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Dieciuc M, Zhang S, Gray N, Lustria MLA, Carr DC, Charness N, Boot WR. Terms of Engagement: Understanding the Motivations, Preferences, and Attitudes of Older Adults Toward Mobile Cognitive Assessment and Training. Gerontologist 2024; 64:gnad048. [PMID: 37097773 PMCID: PMC10825850 DOI: 10.1093/geront/gnad048] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 09/22/2022] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The future of cognitive assessment is likely to involve mobile applications for smartphones and tablets; cognitive training is also often delivered in these formats. Unfortunately, low adherence to these programs can hinder efforts at the early detection of cognitive decline and interfere with examining cognitive training efficacy in clinical trials. We explored factors that increase adherence to these programs among older adults. RESEARCH DESIGN AND METHODS Focus groups were conducted with older adults (N = 21) and a younger adult comparison group (N = 21). Data were processed using reflexive thematic analysis with an inductive, bottom-up approach. RESULTS Three primary themes related to adherence were developed from the focus group data. Switches of engagement reflects factors that must be present; without them, engagement is unlikely. Dials of engagement reflects a cost-benefit analysis that users undergo, the outcome of which determines whether a person will be more or less likely to engage. Bracers of engagement reflects factors that nudge users toward engagement by minimizing barriers associated with the other themes. Older adults in general were more sensitive to opportunity costs, preferred more cooperative interactions, and were more likely to mention technology barriers. DISCUSSION AND IMPLICATIONS Our results are important for informing the design of mobile cognitive assessment and training apps for older adults. These themes provide guidance about ways apps could be modified to increase engagement and adherence, which in turn can more effectively facilitate the early detection of cognitive impairment and the evaluation of cognitive training efficacy.
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Affiliation(s)
- Michael Dieciuc
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Shenghao Zhang
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Nicholas Gray
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
- Institute for Successful Longevity, Florida State University, Tallahassee, Florida, USA
| | - Mia Liza A Lustria
- School of Information, Florida State University, Tallahassee, Florida, USA
| | - Dawn C Carr
- Department of Sociology, Florida State University, Tallahassee, Florida, USA
| | - Neil Charness
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
- Institute for Successful Longevity, Florida State University, Tallahassee, Florida, USA
| | - Walter R Boot
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
- Institute for Successful Longevity, Florida State University, Tallahassee, Florida, USA
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Peeters G, Black IL, Gomersall SR, Fritschi J, Sweeney A, Guedes de Oliveira Y, Panizzutti R, McEvoy CT, Lampit A. Behaviour Change Techniques in Computerized Cognitive Training for Cognitively Healthy Older Adults: A Systematic Review. Neuropsychol Rev 2023; 33:238-254. [PMID: 35157209 PMCID: PMC9998598 DOI: 10.1007/s11065-022-09537-4] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 10/11/2021] [Indexed: 11/28/2022]
Abstract
We aimed to describe behaviour change techniques (BCT) used in trials evaluating computerised cognitive training (CCT) in cognitively healthy older adults, and explore whether BCTs are associated with improved adherence and efficacy. The 90 papers included in a recent meta-analysis were reviewed for information about adherence and use of BCTs in accordance with the Behaviour Change Taxonomy. Studies using a specific BCT were compared with studies not using that BCT on efficacy (difference in Hedges' g [Δg]) using three level meta-regression models and on median adherence using the Wilcoxon test. The median number of BCTs per study was 3 (interquartile range [IQR] = 2-5). 'Feedback on behaviour' (if provided by a person; Δg = -0.19, 95% confidence interval [CI] = -0.31;-0.07) and 'non-specific reward' (Δg = -0.19, CI = -0.34;-0.05) were associated with lower efficacy. Certain BCTs that involve personal contact may be beneficial, although none were statistically significantly associated with greater efficacy. The median percentage of adherence was 90% (IQR = 81-95). Adherence was higher in studies using the BCT 'self-monitoring of behaviour' and lower in studies using the BCT 'graded tasks' than studies not using these BCTs (p < 0.001). These findings provide first evidence that BCTs can influence both adherence to and efficacy of CCT programs in cognitively healthy older adults.
