Results In a population of 262 individuals aged 7-85, we showed that attention span was longer in young adults than in children and older adults. Furthermore, declines in attention span over time during task engagement were related to clinical symptoms of inattention in children. Discussion These results suggest that quantifying attention span is a unique and meaningful method of assessing sustained attention across the lifespan and in populations with inattention symptoms.
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Affiliation(s)
- Alexander J. Simon
- Neuroscape Center, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
- Weill Institute for Neurosciences & Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Courtney L. Gallen
- Neuroscape Center, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
- Weill Institute for Neurosciences & Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - David A. Ziegler
- Neuroscape Center, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
- Weill Institute for Neurosciences & Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
| | - Jyoti Mishra
- Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Elysa J. Marco
- Department of Neurodevelopmental Medicine, Cortica Healthcare, San Rafael, CA, United States
- Department of Radiology, University of California, San Francisco, San Francisco, CA, United States
| | - Joaquin A. Anguera
- Neuroscape Center, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
- Weill Institute for Neurosciences & Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Adam Gazzaley
- Neuroscape Center, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
- Weill Institute for Neurosciences & Kavli Institute for Fundamental Neuroscience, University of California, San Francisco, San Francisco, CA, United States
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
- Department of Physiology, University of California, San Francisco, San Francisco, CA, United States
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Gallen CL, Schachtner JN, Anguera-Singla R, Anguera JA, Gazzaley A. Influence of game features on attention in adults. Front Psychol 2023; 14:1123306. [PMID: 37228349 PMCID: PMC10203248 DOI: 10.3389/fpsyg.2023.1123306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 04/06/2023] [Indexed: 05/27/2023] Open
Abstract
Introduction The incorporation of game features into cognitive tasks can inform us about the influence of reward and motivation on attention. Continuous performance tasks (CPTs), designed to assess attention abilities, are examples of cognitive tasks that have been targeted for the addition of game features. However, previous results have been mixed regarding how game elements affect attention abilities and task performance. Methods Here, we studied if there were factors that predict which individuals exhibit changes in attention from game features added to a CPT. Participants (N = 94, aged 21-71) played a traditional CPT and a game CPT with identical mechanics, but featured engaging game elements (aesthetics, storyline, competition, feedback, and reward). Results We first found corroborating evidence that game features have mixed effects on attention performance: most attention metrics of interest exhibited no overall difference between the traditional and game CPT, while game elements reduced performance for a few metrics. Importantly, we also found that specific behavioral and demographic profiles predicted individual differences in performance on the game CPT compared to the traditional CPT. Those with more attention difficulties (ADHD symptoms), more reward responsiveness, and younger adults performed better on the game CPT while, conversely, those with fewer ADHD symptoms, less reward responsiveness, and older adults performed better on the traditional CPT. Discussion These findings provide insights into how game features can influence attention in different individuals and have important implications for the use of game elements in cognitive tasks and training interventions.
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Affiliation(s)
- Courtney L. Gallen
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
- Neuroscape Center, University of California, San Francisco, San Francisco, CA, United States
| | - Jessica N. Schachtner
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
- Neuroscape Center, University of California, San Francisco, San Francisco, CA, United States
- Department of Psychology, University of Arizona, Tucson, AZ, United States
| | - Roger Anguera-Singla
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
- Neuroscape Center, University of California, San Francisco, San Francisco, CA, United States
| | - Joaquin A. Anguera
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
- Neuroscape Center, University of California, San Francisco, San Francisco, CA, United States
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Adam Gazzaley
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
- Neuroscape Center, University of California, San Francisco, San Francisco, CA, United States
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
- Department of Physiology, University of California, San Francisco, San Francisco, CA, United States
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Anguera JA, Rowe MA, Volponi JJ, Elkurdi M, Jurigova B, Simon AJ, Anguera-Singla R, Gallen CL, Gazzaley A, Marco EJ. Author Correction: Enhancing attention in children using an integrated cognitive-physical videogame: A pilot study. NPJ Digit Med 2023; 6:71. [PMID: 37186002 PMCID: PMC10130012 DOI: 10.1038/s41746-023-00826-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Affiliation(s)
- J A Anguera
- Neuroscape Center, Department of Neurology, University of California, San Francisco, USA.
- Department of Psychiatry, University of California, San Francisco, USA.
| | - M A Rowe
- Department of Neurodevelopmental Medicine, Cortica Healthcare, San Rafael, USA
| | - J J Volponi
- Neuroscape Center, Department of Neurology, University of California, San Francisco, USA
- Department of Psychiatry, University of California, San Francisco, USA
| | - M Elkurdi
- Department of Neurodevelopmental Medicine, Cortica Healthcare, San Rafael, USA
| | - B Jurigova
- Department of Psychiatry, University of California, San Francisco, USA
| | - A J Simon
- Neuroscape Center, Department of Neurology, University of California, San Francisco, USA
- Department of Psychiatry, University of California, San Francisco, USA
| | - R Anguera-Singla
- Neuroscape Center, Department of Neurology, University of California, San Francisco, USA
- Department of Psychiatry, University of California, San Francisco, USA
| | - C L Gallen
- Neuroscape Center, Department of Neurology, University of California, San Francisco, USA
| | - A Gazzaley
- Neuroscape Center, Department of Neurology, University of California, San Francisco, USA
- Department of Psychiatry, University of California, San Francisco, USA
| | - E J Marco
- Department of Neurodevelopmental Medicine, Cortica Healthcare, San Rafael, USA
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Anguera JA, Rowe MA, Volponi JJ, Elkurdi M, Jurigova B, Simon AJ, Anguera-Singla R, Gallen CL, Gazzaley A, Marco EJ. Enhancing attention in children using an integrated cognitive-physical videogame: A pilot study. NPJ Digit Med 2023; 6:65. [PMID: 37046040 PMCID: PMC10097690 DOI: 10.1038/s41746-023-00812-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/27/2023] [Indexed: 04/14/2023] Open
Abstract
Inattention can negatively impact several aspects of a child's life, including at home and school. Cognitive and physical interventions are two promising non-pharmaceutical approaches used to enhance attention abilities, with combined approaches often being marketed to teachers, therapists, and parents typically without research validation. Here, we assessed the feasibility of incorporating an integrated, cognitive-physical, closed-loop video game (body-brain trainer or 'BBT') as an after-school program, and also evaluated if there were attention benefits following its use. Twenty-two children (7-12 years of age) with a range of attention abilities were recruited to participate in this proof of concept, single-arm, longitudinal study (24 sessions over 8 weeks, ~30 min/day). We interrogated attention abilities through a parent survey of their child's behaviors, in addition to objective performance-based and neural measures of attention. Here we observed 95% compliance as well as, significant improvements on the parent-based reports of inattention and on cognitive tests and neural measures of attention that were comparable in scale to previous work. Exploratory measures of other cognitive control abilities and physical fitness also showed similar improvement, with exploratory evaluation of retained benefits on the primary attention-related outcomes being present 1-year later. Lastly, there was no correlation between the baseline parent-rated inattention score and the improvement on the primary task-based measures of attention, suggesting that intervention-based benefits were not solely attained by those who stood the most to gain. These pilot findings warrant future research to replicate and extend these findings.
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Affiliation(s)
- J A Anguera
- Neuroscape Center, Department of Neurology, University of California, San Francisco, USA.
- Department of Psychiatry, University of California, San Francisco, USA.
| | - M A Rowe
- Department of Neurodevelopmental Medicine, Cortica Healthcare, San Rafael, USA
| | - J J Volponi
- Neuroscape Center, Department of Neurology, University of California, San Francisco, USA
- Department of Psychiatry, University of California, San Francisco, USA
| | - M Elkurdi
- Department of Neurodevelopmental Medicine, Cortica Healthcare, San Rafael, USA
| | - B Jurigova
- Department of Psychiatry, University of California, San Francisco, USA
| | - A J Simon
- Neuroscape Center, Department of Neurology, University of California, San Francisco, USA
- Department of Psychiatry, University of California, San Francisco, USA
| | - R Anguera-Singla
- Neuroscape Center, Department of Neurology, University of California, San Francisco, USA
- Department of Psychiatry, University of California, San Francisco, USA
| | - C L Gallen
- Neuroscape Center, Department of Neurology, University of California, San Francisco, USA
| | - A Gazzaley
- Neuroscape Center, Department of Neurology, University of California, San Francisco, USA
- Department of Psychiatry, University of California, San Francisco, USA
| | - E J Marco
- Department of Neurodevelopmental Medicine, Cortica Healthcare, San Rafael, USA
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Hsu WY, Anguera JA, Rizzo A, Campusano R, Chiaravalloti ND, DeLuca J, Gazzaley A, Bove RM. A virtual reality program to assess cognitive function in multiple sclerosis: A pilot study. Front Hum Neurosci 2023; 17:1139316. [PMID: 37007676 PMCID: PMC10060881 DOI: 10.3389/fnhum.2023.1139316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/17/2023] [Indexed: 03/18/2023] Open
Abstract
Introduction: Cognitive impairment is a debilitating symptom in people with multiple sclerosis (MS). Most of the neuropsychological tasks have little resemblance to everyday life. There is a need for ecologically valid tools for assessing cognition in real-life functional contexts in MS. One potential solution would involve the use of virtual reality (VR) to exert finer control over the task presentation environment; however, VR studies in the MS population are scarce.Objectives: To explore the utility and feasibility of a VR program for cognitive assessment in MS.Methods: A VR classroom embedded with a continuous performance task (CPT) was assessed in 10 non-MS adults and 10 people with MS with low cognitive functioning. Participants performed the CPT with distractors (i.e., WD) and without distractors (i.e., ND). The Symbol Digit Modalities Test (SDMT), California Verbal Learning Test—II (CVLT-II), and a feedback survey on the VR program was administered.Results: People with MS exhibited greater reaction time variability (RTV) compared to non-MS participants, and greater RTV in both WD and ND conditions was associated with lower SDMT.Conclusions: VR tools warrant further research to determine their value as an ecologically valid platform for assessing cognition and everyday functioning in people with MS.
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Affiliation(s)
- Wan-Yu Hsu
- Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Joaquin A. Anguera
- Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Neuroscape, University of California, San Francisco, San Francisco, CA, United States
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Albert Rizzo
- Institute for Creative Studies, University of Southern California, Los Angeles, CA, United States
| | - Richard Campusano
- Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Neuroscape, University of California, San Francisco, San Francisco, CA, United States
| | - Nancy D. Chiaravalloti
- Kessler Foundation, East Hanover, NJ, United States
- Department of Physical Medicine & Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, United States
| | - John DeLuca
- Kessler Foundation, East Hanover, NJ, United States
- Department of Physical Medicine & Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, United States
| | - Adam Gazzaley
- Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
- Neuroscape, University of California, San Francisco, San Francisco, CA, United States
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
- Department of Physiology, University of California, San Francisco, San Francisco, CA, United States
| | - Riley M. Bove
- Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
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Oppegaard KR, Mayo SJ, Armstrong TS, Anguera JA, Kober KM, Miaskowski C. The Multifactorial Model of Cancer-Related Cognitive Impairment. Oncol Nurs Forum 2023; 50:135-147. [PMID: 37677800 DOI: 10.1188/23.onf.135-147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
PROBLEM IDENTIFICATION Cancer-related cognitive impairment (CRCI) is common and is associated with cancer and its treatments. Evidence suggests that the causes are multifactorial, but the field is lacking a comprehensive conceptual model of CRCI to summarize existing knowledge and provide a way to understand and predict causal links, as well as to generate hypotheses. LITERATURE SEARCH PubMed® and Google Scholar™ were searched, and 130 articles demonstrated several lacking factors needed for a more comprehensive CRCI model. DATA EVALUATION The new multifactorial model of CRCI includes social determinants of health, patient-specific factors, co-occurring symptoms, treatment factors, and biologic mechanisms. SYNTHESIS The multifactorial model of CRCI is based on established and emerging evidence. This model is inclusive of all cancer types and associated treatments. IMPLICATIONS FOR NURSING Although it would be ideal to evaluate all the concepts and components in this model in a comprehensive fashion, investigators with existing datasets could evaluate portions of the model to determine directionality for some of the proposed relationships. The new model can be used to design preclinical and clinical studies of CRCI. Knowledge of the occurrence of CRCI and factors that contribute to this symptom will allow nurses to perform assessments of modifiable and nonmodifiable risk factors.
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Gallen CL, Schaerlaeken S, Younger JW, Anguera JA, Gazzaley A. Contribution of sustained attention abilities to real-world academic skills in children. Sci Rep 2023; 13:2673. [PMID: 36792755 PMCID: PMC9932079 DOI: 10.1038/s41598-023-29427-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 02/03/2023] [Indexed: 02/17/2023] Open
Abstract
Sustained attention is a critical cognitive ability that improves over the course of development and predicts important real-world outcomes, such as academic achievement. However, the majority of work demonstrating links between sustained attention and academic skills has been conducted in lab-based settings that lack the ecological validity of a more naturalistic environment, like school. Further, most studies focus on targeted academic measures of specific sub-skills and have not fully examined whether this relationship generalizes to broad measures of academic achievement that are used for important, real-world, academic advancement decisions, such as standardized test scores. To address this gap, we examined the role of sustained attention in predicting targeted and broad assessments of academic abilities, where all skills were assessed in group-based environments in schools. In a sample of over 700 students aged 9-14, we showed that attention was positively related to performance on targeted assessments (math fluency and reading comprehension), as well as broad academic measures (statewide standardized test scores). Moreover, we found that attention was more predictive of targeted math sub-skills compared to assessments of broad math abilities, but was equally predictive of reading for both types of measures. Our findings add to our understanding of how sustained attention is linked to academic skills assessed in more 'real-world', naturalistic school environments and have important implications for designing tools to support student's academic success.
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Affiliation(s)
- Courtney L. Gallen
- grid.266102.10000 0001 2297 6811Department of Neurology, University of California San Francisco, San Francisco, CA 94158 USA ,grid.266102.10000 0001 2297 6811Neuroscape, University of California San Francisco, San Francisco, CA 94158 USA
| | - Simon Schaerlaeken
- grid.266102.10000 0001 2297 6811Department of Neurology, University of California San Francisco, San Francisco, CA 94158 USA ,grid.266102.10000 0001 2297 6811Neuroscape, University of California San Francisco, San Francisco, CA 94158 USA
| | - Jessica W. Younger
- grid.266102.10000 0001 2297 6811Department of Neurology, University of California San Francisco, San Francisco, CA 94158 USA ,grid.266102.10000 0001 2297 6811Neuroscape, University of California San Francisco, San Francisco, CA 94158 USA
| | | | - Joaquin A. Anguera
- grid.266102.10000 0001 2297 6811Department of Neurology, University of California San Francisco, San Francisco, CA 94158 USA ,grid.266102.10000 0001 2297 6811Neuroscape, University of California San Francisco, San Francisco, CA 94158 USA ,grid.266102.10000 0001 2297 6811Department of Psychiatry, University of California San Francisco, San Francisco, CA 94158 USA
| | - Adam Gazzaley
- Department of Neurology, University of California San Francisco, San Francisco, CA, 94158, USA. .,Neuroscape, University of California San Francisco, San Francisco, CA, 94158, USA. .,Department of Psychiatry, University of California San Francisco, San Francisco, CA, 94158, USA. .,Department of Physiology, University of California San Francisco, San Francisco, CA, 94158, USA.
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11
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Oppegaard KR, Armstrong TS, Anguera JA, Kober KM, Debr LK, Laister RC, Saligan LN, Ayala AP, Kuruvilla J, Alm MW, Byker WH, Miaskowski C, Mayo SJ. Blood-Based Biomarkers of Cancer-Related Cognitive Impairment in Non-Central Nervous System Cancer: A Scoping Review. Crit Rev Oncol Hematol 2022; 180:103822. [PMID: 36152911 DOI: 10.1016/j.critrevonc.2022.103822] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/17/2022] [Accepted: 09/19/2022] [Indexed: 11/24/2022] Open
Abstract
This scoping review was designed to synthesize the extant literature on associations between subjective and/or objective measures of cancer-related cognitive impairment (CRCI) and blood-based biomarkers in adults with non-central nervous system cancers. The literature search was done for studies published from the start of each database searched (i.e., MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, grey literature) through to October 20, 2021. A total of 95 studies are included in this review. Of note, a wide variety of biomarkers were evaluated. Most studies evaluated patients with breast cancer. A variety of cognitive assessment measures were used. The most consistent significant findings were with various subjective and objective measures of CRCI and levels of interleukin-6 and tumor necrosis factor. Overall, biomarker research is in an exploratory phase. However, this review synthesizes findings and proposes directions for future research.
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Affiliation(s)
- Kate R Oppegaard
- University of California San Francisco, School of Nursing, Department of Physiological Nursing, USA
| | - Terri S Armstrong
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, USA
| | - Joaquin A Anguera
- University of California San Francisco, Department of Neurology and Psychiatry, USA
| | - Kord M Kober
- University of California San Francisco, School of Nursing, Department of Physiological Nursing, USA
| | - Lynch Kelly Debr
- University of Florida, College of Nursing, USA; University of Florida Health Cancer Center, USA
| | - Rob C Laister
- Princess Margaret Health Center, University Health Network, Canada
| | - Leorey N Saligan
- Symptoms Biology Unit, Division of Intramural Research, National Institutes of Health, USA
| | | | - John Kuruvilla
- Princess Margaret Health Center, University Health Network, Canada
| | - Mark W Alm
- Toronto General Hospital, University Health Network, Canada
| | | | - Christine Miaskowski
- University of California San Francisco, School of Medicine, Department of Anesthesia and Perioperative Care, USA
| | - Samantha J Mayo
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Canada.
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12
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Pratap A, Homiar A, Waninger L, Herd C, Suver C, Volponi J, Anguera JA, Areán P. Real-world behavioral dataset from two fully remote smartphone-based randomized clinical trials for depression. Sci Data 2022; 9:522. [PMID: 36030226 PMCID: PMC9420101 DOI: 10.1038/s41597-022-01633-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/15/2022] [Indexed: 11/09/2022] Open
Abstract
Most people with mental health disorders cannot receive timely and evidence-based care despite billions of dollars spent by healthcare systems. Researchers have been exploring using digital health technologies to measure behavior in real-world settings with mixed results. There is a need to create accessible and computable digital mental health datasets to advance inclusive and transparently validated research for creating robust real-world digital biomarkers of mental health. Here we share and describe one of the largest and most diverse real-world behavior datasets from over two thousand individuals across the US. The data were generated as part of the two NIMH-funded randomized clinical trials conducted to assess the effectiveness of delivering mental health care continuously remotely. The longitudinal dataset consists of self-assessment of mood, depression, anxiety, and passively gathered phone-based behavioral data streams in real-world settings. This dataset will provide a timely and long-term data resource to evaluate analytical approaches for developing digital behavioral markers and understand the effectiveness of mental health care delivered continuously and remotely.
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Affiliation(s)
- Abhishek Pratap
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada. .,Department of Psychiatry, University of Toronto, Toronto, ON, Canada. .,Vector Institute for Artificial Intelligence, Toronto, ON, Canada. .,Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK. .,Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, USA.
| | - Ava Homiar
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada.,School of Interdisciplinary Science, McMaster University, Hamilton, ON, Canada
| | - Luke Waninger
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, USA
| | - Calvin Herd
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | | | - Joshua Volponi
- Department of Neurology, University of California San Francisco, San Francisco, WA, USA
| | - Joaquin A Anguera
- Department of Neurology, University of California San Francisco, San Francisco, WA, USA
| | - Pat Areán
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, USA
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13
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Tsirmpas C, Andrikopoulos D, Fatouros P, Eleftheriou G, Anguera JA, Kontoangelos K, Papageorgiou C. Feasibility, engagement, and preliminary clinical outcomes of a digital biodata-driven intervention for anxiety and depression. Front Digit Health 2022; 4:868970. [PMID: 35958737 PMCID: PMC9359094 DOI: 10.3389/fdgth.2022.868970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 06/29/2022] [Indexed: 11/26/2022] Open
Abstract
Hypothesis The main hypothesis is that a digital, biodata-driven, and personalized program would exhibit high user retention and engagement, followed by more effective management of their depressive and anxiety symptoms. Objective This pilot study explores the feasibility, acceptability, engagement, and potential impact on depressive and anxiety and quality of life outcomes of the 16-week Feel Program. Additionally, it examines potential correlations between engagement and impact on mental health outcomes. Methods This single-arm study included 48 adult participants with mild or moderate depressive or anxiety symptoms who joined the 16-week Feel Program, a remote biodata-driven mental health support program created by Feel Therapeutics. The program uses a combination of evidence-based approaches and psychophysiological data. Candidates completed an online demographics and eligibility survey before enrolment. Depressive and anxiety symptoms were measured using the Patient Health Questionnaire and Generalized Anxiety Disorder Scale, respectively. The Satisfaction with Life Scale and the Life Satisfaction Questionnaire were used to assess quality of life. User feedback surveys were employed to evaluate user experience and acceptability. Results In total, 31 participants completed the program with an overall retention rate of 65%. Completed participants spent 60 min in the app, completed 13 Mental Health Actions, including 5 Mental Health Exercises and 4.9 emotion logs on a weekly basis. On average, 96% of the completed participants were active and 76.8% of them were engaged with the sensor during the week. Sixty five percent of participants reported very or extremely high satisfaction, while 4 out of 5 were very likely to recommend the program to someone. Additionally, 93.5% of participants presented a decrease in at least one of the depressive or anxiety symptoms, with 51.6 and 45% of participants showing clinically significant improvement, respectively. Finally, our findings suggest increased symptom improvement for participants with higher engagement throughout the program. Conclusions The findings suggest that the Feel Program may be feasible, acceptable, and valuable for adults with mild or moderate depressive and/or anxiety symptoms. However, controlled trials with bigger sample size, inclusion of a control group, and more diverse participant profiles are required in order to provide further evidence of clinical efficacy.
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Affiliation(s)
- Charalampos Tsirmpas
- Feel Therapeutics Inc., San Francisco, CA, United States
- *Correspondence: Charalampos Tsirmpas
| | | | | | | | - Joaquin A. Anguera
- Departments of Neurology and Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Konstantinos Kontoangelos
- First Department of Psychiatry, Eginition Hospital, Medical School National and Kapodistrian University of Athens, Athens, Greece
- Neurosciences and Precision Medicine Research Institute “Costas Stefanis”, University Mental Health, Athens, Greece
| | - Charalabos Papageorgiou
- Neurosciences and Precision Medicine Research Institute “Costas Stefanis”, University Mental Health, Athens, Greece
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14
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Ziegler DA, Anguera JA, Gallen CL, Hsu WY, Wais PE, Gazzaley A. Leveraging technology to personalize cognitive enhancement methods in aging. Nat Aging 2022; 2:475-483. [PMID: 35873177 PMCID: PMC9302894 DOI: 10.1038/s43587-022-00237-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
As population aging advances at an increasing rate, efforts to help people maintain or improve cognitive function late in life are critical. Although some studies have shown promise, the question of whether cognitive training is an effective tool for improving general cognitive ability remains incompletely explored, and study results to date have been inconsistent. Most approaches to cognitive enhancement in older adults have taken a 'one size fits all' tack, as opposed to tailoring interventions to the specific needs of individuals. In this Perspective, we argue that modern technology has the potential to enable large-scale trials of public health interventions to enhance cognition in older adults in a personalized manner. Technology-based cognitive interventions that rely on closed-loop systems can be tailored to individuals in real time and have the potential for global testing, extending their reach to large and diverse populations of older adults. We propose that the future of cognitive enhancement in older adults will rely on harnessing new technologies in scientifically informed ways.