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Affiliation(s)
- Geeske Peeters
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland. .,Department of Geriatric Medicine, Radboud Institute of Health Science, Radboud University Medical Centre, Nijmegen, Netherlands.
| | - Irene L Black
- Department of Clinical Nutrition and Dietetics, CHI Crumlin, Dublin, Ireland.,UCD Institute of Food and Health, University College Dublin, Dublin, Ireland
| | - Sjaan R Gomersall
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.,School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | | | - Aoife Sweeney
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | | | - Rogerio Panizzutti
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Claire T McEvoy
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | - Amit Lampit
- Department of Psychiatry, University of Melbourne, Melbourne, Australia.,Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
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Polley DB, Schiller D. The promise of low-tech intervention in a high-tech era: Remodeling pathological brain circuits using behavioral reverse engineering. Neurosci Biobehav Rev 2022; 137:104652. [PMID: 35385759 DOI: 10.1016/j.neubiorev.2022.104652] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 10/06/2021] [Revised: 03/09/2022] [Accepted: 03/29/2022] [Indexed: 10/18/2022]
Abstract
As an academic pursuit, neuroscience is enjoying a golden age. From a clinical perspective, our field is failing. Conventional 20th century drugs and devices are not well-matched to the heterogeneity, scale, and connectivity of neural circuits that produce aberrant mental states and behavior. Laboratory-based methods for editing neural genomes and sculpting activity patterns are exciting, but their applications for hundreds of millions of people with mental health disorders is uncertain. We argue that mechanisms for regulating adult brain plasticity and remodeling pathological activity are substantially pre-wired, and we suggest new minimally invasive strategies to harness and direct these endogenous systems. Drawing from studies across the neuroscience literature, we describe approaches that identify neural biomarkers more closely linked to upstream causes-rather than downstream consequences-of disordered behavioral states. We highlight the potential for innovation and discovery in reverse engineering approaches that refine bespoke behavioral "agonists" to drive upstream neural biomarkers in normative directions and reduce clinical symptoms for select classes of neuropsychiatric disorders.
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Affiliation(s)
- Daniel B Polley
- Eaton-Peabody Laboratories, Massachusetts Eye and Ear, Boston, MA, USA; Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, MA, USA.
| | - Daniela Schiller
- Department of Psychiatry, Nash Family Department of Neuroscience, and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Nguyen L, Murphy K, Andrews G. A Game a Day Keeps Cognitive Decline Away? A Systematic Review and Meta-Analysis of Commercially-Available Brain Training Programs in Healthy and Cognitively Impaired Older Adults. Neuropsychol Rev 2021; 32:601-630. [PMID: 34251578 DOI: 10.1007/s11065-021-09515-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/15/2021] [Indexed: 12/31/2022]
Abstract
The rising prevalence rates of age-related cognitive impairment are a worldwide public concern, bringing about a surge in the number of "brain training" programs commercially available to the general public. Numerous companies advertise that their products improve memory and protect against cognitive decline, though researchers have voiced concerns regarding the validity of such claims. To address this issue, the current meta-analytic investigation examined evidence from 43 studies (encompassing 2,636 participants) to evaluate the efficacy of commercial training programs within two separate populations: healthy older adults and older adults with mild cognitive-impairment (MCI). Seven programs were identified: BrainGymmer, BrainHQ, CogMed, CogniFit, Dakim, Lumosity, and MyBrainTrainer. Analyses yielded small, significant near-transfer effects for both healthy and MCI samples. Far-transfer was not observed for the MCI sample, whereas a small, significant effect was found for subjective but not objective measures of far-transfer in the healthy sample. Analyses of individual domains (combining near-and far-transfer outcomes) yielded significant transfer to executive-functioning, memory, and processing-speed in healthy older adults. After adjusting for publication bias, only the effect size for processing speed remained significant. Transfer to attention, objective everyday functioning, fluid-intelligence, and visuospatial domains was not significant. Thus, whilst "brain training" may be suitable for enjoyment and entertainment purposes, there is currently insufficient empirical evidence to support that such training can improve memory, general cognition, or everyday functioning. This area of research is still in its infancy and warrants further investigation to provide more substantial evidence regarding the efficacy of this rapidly expanding industry.