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Affiliation(s)
- David A. Ziegler
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
- Neuroscape, University of California San Francisco, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
- Correspondence should be addressed to David A. Ziegler or Adam Gazzaley. ;
| | - Joaquin A. Anguera
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
- Neuroscape, University of California San Francisco, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Courtney L. Gallen
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
- Neuroscape, University of California San Francisco, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Wan-Yu Hsu
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Peter E. Wais
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
- Neuroscape, University of California San Francisco, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Adam Gazzaley
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
- Neuroscape, University of California San Francisco, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
- Department of Physiology, University of California San Francisco, San Francisco, CA, USA
- Correspondence should be addressed to David A. Ziegler or Adam Gazzaley. ;
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15
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Hsu WY, Rowles W, Anguera JA, Anderson A, Younger JW, Friedman S, Gazzaley A, Bove R. Assessing Cognitive Function in Multiple Sclerosis With Digital Tools: Observational Study. J Med Internet Res 2021; 23:e25748. [PMID: 34967751 PMCID: PMC8759021 DOI: 10.2196/25748] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/29/2021] [Accepted: 11/16/2021] [Indexed: 01/23/2023] Open
Abstract
Background Cognitive impairment (CI) is one of the most prevalent symptoms of multiple sclerosis (MS). However, it is difficult to include cognitive assessment as part of MS standard care since the comprehensive neuropsychological examinations are usually time-consuming and extensive. Objective To improve access to CI assessment, we evaluated the feasibility and potential assessment sensitivity of a tablet-based cognitive battery in patients with MS. Methods In total, 53 participants with MS (24 [45%] with CI and 29 [55%] without CI) and 24 non-MS participants were assessed with a tablet-based cognitive battery (Adaptive Cognitive Evaluation [ACE]) and standard cognitive measures, including the Symbol Digit Modalities Test (SDMT) and the Paced Auditory Serial Addition Test (PASAT). Associations between performance in ACE and the SDMT/PASAT were explored, with group comparisons to evaluate whether ACE modules can capture group-level differences. Results Correlations between performance in ACE and the SDMT (R=–0.57, P<.001), as well as PASAT (R=–0.39, P=.01), were observed. Compared to non-MS and non-CI MS groups, the CI MS group showed a slower reaction time (CI MS vs non-MS: P<.001; CI MS vs non-CI MS: P=.004) and a higher attention cost (CI MS vs non-MS: P=.02; CI MS vs non-CI MS: P<.001). Conclusions These results provide preliminary evidence that ACE, a tablet-based cognitive assessment battery, provides modules that could potentially serve as a digital cognitive assessment for people with MS. Trial Registration ClinicalTrials.gov NCT03569618; https://clinicaltrials.gov/ct2/show/NCT03569618
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Affiliation(s)
- Wan-Yu Hsu
- Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States
| | - William Rowles
- Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States
| | - Joaquin A Anguera
- Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States.,Neuroscape, University of California, San Francisco, CA, United States.,Department of Psychiatry, University of California, San Francisco, CA, United States
| | - Annika Anderson
- Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States
| | - Jessica W Younger
- Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States.,Neuroscape, University of California, San Francisco, CA, United States
| | - Samuel Friedman
- Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States
| | - Adam Gazzaley
- Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States.,Neuroscape, University of California, San Francisco, CA, United States.,Department of Psychiatry, University of California, San Francisco, CA, United States.,Department of Physiology, University of California, San Francisco, CA, United States
| | - Riley Bove
- Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States
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16
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Li G, McGill M, Brewster S, Chen CP, Anguera JA, Gazzaley A, Pollick F. Multimodal Biosensing for Vestibular Network-Based Cybersickness Detection. IEEE J Biomed Health Inform 2021; 26:2469-2480. [PMID: 34882567 DOI: 10.1109/jbhi.2021.3134024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Virtual reality (VR) has the potential to induce cybersickness (CS), which impedes CS-susceptible VR users from the benefit of emerging VR applications. To better detect CS, the current study investigated whether/how the newly proposed human vestibular network (HVN) is involved in flagship consumer VR-induced CS by simultaneously recording autonomic physiological signals as well as neural signals generated in sensorimotor and cognitive domains. The VR stimuli were made up of one or two moderate CS-inducing entertaining task(s) as well as a mild CS-inducing cognitive task implemented before and after the moderate CS task(s). Results not only showed that CS impaired cognitive control ability, represented by the degree of attentional engagement, but also revealed that combined indicators from all three HVN domains could together establish the best regression relationship with CS ratings. More importantly, we found that every HVN domain had its unique advantage with the dynamic changes in CS severity and time. These results provide evidence for involvement of the HVN in CS and indicate the necessity of HVN-based CS detection.
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17
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Oppegaard K, Harris CS, Shin J, Paul SM, Cooper BA, Chan A, Anguera JA, Levine J, Conley Y, Hammer M, Miaskowski CA, Chan RJ, Kober KM. Cancer-related cognitive impairment is associated with perturbations in inflammatory pathways. Cytokine 2021; 148:155653. [PMID: 34388477 PMCID: PMC10792770 DOI: 10.1016/j.cyto.2021.155653] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 02/06/2023]
Abstract
Cancer-related cognitive impairment (CRCI) is a significant problem for patients receiving chemotherapy. While a growing amount of pre-clinical and clinical evidence suggests that inflammatory mechanisms underlie CRCI, no clinical studies have evaluated for associations between CRCI and changes in gene expression. Therefore, the purpose of this study was to evaluate for differentially expressed genes and perturbed inflammatory pathways across two independent samples of patients with cancer who did and did not report CRCI. The Attentional Function Index (AFI) was the self-report measure used to assess CRCI. AFI scores of <5 and of >7.5 indicate low versus high levels of cognitive function, respectively. Of the 185 patients in Sample 1, 49.2% had an AFI score of <5 and 50.8% had an AFI score of >7.5. Of the 158 patients in Sample 2, 50.6% had an AFI score of <5 and 49.4% had an AFI score of >7.5. Data from 182 patients in Sample 1 were analyzed using RNA-seq. Data from 158 patients in Sample 2 were analyzed using microarray. Twelve KEGG signaling pathways were significantly perturbed between the AFI groups, five of which were signaling pathways related to inflammatory mechanisms (e.g., cytokine-cytokine receptor interaction, tumor necrosis factor signaling). This study is the first to describe perturbations in inflammatory pathways associated with CRCI. Findings highlight the role of cytokines both in terms of cytokine-specific pathways, as well as pathways involved in cytokine production and cytokine activation. These findings have the potential to identify new targets for therapeutics and lead to the development of interventions to improve cognition in patients with cancer.
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Affiliation(s)
- Kate Oppegaard
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA 94143-0610, USA.
| | - Carolyn S Harris
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA 94143-0610, USA.
| | - Joosun Shin
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA 94143-0610, USA.
| | - Steven M Paul
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA 94143-0610, USA.
| | - Bruce A Cooper
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA 94143-0610, USA.
| | - Alexandre Chan
- School of Pharmacy and Pharmaceutical Sciences, University of California Irvine, 147B Bison Modular, Irvine, CA 92697, USA.
| | - Joaquin A Anguera
- School of Medicine, University of California, 675 Nelson Rising Lane, San Francisco, CA 94158, USA.
| | - Jon Levine
- School of Medicine, University of California, 675 Nelson Rising Lane, San Francisco, CA 94158, USA; School of Dentistry, University of California, 513 Parnassus Ave, MSB, San Francisco, CA 94117, USA.
| | - Yvette Conley
- School of Nursing, University of Pittsburgh, 440 Victoria Building, 3500 Victoria Street, Pittsburgh, PA 15261, USA.
| | - Marilyn Hammer
- Dana-Farber Cancer Institute, 450 Brookline Avenue, LW523, Boston, MA 02215, USA.
| | - Christine A Miaskowski
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA 94143-0610, USA; School of Medicine, University of California, 675 Nelson Rising Lane, San Francisco, CA 94158, USA.
| | - Raymond J Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park SA5042, Australia.
| | - Kord M Kober
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA 94143-0610, USA.
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18
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Gunning FM, Anguera JA, Victoria LW, Areán PA. A digital intervention targeting cognitive control network dysfunction in middle age and older adults with major depression. Transl Psychiatry 2021; 11:269. [PMID: 33947831 PMCID: PMC8096948 DOI: 10.1038/s41398-021-01386-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 04/08/2021] [Accepted: 04/20/2021] [Indexed: 02/03/2023] Open
Abstract
Nonpharmacological interventions targeting putative network mechanisms of major depressive disorder (MDD) may represent novel treatments. This mechanistic study investigates how a video game-like intervention, designed to improve cognitive control network (CCN) functioning by targeting multitasking, influences the CCN of middle-aged and older adults with MDD. The sample consisted of 34 adults aged 45-75 with SCID-defined diagnosis of MDD, Hamilton depression rating scale scores ≥20, and a deficit in cognitive control. Participants were instructed to play at home for 20-25 min per day, at least 5 times per week, for 4 weeks. Evidence of target engagement was defined a priori as >2/3 of participants showing CCN improvement. CCN engagement was defined as a change in a Z score of ≥0.5 on functional magnetic resonance imaging (fMRI) in activation and functional connectivity of the CCN during task-based and resting-state fMRI, respectively. 74% of participants showed a change in activation of the CCN, and 72% showed an increase in resting-state functional connectivity. Sixty-eight percent demonstrated improved cognitive control function, measured as either improvement on sustained attention or working memory performance or reduced self-reported symptoms of apathy on the frontal systems behavioral scale (FrsBe). Participants also reported a significant reduction in mood symptoms measured by PHQ-9. A remotely deployed neuroscience-informed video game-like intervention improves both CCN functions and mood in middle-aged and older adults with MDD. This easily-disseminated intervention may rescue CCN dysfunction present in a substantial subset of middle-aged and older adults with MDD.
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Affiliation(s)
- Faith M. Gunning
- grid.5386.8000000041936877XDepartment of Psychiatry, Weill Cornell Medicine, New York, NY USA
| | - Joaquin A. Anguera
- grid.266102.10000 0001 2297 6811Departments of Neurology and Psychiatry, University of California San Francisco, San Francisco, CA USA
| | - Lindsay W. Victoria
- grid.5386.8000000041936877XDepartment of Psychiatry, Weill Cornell Medicine, New York, NY USA
| | - Patricia A. Areán
- grid.34477.330000000122986657Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA USA
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19
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Anguera JA, Schachtner JN, Simon AJ, Volponi J, Javed S, Gallen CL, Gazzaley A. Long-term maintenance of multitasking abilities following video game training in older adults. Neurobiol Aging 2021; 103:22-30. [PMID: 33789209 DOI: 10.1016/j.neurobiolaging.2021.02.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 02/24/2021] [Accepted: 02/26/2021] [Indexed: 11/18/2022]
Abstract
The use of cognitive interventions to remediate deficient cognitive functions, or to enhance or preserve intact cognitive abilities, has been explored for some time, especially in older adults. However, few studies have investigated the long-term persistence of any positive benefits, with none examining whether changes in functional brain activity persist several years later. Here, we assessed whether enhanced cognitive abilities and potential underlying neural changes attained via the use of a custom-made video game (NeuroRacer) played by older adults (60-85 years old) continued to be elevated beyond control participants 6 years later. The NeuroRacer group continued to show reduced multitasking costs beyond control participants, with a neural signature of cognitive control, midline frontal theta power, also continuing to show heightened activity. However, previously evidenced performance benefits that had extended to untrained cognitive control abilities (i.e., enhanced sustained attention and working memory) did not persist, highlighting sustainability limitations. These findings continue to demonstrate the robust plasticity of the prefrontal cognitive control system in the aging brain, a potential neural mechanism underlying enhanced performance over time, and the possible long-term impact that digital therapeutics can have.
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Affiliation(s)
- Joaquin A Anguera
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA; Neuroscape Center, University of California, San Francisco, CA, USA; Department of Psychiatry, University of California, San Francisco, CA, USA.
| | - Jessica N Schachtner
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA; Neuroscape Center, University of California, San Francisco, CA, USA
| | - Alexander J Simon
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA; Neuroscape Center, University of California, San Francisco, CA, USA
| | - Joshua Volponi
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA; Neuroscape Center, University of California, San Francisco, CA, USA
| | - Samirah Javed
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA; Neuroscape Center, University of California, San Francisco, CA, USA
| | - Courtney L Gallen
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA; Neuroscape Center, University of California, San Francisco, CA, USA
| | - Adam Gazzaley
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, CA, USA; Neuroscape Center, University of California, San Francisco, CA, USA; Department of Psychiatry, University of California, San Francisco, CA, USA; Department of Physiology, University of California, San Francisco, CA, USA
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20
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Jurigova BG, Gerdes MR, Anguera JA, Marco EJ. Sustained benefits of cognitive training in children with inattention, three-year follow-up. PLoS One 2021; 16:e0246449. [PMID: 33539468 PMCID: PMC7861383 DOI: 10.1371/journal.pone.0246449] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 01/19/2021] [Indexed: 11/19/2022] Open
Abstract
The goal of this study was to test for long-term benefits three years after the completion of a cognitive training intervention (Project: EVO™) in a subset of children with Sensory Processing Dysfunction (SPD). Our initial findings revealed that children with SPD who also met research criteria for Attention Deficit Hyperactivity Disorder (SPD+IA) showed a significant decrease in parent-observed inattentive behaviors, which remained stable in a nine-month follow-up assessment. Forty nine caregivers of participants who completed the Project: EVO™ training were contacted to be included in this follow up study. Each was emailed an invitation to complete the Vanderbilt ADHD Diagnostic Parent Rating Scale, which yielded a completion rate of 39/49 (80%). A Generalized Estimating Equations analysis was used to assess changes in symptoms over time, specifically to determine whether the initial improvements were retained. The SPD+IA cohort continued to show sustained benefits on their parent-reported scores of inattention, with 54% of SPD+IA individuals no longer meeting criteria for ADHD three years following intervention. These findings provide initial insights into the potential long-term benefits of a digital health intervention for children with attention-based issues.
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Affiliation(s)
- Barbora G. Jurigova
- Department of Neurology, University of California San Francisco, San Francisco, California, United States of America
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, California, United States of America
| | - Molly R. Gerdes
- Research Division, Cortica Healthcare, San Rafael, California, United States of America
| | - Joaquin A. Anguera
- Department of Neurology, University of California San Francisco, San Francisco, California, United States of America
- Department of Psychiatry, University of California San Francisco, San Francisco, California, United States of America
| | - Elysa J. Marco
- Research Division, Cortica Healthcare, San Rafael, California, United States of America
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21
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Hsu WY, Rowles W, Anguera JA, Zhao C, Anderson A, Alexander A, Sacco S, Henry R, Gazzaley A, Bove R. Correction: Application of an Adaptive, Digital, Game-Based Approach for Cognitive Assessment in Multiple Sclerosis: Observational Study. J Med Internet Res 2021; 23:e27440. [PMID: 33502997 PMCID: PMC7875698 DOI: 10.2196/27440] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 01/25/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
- Wan-Yu Hsu
- Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - William Rowles
- Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Joaquin A Anguera
- Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States.,Neuroscape, University of California, San Francisco, San Francisco, CA, United States.,Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Chao Zhao
- Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Annika Anderson
- Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Amber Alexander
- Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Simone Sacco
- Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Roland Henry
- Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Adam Gazzaley
- Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States.,Neuroscape, University of California, San Francisco, San Francisco, CA, United States.,Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States.,Department of Physiology, University of California, San Francisco, San Francisco, CA, United States
| | - Riley Bove
- Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
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22
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Abstract
Abstract
Some evidence suggests that experiencing a given scenario using virtual reality (VR) may engage greater attentional resources than experiencing the same scenario on a 2D computer monitor. However, the underlying neural processes associated with these VR-related effects, especially those pertaining to current consumer-friendly head-mounted displays of virtual reality (HMD-VR), remain unclear. Here, two experiments were conducted to compare task performance and EEG-based neural metrics captured during a perceptual discrimination task presented on two different viewing platforms. Forty participants (20–25 years old) completed this task using both an HMD-VR and traditional computer monitor in a within-group, randomized design. Although Experiment I (n = 20) was solely behavioral in design, Experiment II (n = 20) utilized combined EEG recordings to interrogate the neural correlates underlying potential performance differences across platforms. These experiments revealed that (1) there was no significant difference in the amount of arousal measured between platforms and (2) selective attention abilities in HMD-VR environment were enhanced from both a behavioral and neural perspective. These findings suggest that the allocation of attentional resources in HMD-VR may be superior to approaches more typically used to assess these abilities (e.g., desktop/laptop/tablet computers with 2D screens).
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Affiliation(s)
- Gang Li
- Shanghai Jiao Tong University
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23
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Bove R, Rowles W, Zhao C, Anderson A, Friedman S, Langdon D, Alexander A, Sacco S, Henry R, Gazzaley A, Feinstein A, Anguera JA. A novel in-home digital treatment to improve processing speed in people with multiple sclerosis: A pilot study. Mult Scler 2020; 27:778-789. [PMID: 32584155 DOI: 10.1177/1352458520930371] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess whether a videogame-like digital treatment is superior to a control in improving processing speed in adults with multiple sclerosis (MS). METHODS Adults with MS and baseline Symbol Digit Modalities Test (SDMT) z-scores between -2 and 0 were enrolled in a double-blind randomized controlled clinical trial. After completing a baseline in-clinic evaluation (Visit 1), they were randomized to complete an in-home, tablet-based videogame-like digital treatment (AKL-T03) or control word game (AKL-T09) for up to 25 minutes/day, 5 days/week, for 6 weeks. A repeat in-clinic evaluation occurred at 6 weeks (Visit 2), and again 8 weeks later to determine persistence of effects (Visit 3). The pre-specified primary outcome was change in SDMT score between Visits 1 and 2. RESULTS SDMT increased at Visit 2 for participants randomized to both AKL-T03 (p < 0.001) and AKL-T09 (p = 0.024). These respective mean improvements were +6.10 and +3.55 (comparison p = 0.21). At Visit 3, 70% of participants randomized to AKL-T03 maintained a clinically meaningful 4+-point increase in SDMT above their baseline, compared with 37% for AKL-T09 (p = 0.038). CONCLUSION This in-home digital intervention resulted in substantial and durable improvements in processing speed. A larger randomized controlled clinical trial is planned. TRIAL REGISTRATION This trial is registered on ClinicalTrials.gov under "NCT03569618," https://clinicaltrials.gov/ct2/show/NCT03569618.
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Affiliation(s)
- Riley Bove
- Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - William Rowles
- Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Chao Zhao
- Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Annika Anderson
- Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Samuel Friedman
- Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | | | - Amber Alexander
- Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Simone Sacco
- Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Roland Henry
- Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Adam Gazzaley
- Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Anthony Feinstein
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada/Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Joaquin A Anguera
- Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
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24
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Kaup AR, Schachtner J, Byers AL, Barnes DE, Anguera JA, Harmell AL, Amaya MP, Gross M, Yaffe K. P1-054: MOBILE COGNITIVE INTERVENTION IN OLDER VETERANS WITH TRAUMATIC BRAIN INJURY: RESULTS FROM THE BRAVE (BRAIN AGING IN VETERANS) TRAINING PILOT STUDY. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Allison R. Kaup
- San Francisco VA Health Care System; San Francisco CA USA
- The Neurology Center of Southern California; Carlsbad CA USA
- University of California, San Francisco; San Francisco CA USA
| | | | - Amy L. Byers
- San Francisco VA Health Care System; San Francisco CA USA
- University of California, San Francisco; San Francisco CA USA
| | - Deborah E. Barnes
- San Francisco VA Health Care System; San Francisco CA USA
- University of California, San Francisco; San Francisco CA USA
| | | | | | - Maria-Paulina Amaya
- San Francisco VA Health Care System; San Francisco CA USA
- The Neurology Center of Southern California; Carlsbad CA USA
| | - Margaret Gross
- San Francisco VA Health Care System; San Francisco CA USA
| | - Kristine Yaffe
- San Francisco VA Health Care System; San Francisco CA USA
- University of California, San Francisco; San Francisco CA USA
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25
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Ziegler DA, Simon AJ, Gallen CL, Skinner S, Janowich JR, Volponi JJ, Rolle CE, Mishra J, Kornfield J, Anguera JA, Gazzaley A. Closed-loop digital meditation improves sustained attention in young adults. Nat Hum Behav 2019; 3:746-757. [PMID: 31160812 PMCID: PMC7534732 DOI: 10.1038/s41562-019-0611-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 04/16/2019] [Indexed: 11/09/2022]
Abstract
Attention is a fundamental cognitive process that is critical for essentially all aspects of higher-order cognition and real-world activities. Younger generations have deeply embraced information technology and multitasking in their personal lives, school and the workplace, creating myriad challenges to their attention. While improving sustained attention in healthy young adults would be beneficial, enhancing this ability has proven notoriously difficult in this age group. Here we show that 6 weeks of engagement with a meditation-inspired, closed-loop software program (MediTrain) delivered on mobile devices led to gains in both sustained attention and working memory in healthy young adults. These improvements were associated with positive changes in key neural signatures of attentional control (frontal theta inter-trial coherence and parietal P3b latency), as measured by electroencephalography. Our findings suggest the utility of delivering aspects of the ancient practice of focused-attention meditation in a modern, technology-based approach and its benefits on enhancing sustained attention.
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Affiliation(s)
- David A Ziegler
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA. .,Neuroscape, University of California San Francisco, San Francisco, CA, USA. .,Weill Institute for Neurosciences & Kavli Institute for Fundamental Neuroscience, University of California San Francisco, San Francisco, CA, USA.
| | - Alexander J Simon
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA.,Neuroscape, University of California San Francisco, San Francisco, CA, USA.,Weill Institute for Neurosciences & Kavli Institute for Fundamental Neuroscience, University of California San Francisco, San Francisco, CA, USA
| | - Courtney L Gallen
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA.,Neuroscape, University of California San Francisco, San Francisco, CA, USA.,Weill Institute for Neurosciences & Kavli Institute for Fundamental Neuroscience, University of California San Francisco, San Francisco, CA, USA
| | - Sasha Skinner
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | | | - Joshua J Volponi
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA.,Neuroscape, University of California San Francisco, San Francisco, CA, USA.,Weill Institute for Neurosciences & Kavli Institute for Fundamental Neuroscience, University of California San Francisco, San Francisco, CA, USA
| | - Camarin E Rolle
- Department of Psychiatry, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Jyoti Mishra
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | | | - Joaquin A Anguera
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA.,Neuroscape, University of California San Francisco, San Francisco, CA, USA.,Weill Institute for Neurosciences & Kavli Institute for Fundamental Neuroscience, University of California San Francisco, San Francisco, CA, USA.,Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Adam Gazzaley
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA. .,Neuroscape, University of California San Francisco, San Francisco, CA, USA. .,Weill Institute for Neurosciences & Kavli Institute for Fundamental Neuroscience, University of California San Francisco, San Francisco, CA, USA. .,Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA. .,Department of Physiology, University of California San Francisco, San Francisco, CA, USA.