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Affiliation(s)
- Lan Nguyen
- School of Applied Psychology, Griffith University, Griffith University, Gold Coast, QLD 4222, Australia.
| | - Karen Murphy
- School of Applied Psychology, Griffith University, Griffith University, Gold Coast, QLD 4222, Australia
| | - Glenda Andrews
- School of Applied Psychology, Griffith University, Griffith University, Gold Coast, QLD 4222, Australia
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5
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Routledge KM, Williams LM, Harris AWF, Schofield PR, Gatt JM. The impact of online brain training exercises on experiences of depression, anxiety and emotional wellbeing in a twin sample. J Psychiatr Res 2021; 134:138-149. [PMID: 33385632 DOI: 10.1016/j.jpsychires.2020.12.054] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 12/15/2020] [Accepted: 12/18/2020] [Indexed: 12/25/2022]
Abstract
This study assessed the effectiveness of cognitive and emotional brain training and transfer effects to wellbeing and depression and anxiety symptoms. 352 healthy adult twins were randomised to a training group where they were asked to play brain training games over a 30-day period, or a waitlist control group. This study focused on the impact of the brain training on explicit and implicit emotional cognition, and analysed effects using both Intention-To-Treat (ITT) and Per-Protocol (PP) approaches. Both analyses revealed significant training effects for improvement in the explicit identification of fear expressions (ITT: p < 0.001, d = 0.33; PP training 3 h+: p < 0.001, d = 0.55), and a reduction in implicit bias for anger expressions amongst males (ITT: p < 0.001, d = 0.94; PP training 3 h+: p = 0.04, d = 0.90). Female participants also showed improvements in implicit bias for happy expressions (ITT: p = 0.003, d = 0.34; PP training 3 h+: p = 0.03, d = 0.47). Improvements resulting from training in emotional cognition did not directly improve wellbeing, depression or anxiety symptoms. Regression modelling also suggested training improvements in emotional cognition yielded no indirect transfer effects for the mental health and wellbeing measures. The results suggest brain training in healthy populations has potential for improving emotional cognition, but the subsequent impact on improving wellbeing and mental health symptoms is still equivocal.
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Affiliation(s)
- Kylie M Routledge
- The Brain Dynamics Centre, Westmead Institute for Medical Research, University of Sydney, Westmead, NSW, 2145, Australia.
| | - Leanne M Williams
- Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Stanford University, Stanford, CA, 94305-5717, United States.
| | - Anthony W F Harris
- The Brain Dynamics Centre, Westmead Institute for Medical Research, University of Sydney, Westmead, NSW, 2145, Australia; Specialty of Psychiatry, Sydney Medical School, University of Sydney, NSW, 2006, Australia.
| | - Peter R Schofield
- Neuroscience Research Australia, Randwick, NSW, 2031, Australia; School of Medical Sciences, University of New South Wales, Sydney, NSW, 2052, Australia.
| | - Justine M Gatt
- Neuroscience Research Australia, Randwick, NSW, 2031, Australia; School of Psychology, University of New South Wales, Sydney, NSW, 2052, Australia.
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Mayo SJ, Rourke SB, Atenafu EG, Vitorino R, Chen C, Kuruvilla J. Computerized cognitive training in post-treatment hematological cancer survivors: a feasibility study. Pilot Feasibility Stud 2021; 7:36. [PMID: 33514444 PMCID: PMC7847007 DOI: 10.1186/s40814-021-00778-3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 01/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Computerized cognitive training (CCT) programs have shown some effectiveness in alleviating cognitive symptoms in long-term cancer survivors. For patients presenting with cognitive symptoms in the early post-treatment phase, the benefit of CCT is unclear. To assess the possibility of testing the effectiveness of CCT in the early post-treatment period, our aim was to investigate the feasibility of an 8-week home-based, online CCT intervention among patients who have recently completed treatment for hematological malignancy. METHODS This study was a single-arm, non-blinded, feasibility study. All participants were provided with the CCT intervention for an 8-week period. Feasibility was evaluated based on participant adherence and patient perceptions of the intervention, assessed through responses to an acceptability questionnaire and semi-structured interviews at the end of the intervention period. RESULTS The feasibility study included 19 patients who had completed treatment for hematological malignancy at a Canadian tertiary cancer center. Adherence to the CCT intervention was limited, with only one participant meeting the criteria for intervention adherence. At the end of the intervention period, participants characterized the program as easy to follow (92%) and felt well-prepared for how to complete the exercises (100%). In semi-structured interviews, participants highlighted post-treatment barriers to intervention adherence that included symptom burden and competing time demands. Participants also suggested improvements to the intervention that could help maintain adherence despite these barriers, such as fostering a sense of accountability, providing personalized feedback and coaching, and enabling opportunities for peer support. CONCLUSIONS Participation in CCT can be challenging in the post-treatment period for hematological cancers. Further research on the effectiveness of CCT in this setting may require the implementation of strategies that support participants' engagement with the intervention in the context of symptoms and competing demands, such as establishing a minimum dose requirement and integrating approaches to help promote and sustain motivation.