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26
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Brandes-Aitken A, Anguera JA, Chang YS, Demopoulos C, Owen JP, Gazzaley A, Mukherjee P, Marco EJ. White Matter Microstructure Associations of Cognitive and Visuomotor Control in Children: A Sensory Processing Perspective. Front Integr Neurosci 2019; 12:65. [PMID: 30692921 PMCID: PMC6339953 DOI: 10.3389/fnint.2018.00065] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 12/11/2018] [Indexed: 01/08/2023] Open
Abstract
Objective: Recent evidence suggests that co-occurring deficits in cognitive control and visuomotor control are common to many neurodevelopmental disorders. Specifically, children with sensory processing dysfunction (SPD), a condition characterized by sensory hyper/hypo-sensitivity, show varying degrees of overlapping attention and visuomotor challenges. In this study, we assess associations between cognitive and visuomotor control abilities among children with and without SPD. In this same context, we also examined the common and unique diffusion tensor imaging (DTI) tracts that may support the overlap of cognitive control and visuomotor control. Method: We collected cognitive control and visuomotor control behavioral measures as well as DTI data in 37 children with SPD and 25 typically developing controls (TDCs). We constructed regressions to assess for associations between behavioral performance and mean fractional anisotropy (FA) in selected regions of interest (ROIs). Results: We observed an association between behavioral performance on cognitive control and visuomotor control. Further, our findings indicated that FA in the anterior limb of the internal capsule (ALIC), the anterior thalamic radiation (ATR), and the superior longitudinal fasciculus (SLF) are associated with both cognitive control and visuomotor control, while FA in the superior corona radiata (SCR) uniquely correlate with cognitive control performance and FA in the posterior limb of the internal capsule (PLIC) and the cerebral peduncle (CP) tract uniquely correlate with visuomotor control performance. Conclusions: These findings suggest that children who demonstrate lower cognitive control are also more likely to demonstrate lower visuomotor control, and vice-versa, regardless of clinical cohort assignment. The overlapping neural tracts, which correlate with both cognitive and visuomotor control suggest a possible common neural mechanism supporting both control-based processes.
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Affiliation(s)
- Annie Brandes-Aitken
- Neuroscape Center, Departments of Neurology, Pediatrics, Physiology, Radiology, and Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Joaquin A Anguera
- Neuroscape Center, Departments of Neurology, Pediatrics, Physiology, Radiology, and Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Yi-Shin Chang
- Neuroscape Center, Departments of Neurology, Pediatrics, Physiology, Radiology, and Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Carly Demopoulos
- Neuroscape Center, Departments of Neurology, Pediatrics, Physiology, Radiology, and Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Julia P Owen
- Neuroscape Center, Departments of Neurology, Pediatrics, Physiology, Radiology, and Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Adam Gazzaley
- Neuroscape Center, Departments of Neurology, Pediatrics, Physiology, Radiology, and Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Pratik Mukherjee
- Neuroscape Center, Departments of Neurology, Pediatrics, Physiology, Radiology, and Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Elysa J Marco
- Neuroscape Center, Departments of Neurology, Pediatrics, Physiology, Radiology, and Psychiatry, University of California, San Francisco, San Francisco, CA, United States
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27
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Pratap A, Atkins DC, Renn BN, Tanana MJ, Mooney SD, Anguera JA, Areán PA. The accuracy of passive phone sensors in predicting daily mood. Depress Anxiety 2019; 36:72-81. [PMID: 30129691 PMCID: PMC8491547 DOI: 10.1002/da.22822] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 04/25/2018] [Accepted: 07/01/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Smartphones provide a low-cost and efficient means to collect population level data. Several small studies have shown promise in predicting mood variability from smartphone-based sensor and usage data, but have not been generalized to nationally recruited samples. This study used passive smartphone data, demographic characteristics, and baseline depressive symptoms to predict prospective daily mood. METHOD Daily phone usage data were collected passively from 271 Android phone users participating in a fully remote randomized controlled trial of depression treatment (BRIGHTEN). Participants completed daily Patient Health Questionnaire-2. A machine learning approach was used to predict daily mood for the entire sample and individual participants. RESULTS Sample-wide estimates showed a marginally significant association between physical mobility and self-reported daily mood (B = -0.04, P < 0.05), but the predictive models performed poorly for the sample as a whole (median R2 ∼ 0). Focusing on individuals, 13.9% of participants showed significant association (FDR < 0.10) between a passive feature and daily mood. Personalized models combining features provided better prediction performance (median area under the curve [AUC] > 0.50) for 80.6% of participants and very strong prediction in a subset (median AUC > 0.80) for 11.8% of participants. CONCLUSIONS Passive smartphone data with current features may not be suited for predicting daily mood at a population level because of the high degree of intra- and interindividual variation in phone usage patterns and daily mood ratings. Personalized models show encouraging early signs for predicting an individual's mood state changes, with GPS-derived mobility being the top most important feature in the present sample.
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Affiliation(s)
- Abhishek Pratap
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington,Sage Bionetworks, Seattle, Washington
| | - David C. Atkins
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, Washington
| | - Brenna N. Renn
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, Washington
| | | | - Sean D. Mooney
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington
| | - Joaquin A. Anguera
- Department of Neurology, University of California, San Francisco (UCSF), San Francisco, California
| | - Patricia A. Areán
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, Washington
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28
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Pratap A, Renn BN, Volponi J, Mooney SD, Gazzaley A, Arean PA, Anguera JA. Using Mobile Apps to Assess and Treat Depression in Hispanic and Latino Populations: Fully Remote Randomized Clinical Trial. J Med Internet Res 2018; 20:e10130. [PMID: 30093372 PMCID: PMC6107735 DOI: 10.2196/10130] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 06/08/2018] [Accepted: 06/10/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Most people with mental health disorders fail to receive timely access to adequate care. US Hispanic/Latino individuals are particularly underrepresented in mental health care and are historically a very difficult population to recruit into clinical trials; however, they have increasing access to mobile technology, with over 75% owning a smartphone. This technology has the potential to overcome known barriers to accessing and utilizing traditional assessment and treatment approaches. OBJECTIVE This study aimed to compare recruitment and engagement in a fully remote trial of individuals with depression who either self-identify as Hispanic/Latino or not. A secondary aim was to assess treatment outcomes in these individuals using three different self-guided mobile apps: iPST (based on evidence-based therapeutic principles from problem-solving therapy, PST), Project Evolution (EVO; a cognitive training app based on cognitive neuroscience principles), and health tips (a health information app that served as an information control). METHODS We recruited Spanish and English speaking participants through social media platforms, internet-based advertisements, and traditional fliers in select locations in each state across the United States. Assessment and self-guided treatment was conducted on each participant's smartphone or tablet. We enrolled 389 Hispanic/Latino and 637 non-Hispanic/Latino adults with mild to moderate depression as determined by Patient Health Questionnaire-9 (PHQ-9) score≥5 or related functional impairment. Participants were first asked about their preferences among the three apps and then randomized to their top two choices. Outcomes were depressive symptom severity (measured using PHQ-9) and functional impairment (assessed with Sheehan Disability Scale), collected over 3 months. Engagement in the study was assessed based on the number of times participants completed active surveys. RESULTS We screened 4502 participants and enrolled 1040 participants from throughout the United States over 6 months, yielding a sample of 348 active users. Long-term engagement surfaced as a key issue among Hispanic/Latino participants, who dropped from the study 2 weeks earlier than their non-Hispanic/Latino counterparts (P<.02). No significant differences were observed for treatment outcomes between those identifying as Hispanic/Latino or not. Although depressive symptoms improved (beta=-2.66, P=.006) over the treatment course, outcomes did not vary by treatment app. CONCLUSIONS Fully remote mobile-based studies can attract a diverse participant pool including people from traditionally underserved communities in mental health care and research (here, Hispanic/Latino individuals). However, keeping participants engaged in this type of "low-touch" research study remains challenging. Hispanic/Latino populations may be less willing to use mobile apps for assessing and managing depression. Future research endeavors should use a user-centered design to determine the role of mobile apps in the assessment and treatment of depression for this population, app features they would be interested in using, and strategies for long-term engagement. TRIAL REGISTRATION Clinicaltrials.gov NCT01808976; https://clinicaltrials.gov/ct2/show/NCT01808976 (Archived by WebCite at http://www.webcitation.org/70xI3ILkz).
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Affiliation(s)
- Abhishek Pratap
- Department of Biomedical Informatics and Medical Education, School of Medicine, University of Washington, Seattle, WA, United States.,Sage Bionetworks, Seattle, WA, United States
| | - Brenna N Renn
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Joshua Volponi
- Department of Neurology, University of California San Francisco, San Francisco, WA, United States.,Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States
| | - Sean D Mooney
- Department of Biomedical Informatics and Medical Education, School of Medicine, University of Washington, Seattle, WA, United States
| | - Adam Gazzaley
- Department of Neurology, University of California San Francisco, San Francisco, WA, United States.,Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States
| | - Patricia A Arean
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Joaquin A Anguera
- Department of Neurology, University of California San Francisco, San Francisco, WA, United States.,Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States
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29
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Bauer AM, Baldwin SA, Anguera JA, Areán PA, Atkins DC. Comparing Approaches to Mobile Depression Assessment for Measurement-Based Care: Prospective Study. J Med Internet Res 2018; 20:e10001. [PMID: 29921564 PMCID: PMC6030575 DOI: 10.2196/10001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 03/26/2018] [Accepted: 03/27/2018] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND To inform measurement-based care, practice guidelines suggest routine symptom monitoring, often on a weekly or monthly basis. Increasingly, patient-provider contacts occur remotely (eg, by telephone and Web-based portals), and mobile health tools can now monitor depressed mood daily or more frequently. However, the reliability and utility of daily ratings are unclear. OBJECTIVE This study aimed to examine the association between a daily depressive symptom measure and the Patient Health Questionnaire-9 (PHQ-9), the most widely adopted depression self-report measure, and compare how well these 2 assessment methods predict patient outcomes. METHODS A total of 547 individuals completed smartphone-based measures, including the Patient Health Questionnaire-2 (PHQ-2) modified for daily administration, the PHQ-9, and the Sheehan Disability Scale. Multilevel factor analyses evaluated the reliability of latent depression based on the PHQ-2 (for repeated measures) between weeks 2 and 4 and its correlation with the PHQ-9 at week 4. Regression models predicted week 8 depressive symptoms and disability ratings with daily PHQ-2 and PHQ-9. RESULTS The daily PHQ-2 and PHQ-9 are highly reliable (range: 0.80-0.88) and highly correlated (r=.80). Findings were robust across demographic groups (age, gender, and ethnic minority status). Daily PHQ-2 and PHQ-9 were comparable in predicting week 8 disability and were independent predictors of week 8 depressive symptoms and disability, though the unique contribution of the PHQ-2 was small in magnitude. CONCLUSIONS Daily completion of the PHQ-2 is a reasonable proxy for the PHQ-9 and is comparable to the PHQ-9 in predicting future outcomes. Mobile assessment methods offer researchers and clinicians reliable and valid new methods for depression assessment that may be leveraged for measurement-based depression care.
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Affiliation(s)
- Amy M Bauer
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Scott A Baldwin
- Department of Psychology, Brigham Young University, Provo, UT, United States
| | - Joaquin A Anguera
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Patricia A Areán
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - David C Atkins
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
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Brandes-Aitken A, Anguera JA, Rolle CE, Desai SS, Demopoulos C, Skinner SN, Gazzaley A, Marco EJ. Characterizing cognitive and visuomotor control in children with sensory processing dysfunction and autism spectrum disorders. Neuropsychology 2018; 32:148-160. [PMID: 29376661 DOI: 10.1037/neu0000404] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Children with autism spectrum disorders (ASD) and sensory processing dysfunction (SPD) are reported to show difficulties involving cognitive and visuomotor control. We sought to determine whether performance on computerized, behavioral measures of cognitive control aimed at assessing selective attention, as well as visuomotor abilities differentiated children with ASD (n = 14), SPD (n = 14) and typically developing controls (TDC; n = 28). METHOD Cognitive control differences were measured by assessing selective attention-based abilities both with and without distracting stimuli, and visuomotor differences were measured by characterizing visuomotor tracking and tracing skills. Performance in cognitive control and visuomotor domains were investigated globally as composite scores, and specifically within each task. RESULTS Our results indicated that though the ASD group showed the most impaired selective attention performance, the SPD group had intermediate abilities-performing above the ASD group but below the TDC group. Furthermore, both the SPD and ASD groups demonstrated equally impaired visuomotor abilities relative to the TDC group. A correlational analysis between cognitive and visuomotor control suggest a relationship between these overlapping control networks. CONCLUSIONS This study supports the importance of direct, phenotypic characterizations of control-based abilities in children with ASD and SPD to personalize characterization and treatment interventions for at-risk children. (PsycINFO Database Record
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Affiliation(s)
| | | | | | | | - Carly Demopoulos
- Department of Radiology & Biomedical Imaging, University of California
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Rolle CE, Anguera JA, Skinner SN, Voytek B, Gazzaley A. Enhancing Spatial Attention and Working Memory in Younger and Older Adults. J Cogn Neurosci 2017; 29:1483-1497. [PMID: 28654361 DOI: 10.1162/jocn_a_01159] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Daily experiences demand both focused and broad allocation of attention for us to interact efficiently with our complex environments. Many types of attention have shown age-related decline, although there is also evidence that such deficits may be remediated with cognitive training. However, spatial attention abilities have shown inconsistent age-related differences, and the extent of potential enhancement of these abilities remains unknown. Here, we assessed spatial attention in both healthy younger and older adults and trained this ability in both age groups for 5 hr over the course of 2 weeks using a custom-made, computerized mobile training application. We compared training-related gains on a spatial attention assessment and spatial working memory task to age-matched controls who engaged in expectancy-matched, active placebo computerized training. Age-related declines in spatial attention abilities were observed regardless of task difficulty. Spatial attention training led to improved focused and distributed attention abilities as well as improved spatial working memory in both younger and older participants. No such improvements were observed in either of the age-matched control groups. Note that these findings were not a function of improvements in simple response time, as basic motoric function did not change after training. Furthermore, when using change in simple response time as a covariate, all findings remained significant. These results suggest that spatial attention training can lead to enhancements in spatial working memory regardless of age.
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Abstract
Sophisticated video games that integrate engaging cognitive training with real-time biosensing and neurostimulation have the potential to optimize cognitive performance in health and disease. We argue that technology development must be paired with rigorous scientific validation and discuss academic and industry opportunities in this field.
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Affiliation(s)
- Jyoti Mishra
- Departments of Neurology and Psychiatry, University of California, San Francisco, San Francisco, CA 00000, USA.
| | - Joaquin A Anguera
- Departments of Neurology and Psychiatry, University of California, San Francisco, San Francisco, CA 00000, USA
| | - Adam Gazzaley
- Departments of Neurology and Psychiatry, University of California, San Francisco, San Francisco, CA 00000, USA; Department of Physiology, University of California, San Francisco, San Francisco, CA 00000, USA.
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Anguera JA, Gunning FM, Areán PA. Improving late life depression and cognitive control through the use of therapeutic video game technology: A proof-of-concept randomized trial. Depress Anxiety 2017; 34:508-517. [PMID: 28052513 PMCID: PMC6093618 DOI: 10.1002/da.22588] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 10/14/2016] [Accepted: 11/14/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Existing treatments for depression are known to have only modest effects, are insufficiently targeted, and are inconsistently utilized, particularly in older adults. Indeed, older adults with impaired cognitive control networks tend to demonstrate poor response to a majority of existing depression interventions. Cognitive control interventions delivered using entertainment software have the potential to not only target the underlying cerebral dysfunction associated with depression, but to do so in a manner that is engaging and engenders adherence to treatment protocol. METHODS In this proof-of-concept trial (Clinicaltrials.gov #: NCT02229188), individuals with late life depression (LLD) (22; 60+ years old) were randomized to either problem solving therapy (PST, n = 10) or a neurobiologically inspired digital platform designed to enhance cognitive control faculties (Project: EVO™, n = 12). Given the overlapping functional neuroanatomy of mood disturbances and executive dysfunction, we explored the impact of an intervention targeting cognitive control abilities, functional disability, and mood in older adults suffering from LLD, and how those outcomes compare to a therapeutic gold standard. RESULTS EVO participants demonstrated similar improvements in mood and self-reported function after 4 weeks of treatment to PST participants. The EVO participants also showed generalization to untrained measures of working memory and attention, as well as negativity bias, a finding not evident in the PST condition. Individuals assigned to EVO demonstrated 100% adherence. CONCLUSIONS This study provides preliminary findings that this therapeutic video game targeting cognitive control deficits may be an efficacious LLD intervention. Future research is needed to confirm these findings.
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Affiliation(s)
- Joaquin A. Anguera
- Department of Neurology, University of California, San Francisco, CA, USA,Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Faith M. Gunning
- Department of Psychiatry, Weil Cornell Medicine, New York, NY, USA
| | - Patricia A. Areán
- Department of Psychiatry and Behavioral Sciences, University of Washington
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Schlosser DA, Campellone TR, Truong B, Anguera JA, Vergani S, Vinogradov S, Arean P. The feasibility, acceptability, and outcomes of PRIME-D: A novel mobile intervention treatment for depression. Depress Anxiety 2017; 34:546-554. [PMID: 28419621 PMCID: PMC5634707 DOI: 10.1002/da.22624] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 03/09/2017] [Accepted: 03/10/2017] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Despite decades of research and development, depression has risen from the fifth to the leading cause of disability in the United States. Barriers to progress in the field are (1) poor access to high-quality care; (2) limited mental health workforce; and (3) few providers trained in the delivery of evidence-based treatments (EBTs). Although mobile platforms are being developed to give consumers greater access to high-quality care, too often these tools do not have empirical support for their effectiveness. In this study, we evaluated PRIME-D, a mobile app intervention that uses social networking, goal setting, and a mental health coach to deliver text-based, EBT's to treat mood symptoms and functioning in adults with depression. METHODS Thirty-six adults with depression remotely participated in PRIME-D over an 8-week period with a 4-week follow-up, with 83% retained over the 12-week course of thestudy. RESULTS On average, participants logged into the app 5 days/week. Depression scores (PHQ-9) significantly improved over time (over 50% reduction), with coach interactions enhancing these effects. Mood-related disability (Sheehan Disability Scale (SDS)) also significantly decreased over time with participants no longer being impaired by their mood symptoms. Overall use of PRIME-D predicted greater gains in functioning. Improvements in mood and functioning were sustained over the 4-week follow-up. CONCLUSIONS Results suggest that PRIME-D is a feasible, acceptable, and effective intervention for adults with depression and that a mobile service delivery model may address the serious public health problem of poor access to high-quality mental health care.
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Affiliation(s)
| | | | | | | | | | - Sophia Vinogradov
- University of California at San Francisco,San Francisco Veterans Affairs Medical Center
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Mah CD, Anguera JA, Gazzaley A, Luke A. 0749 SLEEP LOADING IMPROVES VISUAL SEARCH RESPONSE TIME AND REDUCES FATIGUE IN PROFESSIONAL BASEBALL PLAYERS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Anguera JA, Brandes-Aitken AN, Antovich AD, Rolle CE, Desai SS, Marco EJ. A pilot study to determine the feasibility of enhancing cognitive abilities in children with sensory processing dysfunction. PLoS One 2017; 12:e0172616. [PMID: 28380008 PMCID: PMC5381761 DOI: 10.1371/journal.pone.0172616] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 02/01/2017] [Indexed: 12/31/2022] Open
Abstract
Children with Sensory Processing Dysfunction (SPD) experience incoming information in atypical, distracting ways. Qualitative challenges with attention have been reported in these children, but such difficulties have not been quantified using either behavioral or functional neuroimaging methods. Furthermore, the efficacy of evidence-based cognitive control interventions aimed at enhancing attention in this group has not been tested. Here we present work aimed at characterizing and enhancing attentional abilities for children with SPD. A sample of 38 SPD and 25 typically developing children were tested on behavioral, neural, and parental measures of attention before and after a 4-week iPad-based at-home cognitive remediation program. At baseline, 54% of children with SPD met or exceeded criteria on a parent report measure for inattention/hyperactivity. Significant deficits involving sustained attention, selective attention and goal management were observed only in the subset of SPD children with parent-reported inattention. This subset of children also showed reduced midline frontal theta activity, an electroencephalographic measure of attention. Following the cognitive intervention, only the SPD children with inattention/hyperactivity showed both improvements in midline frontal theta activity and on a parental report of inattention. Notably, 33% of these individuals no longer met the clinical cut-off for inattention, with the parent-reported improvements persisting for 9 months. These findings support the benefit of a targeted attention intervention for a subset of children with SPD, while simultaneously highlighting the importance of having a multifaceted assessment for individuals with neurodevelopmental conditions to optimally personalize treatment.