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Affiliation(s)
- Samantha J Mayo
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College St., Suite 130, Toronto, ON, M5T 1P8, Canada. .,Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
| | - Sean B Rourke
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Eshetu G Atenafu
- Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Rita Vitorino
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Christine Chen
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - John Kuruvilla
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
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7
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Manasse SM, Lampe EW, Juarascio AS, Zhu J, Forman EM. Using virtual reality to train inhibitory control and reduce binge eating: A proof-of-concept study. Appetite 2021; 157:104988. [PMID: 33049341 DOI: 10.1016/j.appet.2020.104988] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 09/30/2020] [Accepted: 10/02/2020] [Indexed: 01/13/2023]
Abstract
OBJECTIVE One reason for limited efficacy of treatments for binge eating disorder (BED) and bulimia nervosa (BN) is a failure to directly target deficits in inhibitory control (i.e., the ability to withhold a pre-potent response). Inhibitory control trainings (ICTs; computerized tasks meant to improve inhibitory control) have shown promise but appear not to be powerful enough to generalize to real-word eating behavior or engaging enough for to sustain long-term compliance. Delivering an ICT through virtual reality (VR) technology should increase intervention power because 3D imagery and actual real hand/arm movements are lifelike and may improve compliance because the VR environment is highly engaging. Thus, we created the first-ever VR-based ICT to test its initial feasibility, acceptability, and impact on binge eating. METHOD We recruited participants (N = 14) with once-weekly loss-of-control (LOC) eating to use the VR ICT daily, at home, for two weeks, and measured feasibility, acceptability and change in LOC eating at post-intervention and 2-week follow-up. RESULTS The VR ICT was feasible to construct and deploy, and demonstrated high acceptability and compliance (i.e., 86.8% of daily trainings completed). Users of the VR ICT experienced large decreases in LOC eating at post-intervention and 2-week follow-up. DISCUSSION Results from this initial pilot indicate that delivering ICT through VR is feasible, acceptable, and is associated with reductions in binge eating. Future study is warranted and should examine whether a VR ICT can serve as a useful adjunct to standard treatment for BN and BED.
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Yhnell E, Furby H, Lowe RS, Brookes-Howell LC, Drew CJG, Playle R, Watson G, Metzler-Baddeley C, Rosser AE, Busse ME. A randomised feasibility study of computerised cognitive training as a therapeutic intervention for people with Huntington's disease (CogTrainHD). Pilot Feasibility Stud 2020; 6:88. [PMID: 32577299 PMCID: PMC7304172 DOI: 10.1186/s40814-020-00623-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 05/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Huntington's disease (HD) is associated with a range of cognitive deficits including problems with executive function. In the absence of a disease modifying treatment, cognitive training has been proposed as a means of slowing cognitive decline; however, the impact of cognitive training in HD patient populations remains unclear. The CogTrainHD study assessed the feasibility and acceptability of home-based computerised executive function training, for people impacted by HD. METHODS Thirty HD gene carriers were recruited and randomised to either executive function training or non-intervention control groups. Participants allocated to the intervention group were asked to complete executive function training three times a week for 30 min for 12 weeks in their own homes. Semi-structured interviews were conducted with participants and friends, family or carers, to determine their views on the study. RESULTS 26 out of 30 participants completed the baseline assessments and were subsequently randomised: 13 to the control group and 13 to the intervention group. 23 of the 30 participants were retained until study completion: 10/13 in the intervention group and 13/13 in the control group. 4/10 participants fully adhered to the executive function training. All participants in the control group 13/13 completed the study as intended. Interview data suggested several key facilitators including participant determination, motivation, incorporation of the intervention into routine and support from friends and family members. Practical limitations, including lack of time, difficulty and frustration in completing the intervention, were identified as barriers to study completion. CONCLUSIONS The CogTrainHD feasibility study provides important evidence regarding the feasibility and acceptability of a home-based cognitive training intervention for people with HD. Variable adherence to the cognitive training implies that the intervention is not feasible to all participants in its current form. The study has highlighted important aspects in relation to both the study and intervention design that require consideration, and these include the design of games in the executive function training software, logistical considerations such as lack of time, the limited time participants had to complete the intervention and the number of study visits required. Further studies are necessary before computerised executive function training can be recommended routinely for people with HD. TRIAL REGISTRATION ClinicalTrials.gov, Registry number NCT02990676.