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Affiliation(s)
- Joaquin A. Anguera
- Department of Neurology, University of California, San Francisco, United States of America
- Department of Psychiatry, University of California, San Francisco, United States of America
- * E-mail:
| | - Anne N. Brandes-Aitken
- Department of Neurology, University of California, San Francisco, United States of America
| | - Ashley D. Antovich
- Department of Neurology, University of California, San Francisco, United States of America
| | - Camarin E. Rolle
- Department of Neurology, University of California, San Francisco, United States of America
| | - Shivani S. Desai
- Department of Neurology, University of California, San Francisco, United States of America
| | - Elysa J. Marco
- Department of Neurology, University of California, San Francisco, United States of America
- Department of Psychiatry, University of California, San Francisco, United States of America
- Department of Pediatrics, University of California, San Francisco, United States of America
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Arean PA, Hallgren KA, Jordan JT, Gazzaley A, Atkins DC, Heagerty PJ, Anguera JA. The Use and Effectiveness of Mobile Apps for Depression: Results From a Fully Remote Clinical Trial. J Med Internet Res 2016; 18:e330. [PMID: 27998876 PMCID: PMC5209607 DOI: 10.2196/jmir.6482] [Citation(s) in RCA: 182] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 11/14/2016] [Accepted: 11/30/2016] [Indexed: 12/26/2022] Open
Abstract
Background Mobile apps for mental health have the potential to overcome access barriers to mental health care, but there is little information on whether patients use the interventions as intended and the impact they have on mental health outcomes. Objective The objective of our study was to document and compare use patterns and clinical outcomes across the United States between 3 different self-guided mobile apps for depression. Methods Participants were recruited through Web-based advertisements and social media and were randomly assigned to 1 of 3 mood apps. Treatment and assessment were conducted remotely on each participant’s smartphone or tablet with minimal contact with study staff. We enrolled 626 English-speaking adults (≥18 years old) with mild to moderate depression as determined by a 9-item Patient Health Questionnaire (PHQ-9) score ≥5, or if their score on item 10 was ≥2. The apps were (1) Project: EVO, a cognitive training app theorized to mitigate depressive symptoms by improving cognitive control, (2) iPST, an app based on an evidence-based psychotherapy for depression, and (3) Health Tips, a treatment control. Outcomes were scores on the PHQ-9 and the Sheehan Disability Scale. Adherence to treatment was measured as number of times participants opened and used the apps as instructed. Results We randomly assigned 211 participants to iPST, 209 to Project: EVO, and 206 to Health Tips. Among the participants, 77.0% (482/626) had a PHQ-9 score >10 (moderately depressed). Among the participants using the 2 active apps, 57.9% (243/420) did not download their assigned intervention app but did not differ demographically from those who did. Differential treatment effects were present in participants with baseline PHQ-9 score >10, with the cognitive training and problem-solving apps resulting in greater effects on mood than the information control app (χ22=6.46, P=.04). Conclusions Mobile apps for depression appear to have their greatest impact on people with more moderate levels of depression. In particular, an app that is designed to engage cognitive correlates of depression had the strongest effect on depressed mood in this sample. This study suggests that mobile apps reach many people and are useful for more moderate levels of depression. ClinicalTrial Clinicaltrials.gov NCT00540865; https://www.clinicaltrials.gov/ct2/show/NCT00540865 (Archived by WebCite at http://www.webcitation.org/6mj8IPqQr)
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Affiliation(s)
- Patricia A Arean
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Kevin A Hallgren
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States
| | - Joshua T Jordan
- Department of Neurology, University of California San Francisco, San Francisco, CA, United States.,Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States
| | - Adam Gazzaley
- Department of Neurology, University of California San Francisco, San Francisco, CA, United States.,Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States
| | - David C Atkins
- Department of Biostatistics in the School of Public Health, University of Washington, Seattle, WA, United States
| | - Patrick J Heagerty
- Department of Biostatistics in the School of Public Health, University of Washington, Seattle, WA, United States
| | - Joaquin A Anguera
- Department of Neurology, University of California San Francisco, San Francisco, CA, United States.,Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States
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Anguera JA, Brandes-Aitken AN, Rolle CE, Skinner SN, Desai SS, Bower JD, Martucci WE, Chung WK, Sherr EH, Marco EJ. Characterizing cognitive control abilities in children with 16p11.2 deletion using adaptive 'video game' technology: a pilot study. Transl Psychiatry 2016; 6:e893. [PMID: 27648915 PMCID: PMC5048213 DOI: 10.1038/tp.2016.178] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 07/13/2016] [Accepted: 07/18/2016] [Indexed: 02/07/2023] Open
Abstract
Assessing cognitive abilities in children is challenging for two primary reasons: lack of testing engagement can lead to low testing sensitivity and inherent performance variability. Here we sought to explore whether an engaging, adaptive digital cognitive platform built to look and feel like a video game would reliably measure attention-based abilities in children with and without neurodevelopmental disabilities related to a known genetic condition, 16p11.2 deletion. We assessed 20 children with 16p11.2 deletion, a genetic variation implicated in attention deficit/hyperactivity disorder and autism, as well as 16 siblings without the deletion and 75 neurotypical age-matched children. Deletion carriers showed significantly slower response times and greater response variability when compared with all non-carriers; by comparison, traditional non-adaptive selective attention assessments were unable to discriminate group differences. This phenotypic characterization highlights the potential power of administering tools that integrate adaptive psychophysical mechanics into video-game-style mechanics to achieve robust, reliable measurements.
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Affiliation(s)
- J A Anguera
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA,Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA,University of California, San Francisco, Mission Bay – Sandler Neurosciences Center, UCSF MC 0444, 675 Nelson Rising Lane, Room 502, San Francisco, CA 94158, USA. E-mail: or
| | - A N Brandes-Aitken
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - C E Rolle
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - S N Skinner
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - S S Desai
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - J D Bower
- Akili Interactive Labs, Boston, MA, USA
| | | | - W K Chung
- Department of Pediatrics, Columbia University Medical Center, New York, NY, USA
| | - E H Sherr
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA,Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - E J Marco
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA,Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA,Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA,University of California, San Francisco, Mission Bay – Sandler Neurosciences Center, UCSF MC 0444, 675 Nelson Rising Lane, Room 502, San Francisco, CA 94158, USA. E-mail: or
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Owen-Smith AA, Panneton M, Arean P, Anguera JA, Reetz S, Clarke GN. Mobile Assessment of Depression Treatment Response: Recruitment Challenges and Possible Solutions. J Patient Cent Res Rev 2016. [DOI: 10.17294/2330-0698.1376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Anguera JA, Jordan JT, Castaneda D, Gazzaley A, Areán PA. Conducting a fully mobile and randomised clinical trial for depression: access, engagement and expense. ACTA ACUST UNITED AC 2016; 2:14-21. [PMID: 27019745 PMCID: PMC4789688 DOI: 10.1136/bmjinnov-2015-000098] [Citation(s) in RCA: 126] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Importance Advances in mobile technology have resulted in federal and industry-level initiatives to facilitate large-scale clinical research using smart devices. Although the benefits of technology to expand data collection are obvious, assumptions about the reach of mobile research methods (access), participant willingness to engage in mobile research protocols (engagement), and the cost of this research (cost) remain untested. Objective To assess the feasibility of a fully mobile randomised controlled trial using assessments and treatments delivered entirely through mobile devices to depressed individuals. Design Using a web-based research portal, adult participants with depression who also owned a smart device were screened, consented and randomised to 1 of 3 mental health apps for treatment. Assessments of self-reported mood and cognitive function were conducted at baseline, 4, 8 and 12 weeks. Physical and social activity was monitored daily using passively collected phone use data. All treatment and assessment tools were housed on each participant's smart phone or tablet. Interventions A cognitive training application, an application based on problem-solving therapy, and a mobile-sensing application promoting daily activities. Results Access: We screened 2923 people and enrolled 1098 participants in 5 months. The sample characteristics were comparable to the 2013 US census data. Recruitment via Craigslist.org yielded the largest sample. Engagement: Study engagement was high during the first 2 weeks of treatment, falling to 44% adherence by the 4th week. Cost: The total amount spent on for this project, including staff costs and β testing, was $314 264 over 2 years. Conclusions and relevance These findings suggest that mobile randomised control trials can recruit large numbers of participants in a short period of time and with minimal cost, but study engagement remains challenging. Trial registration number NCT00540865.
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Affiliation(s)
- Joaquin A Anguera
- Departments of Neurology and Psychiatry , University of California , San Francisco, California , USA
| | - Joshua T Jordan
- Departments of Neurology and Psychiatry , University of California , San Francisco, California , USA
| | - Diego Castaneda
- Departments of Neurology and Psychiatry , University of California , San Francisco, California , USA
| | - Adam Gazzaley
- Departments of Neurology and Psychiatry , University of California , San Francisco, California , USA
| | - Patricia A Areán
- Department of Psychiatry and Behavioral Sciences , University of Washington , Seattle, Washington , USA
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Hsu WY, Zanto TP, Anguera JA, Lin YY, Gazzaley A. Delayed enhancement of multitasking performance: Effects of anodal transcranial direct current stimulation on the prefrontal cortex. Cortex 2015; 69:175-85. [PMID: 26073148 DOI: 10.1016/j.cortex.2015.05.014] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 01/17/2015] [Accepted: 05/12/2015] [Indexed: 12/23/2022]
Abstract
BACKGROUND The dorsolateral prefrontal cortex (DLPFC) has been proposed to play an important role in neural processes that underlie multitasking performance. However, this claim is underexplored in terms of direct causal evidence. OBJECTIVE The current study aimed to delineate the causal involvement of the DLPFC during multitasking by modulating neural activity with transcranial direct current stimulation (tDCS) prior to engagement in a demanding multitasking paradigm. METHODS The study is a single-blind, crossover, sham-controlled experiment. Anodal tDCS or sham tDCS was applied over left DLPFC in forty-one healthy young adults (aged 18-35 years) immediately before they engaged in a 3-D video game designed to assess multitasking performance. Participants were separated into three subgroups: real-sham (i.e., real tDCS in the first session, followed by sham tDCS in the second session 1 h later), sham-real (sham tDCS first session, real tDCS second session), and sham-sham (sham tDCS in both sessions). RESULTS The real-sham group showed enhanced multitasking performance and decreased multitasking cost during the second session, compared to first session, suggesting delayed cognitive benefits of tDCS. Interestingly, performance benefits were observed only for multitasking and not on a single-task version of the game. No significant changes were found between the first and second sessions for either the sham-real or the sham-sham groups. CONCLUSIONS These results suggest a causal role of left prefrontal cortex in facilitating the simultaneous performance of more than one task, or multitasking. Moreover, these findings reveal that anodal tDCS may have delayed benefits that reflect an enhanced rate of learning.
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Affiliation(s)
- Wan-Yu Hsu
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Laboratory of Neurophysiology, Taipei Veterans General Hospital, Taipei, Taiwan; Integrated Brain Research Laboratory, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Theodore P Zanto
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Joaquin A Anguera
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Yung-Yang Lin
- Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Department of Neurology, National Yang-Ming University, Taipei, Taiwan; Institute of Physiology, National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Laboratory of Neurophysiology, Taipei Veterans General Hospital, Taipei, Taiwan; Integrated Brain Research Laboratory, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Adam Gazzaley
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA; Departments of Physiology and Psychiatry, University of California, San Francisco, San Francisco, California, USA.
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Guerreiro MJS, Anguera JA, Mishra J, Van Gerven PWM, Gazzaley A. Age-equivalent top-down modulation during cross-modal selective attention. J Cogn Neurosci 2014; 26:2827-39. [PMID: 25010198 DOI: 10.1162/jocn_a_00685] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Selective attention involves top-down modulation of sensory cortical areas, such that responses to relevant information are enhanced whereas responses to irrelevant information are suppressed. Suppression of irrelevant information, unlike enhancement of relevant information, has been shown to be deficient in aging. Although these attentional mechanisms have been well characterized within the visual modality, little is known about these mechanisms when attention is selectively allocated across sensory modalities. The present EEG study addressed this issue by testing younger and older participants in three different tasks: Participants attended to the visual modality and ignored the auditory modality, attended to the auditory modality and ignored the visual modality, or passively perceived information presented through either modality. We found overall modulation of visual and auditory processing during cross-modal selective attention in both age groups. Top-down modulation of visual processing was observed as a trend toward enhancement of visual information in the setting of auditory distraction, but no significant suppression of visual distraction when auditory information was relevant. Top-down modulation of auditory processing, on the other hand, was observed as suppression of auditory distraction when visual stimuli were relevant, but no significant enhancement of auditory information in the setting of visual distraction. In addition, greater visual enhancement was associated with better recognition of relevant visual information, and greater auditory distractor suppression was associated with a better ability to ignore auditory distraction. There were no age differences in these effects, suggesting that when relevant and irrelevant information are presented through different sensory modalities, selective attention remains intact in older age.