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Affiliation(s)
- Emma Yhnell
- Neuroscience and Mental Health Research Institute, Cardiff University (NMHRI), 3rd Floor, Hadyn Ellis Building, Maindy Road, Cardiff, CF24 4HQ UK
- Cardiff University School of Biosciences, The Sir Martin Evans Building, Museum Avenue, Cardiff, CF10 3AX UK
| | - Hannah Furby
- School of Psychology, Cardiff University Brain Research Imaging Centre (CUBRIC), Maindy Road, Cardiff University, Cardiff, CF24 4HQ UK
| | - Rachel S. Lowe
- Centre for Trials Research (CTR), Cardiff University, Neuadd Meironnydd, Heath Park, Cardiff, CF14 4YS UK
| | - Lucy C. Brookes-Howell
- Centre for Trials Research (CTR), Cardiff University, Neuadd Meironnydd, Heath Park, Cardiff, CF14 4YS UK
| | - Cheney J. G. Drew
- Centre for Trials Research (CTR), Cardiff University, Neuadd Meironnydd, Heath Park, Cardiff, CF14 4YS UK
| | - Rebecca Playle
- Centre for Trials Research (CTR), Cardiff University, Neuadd Meironnydd, Heath Park, Cardiff, CF14 4YS UK
| | - Gareth Watson
- Centre for Trials Research (CTR), Cardiff University, Neuadd Meironnydd, Heath Park, Cardiff, CF14 4YS UK
| | - Claudia Metzler-Baddeley
- School of Psychology, Cardiff University Brain Research Imaging Centre (CUBRIC), Maindy Road, Cardiff University, Cardiff, CF24 4HQ UK
| | - Anne E. Rosser
- Neuroscience and Mental Health Research Institute, Cardiff University (NMHRI), 3rd Floor, Hadyn Ellis Building, Maindy Road, Cardiff, CF24 4HQ UK
- Cardiff University Brain Repair Group, Life Sciences Building, Museum Avenue, Cardiff, CF10 3AX UK
| | - Monica E. Busse
- Centre for Trials Research (CTR), Cardiff University, Neuadd Meironnydd, Heath Park, Cardiff, CF14 4YS UK
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Faust ME, Multhaup KS, Ong MS, Demakis GJ, Balz KG. Exploring the Specificity, Synergy, and Durability of Auditory and Visual Computer Gameplay Transfer Effects in Healthy Older Adults. J Gerontol B Psychol Sci Soc Sci 2020; 75:1170-1180. [PMID: 31410475 PMCID: PMC7265809 DOI: 10.1093/geronb/gbz096] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 12/10/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To determine whether auditory and visual computer games yield transfer effects that (a) are modality-specific to verbal memory (auditory stimulus presentation) and visual-processing tests, (b) affect working memory and processing speed, (c) are synergistic for combined game-type play, and (d) are durable. METHOD A Pilot Study (N = 44) assessed visual transfer effects in a two-group pre-post design. The Main Study (N = 151) employed a 2 (visual games: yes, no) × 2 (auditory games: yes, no) × 3 (test session: pretest, post-test, follow-up) design, allowing different training groups to act as active controls for each other. Neuropsychological test scores were aggregated into verbal-memory (auditory presentation), visual-processing, working-memory, and processing-speed indexes. RESULTS Visual-processing and working-memory pre-post-training change scores were differentially modulated across the four gameplay groups in the main sample, demonstrating transfer effects differing across both active- and passive-control groups. Visual training yielded modality-specific transfer effects in both samples, transfer to working memory in the main sample, and transfer to processing speed in the pilot sample. There were no comparable transfer effects for auditory training. Combined-visual-and-auditory training failed to yield synergistic effects or any significant transfer effects. Visual-processing transfer effects remained significant at follow-up. DISCUSSION Visual and auditory games differentially modulated transfer effects. Domain-specific visual transfer effects were found at post-test and were durable at follow-up. Visual gameplay holds potential to ameliorate age-related cognitive decline in visual cognition.