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Anguera JA, Lyman K, Zanto TP, Bollinger J, Gazzaley A. Reconciling the influence of task-set switching and motor inhibition processes on stop signal after-effects. Front Psychol 2013; 4:649. [PMID: 24069010 PMCID: PMC3781352 DOI: 10.3389/fpsyg.2013.00649] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Accepted: 08/30/2013] [Indexed: 11/13/2022] Open
Abstract
Executive response functions can be affected by preceding events, even if they are no longer associated with the current task at hand. For example, studies utilizing the stop signal task have reported slower response times to “GO” stimuli when the preceding trial involved the presentation of a “STOP” signal. However, the neural mechanisms that underlie this behavioral after-effect are unclear. To address this, behavioral and electroencephalography (EEG) measures were examined in 18 young adults (18–30 years) on “GO” trials following a previously “Successful Inhibition” trial (pSI), a previously “Failed Inhibition” trial (pFI), and a previous “GO” trial (pGO). Like previous research, slower response times were observed during both pSI and pFI trials (i.e., “GO” trials that were preceded by a successful and unsuccessful inhibition trial, respectively) compared to pGO trials (i.e., “GO” trials that were preceded by another “GO” trial). Interestingly, response time slowing was greater during pSI trials compared to pFI trials, suggesting executive control is influenced by both task set switching and persisting motor inhibition processes. Follow-up behavioral analyses indicated that these effects resulted from between-trial control adjustments rather than repetition priming effects. Analyses of inter-electrode coherence (IEC) and inter-trial coherence (ITC) indicated that both pSI and pFI trials showed greater phase synchrony during the inter-trial interval compared to pGO trials. Unlike the IEC findings, differential ITC was present within the beta and alpha frequency bands in line with the observed behavior (pSI > pFI > pGO), suggestive of more consistent phase synchrony involving motor inhibition processes during the ITI at a regional level. These findings suggest that between-trial control adjustments involved with task-set switching and motor inhibition processes influence subsequent performance, providing new insights into the dynamic nature of executive control.
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Affiliation(s)
- Joaquin A Anguera
- Departments of Neurology, Physiology and Psychiatry, Center for Integrative Neurosciences, University of California San Francisco San Francisco, CA, USA
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Anguera JA, Boccanfuso J, Rintoul JL, Al-Hashimi O, Faraji F, Janowich J, Kong E, Larraburo Y, Rolle C, Johnston E, Gazzaley A. Video game training enhances cognitive control in older adults. Nature 2013. [PMID: 24005416 DOI: 10.1038/nature12486.video] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
Cognitive control is defined by a set of neural processes that allow us to interact with our complex environment in a goal-directed manner. Humans regularly challenge these control processes when attempting to simultaneously accomplish multiple goals (multitasking), generating interference as the result of fundamental information processing limitations. It is clear that multitasking behaviour has become ubiquitous in today's technologically dense world, and substantial evidence has accrued regarding multitasking difficulties and cognitive control deficits in our ageing population. Here we show that multitasking performance, as assessed with a custom-designed three-dimensional video game (NeuroRacer), exhibits a linear age-related decline from 20 to 79 years of age. By playing an adaptive version of NeuroRacer in multitasking training mode, older adults (60 to 85 years old) reduced multitasking costs compared to both an active control group and a no-contact control group, attaining levels beyond those achieved by untrained 20-year-old participants, with gains persisting for 6 months. Furthermore, age-related deficits in neural signatures of cognitive control, as measured with electroencephalography, were remediated by multitasking training (enhanced midline frontal theta power and frontal-posterior theta coherence). Critically, this training resulted in performance benefits that extended to untrained cognitive control abilities (enhanced sustained attention and working memory), with an increase in midline frontal theta power predicting the training-induced boost in sustained attention and preservation of multitasking improvement 6 months later. These findings highlight the robust plasticity of the prefrontal cognitive control system in the ageing brain, and provide the first evidence, to our knowledge, of how a custom-designed video game can be used to assess cognitive abilities across the lifespan, evaluate underlying neural mechanisms, and serve as a powerful tool for cognitive enhancement.
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Affiliation(s)
- J A Anguera
- Department of Neurology, University of California, San Francisco, California 94158, USA.
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Anguera JA, Boccanfuso J, Rintoul JL, Al-Hashimi O, Faraji F, Janowich J, Kong E, Larraburo Y, Rolle C, Johnston E, Gazzaley A. Video game training enhances cognitive control in older adults. Nature 2013. [PMID: 24005416 DOI: 10.1038/nature12486.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Cognitive control is defined by a set of neural processes that allow us to interact with our complex environment in a goal-directed manner. Humans regularly challenge these control processes when attempting to simultaneously accomplish multiple goals (multitasking), generating interference as the result of fundamental information processing limitations. It is clear that multitasking behaviour has become ubiquitous in today's technologically dense world, and substantial evidence has accrued regarding multitasking difficulties and cognitive control deficits in our ageing population. Here we show that multitasking performance, as assessed with a custom-designed three-dimensional video game (NeuroRacer), exhibits a linear age-related decline from 20 to 79 years of age. By playing an adaptive version of NeuroRacer in multitasking training mode, older adults (60 to 85 years old) reduced multitasking costs compared to both an active control group and a no-contact control group, attaining levels beyond those achieved by untrained 20-year-old participants, with gains persisting for 6 months. Furthermore, age-related deficits in neural signatures of cognitive control, as measured with electroencephalography, were remediated by multitasking training (enhanced midline frontal theta power and frontal-posterior theta coherence). Critically, this training resulted in performance benefits that extended to untrained cognitive control abilities (enhanced sustained attention and working memory), with an increase in midline frontal theta power predicting the training-induced boost in sustained attention and preservation of multitasking improvement 6 months later. These findings highlight the robust plasticity of the prefrontal cognitive control system in the ageing brain, and provide the first evidence, to our knowledge, of how a custom-designed video game can be used to assess cognitive abilities across the lifespan, evaluate underlying neural mechanisms, and serve as a powerful tool for cognitive enhancement.
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Affiliation(s)
- J A Anguera
- Department of Neurology, University of California, San Francisco, California 94158, USA.
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Abstract
Researchers have begun to delineate the precise nature and neural correlates of the cognitive processes that contribute to motor skill learning. The authors review recent work from their laboratory designed to further understand the neurocognitive mechanisms of skill acquisition. The authors have demonstrated an important role for spatial working memory in 2 different types of motor skill learning, sensorimotor adaptation and motor sequence learning. They have shown that individual differences in spatial working memory capacity predict the rate of motor learning for sensorimotor adaptation and motor sequence learning, and have also reported neural overlap between a spatial working memory task and the early, but not late, stages of adaptation, particularly in the right dorsolateral prefrontal cortex and bilateral inferior parietal lobules. The authors propose that spatial working memory is relied on for processing motor error information to update motor control for subsequent actions. Further, they suggest that working memory is relied on during learning new action sequences for chunking individual action elements together.
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Affiliation(s)
- Rachael D Seidler
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109-2214, USA.
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Abstract
All of us are familiar with the negative impact of interference on achieving our task goals. We are referring to interference by information, which either impinges on our senses from an external environmental source or is internally generated by our thoughts. Informed by more than a decade of research on the cognitive and neural processing of interference, we have developed a framework for understanding how interference impacts our neural systems and especially how it is regulated and suppressed during efficient on-task performance. Importantly, externally and internally generated interferences have distinct neural signatures, and further, distinct neural processing emerges depending on whether individuals must ignore and suppress the interference, as for distractions, or engage with them in a secondary task, as during multitasking. Here, we elaborate on this cognitive framework and how it changes throughout the human lifespan, focusing mostly on research evidence from younger adults and comparing these findings to data from older adults, children, and cognitively impaired populations. With insights gleaned from our growing understanding, we then describe three novel translational efforts in our lab directed at improving distinct aspects of interference resolution using cognitive training. Critically, these training approaches were specifically developed to target improved interference resolution based on neuroplasticity principles and have shown much success in randomized controlled first version evaluations in healthy aging. Our results show not only on-task training improvements but also robust generalization of benefit to other cognitive control abilities. This research showcases how an in-depth understanding of neural mechanisms can then inform the development of effective deficit-targeted interventions, which can in turn benefit both healthy and cognitively impaired populations.
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Affiliation(s)
- Jyoti Mishra
- Departments of Neurology, Physiology and Psychiatry, University of California, San Francisco, CA, USA.
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Anguera JA, Bernard JA, Jaeggi SM, Buschkuehl M, Benson BL, Jennett S, Humfleet J, Reuter-Lorenz PA, Jonides J, Seidler RD. The effects of working memory resource depletion and training on sensorimotor adaptation. Behav Brain Res 2011; 228:107-15. [PMID: 22155489 DOI: 10.1016/j.bbr.2011.11.040] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Revised: 11/06/2011] [Accepted: 11/28/2011] [Indexed: 11/25/2022]
Abstract
We have recently demonstrated that visuospatial working memory performance predicts the rate of motor skill learning, particularly during the early phase of visuomotor adaptation. Here, we follow up these correlational findings with direct manipulations of working memory resources to determine the impact on visuomotor adaptation, a form of motor learning. We conducted two separate experiments. In the first one, we used a resource depletion strategy to investigate whether the rate of early visuomotor adaptation would be negatively affected by fatigue of spatial working memory resources. In the second study, we employed a dual n-back task training paradigm that has been shown to result in transfer effects [1] over five weeks to determine whether training-related improvements would boost the rate of early visuomotor adaptation. The depletion of spatial working memory resources negatively affected the rate of early visuomotor adaptation. However, enhancing working memory capacity via training did not lead to improved rates of visuomotor adaptation, suggesting that working memory capacity may not be the factor limiting maximal rate of visuomotor adaptation in young adults. These findings are discussed from a resource limitation/capacity framework with respect to current views of motor learning.
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Anguera JA, Gazzaley A. Dissociation of motor and sensory inhibition processes in normal aging. Clin Neurophysiol 2011; 123:730-40. [PMID: 21963321 DOI: 10.1016/j.clinph.2011.08.024] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Revised: 07/18/2011] [Accepted: 08/22/2011] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Age-related cognitive impairments have been attributed to deficits in inhibitory processes that mediate both motor restraint and sensory filtering. However, behavioral studies have failed to show an association between tasks that measure these distinct types of inhibition. In the present study, we hypothesized neural markers reflecting each type of inhibition may reveal a relationship across inhibitory domains in older adults. METHODS Electroencephalography (EEG) and behavioral measures were used to explore whether there was an across-participant correlation between sensory suppression and motor inhibition. Sixteen healthy older adult participants (65-80 years) engaged in two separate experimental paradigms: a selective attention, delayed-recognition task and a stop-signal task. RESULTS Findings revealed no significant relationship existed between neural markers of sensory suppression (P1 amplitude; N170 latency) and markers of motor inhibition (N2 and P3 amplitude and latency) in older adults. CONCLUSIONS These distinct inhibitory domains are differentially impacted in normal aging, as evidenced by previous behavioral work and the current neural findings. Thus a generalized inhibitory deficit may not be a common impairment in cognitive aging. SIGNIFICANCE Given that some theories of cognitive aging suggest age-related failure of inhibitory mechanisms may span different modalities, the present findings contribute to an alternative view where age-related declines within each inhibitory modality are unrelated.
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Affiliation(s)
- Joaquin A Anguera
- Departments of Neurology, Physiology and Psychiatry, WM Keck Center for Integrative Neurosciences, University of California, San Francisco, CA 94158-2330, USA.
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