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Affiliation(s)
- Mark E Faust
- Department of Psychological Science, University of North Carolina at Charlotte, North Carolina
| | | | | | - George J Demakis
- Department of Psychological Science, University of North Carolina at Charlotte, North Carolina
| | - Kelly G Balz
- Department of Psychology, Davidson College, North Carolina
- Brooks Rehabilitation Hospital, Jacksonville, Florida
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Martínez-Maldonado A, Jurado-Barba R, Sion A, Domínguez-Centeno I, Castillo-Parra G, Prieto-Montalvo J, Rubio G. Brain functional connectivity after cognitive-bias modification and behavioral changes in abstinent alcohol-use disorder patients. Int J Psychophysiol 2019; 154:46-58. [PMID: 31654697 DOI: 10.1016/j.ijpsycho.2019.10.004] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 09/23/2019] [Accepted: 10/03/2019] [Indexed: 12/12/2022]
Abstract
The use of the cognitive-bias modification (CBM) method has emerged as a therapeutic complement in the treatment of alcoholism, producing changes at behavioral and brain level. Nevertheless, the impact of the CBM procedure could be improved by the memory retrieval-extinction process (REP). Different studies have demonstrated that the retrieval of drug memories before extinction training later reduced the reinstatement of drug-seeking behavior. The main aim of this work was to study the effect of the CBM procedure itself, as well as in combination with the activation of alcohol-related memories, on the brain oscillatory activity of abstinent patients with alcohol-use disorder. The study sample comprised 33 patients divided into three groups: A-CBM (alcohol-related memory activation + CBM), N-CBM (neutral memory activation + CBM) and N-INT (no-intervention) groups. A resting-state EEG was obtained before and after each protocol, along with the assessment of the automatic action tendencies. A-CBM group showed a general alpha synchronization increase after the protocol, while the other groups did not show any significant change. Besides, A-CBM group showed significant intra and inter-group differences in the automatic action tendencies after the protocol, reflected in higher avoidance bias toward appetitive, aversive and without context alcohol-related stimuli. The alpha phase synchronization increase could be the neural manifestation of the conditioning produced between the alcohol-related stimuli and the automatic avoidance response. Moreover, the activation of the alcohol-related memories favors this conditioning with those alcohol-related stimuli associated with the activated memories, because it increases their threat level for the abstinence maintenance.
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Affiliation(s)
- Andrés Martínez-Maldonado
- Biomedical Research Institute Hospital 12 de Octubre, Cordoba Ave., s/n, 28041 Madrid, Spain; Psychology Department, Education and Health Science Faculty, Camilo José Cela University, Villafranca del Castillo Urb., Castillo de Alarcón St., 49, 28692 Villanueva de la Cañada, Madrid, Spain.
| | - Rosa Jurado-Barba
- Biomedical Research Institute Hospital 12 de Octubre, Cordoba Ave., s/n, 28041 Madrid, Spain; Psychology Department, Education and Health Science Faculty, Camilo José Cela University, Villafranca del Castillo Urb., Castillo de Alarcón St., 49, 28692 Villanueva de la Cañada, Madrid, Spain
| | - Ana Sion
- Biomedical Research Institute Hospital 12 de Octubre, Cordoba Ave., s/n, 28041 Madrid, Spain
| | - Isabel Domínguez-Centeno
- Biomedical Research Institute Hospital 12 de Octubre, Cordoba Ave., s/n, 28041 Madrid, Spain; Psychology Department, Education and Health Science Faculty, Camilo José Cela University, Villafranca del Castillo Urb., Castillo de Alarcón St., 49, 28692 Villanueva de la Cañada, Madrid, Spain
| | - Gabriela Castillo-Parra
- Psychology Department, Education and Health Science Faculty, Camilo José Cela University, Villafranca del Castillo Urb., Castillo de Alarcón St., 49, 28692 Villanueva de la Cañada, Madrid, Spain
| | - Julio Prieto-Montalvo
- Department of Clinical Neurophysiology, Hospital Gregorio Marañon, Dr Esquerdo St., 46, 28007 Madrid, Spain
| | - Gabriel Rubio
- Biomedical Research Institute Hospital 12 de Octubre, Cordoba Ave., s/n, 28041 Madrid, Spain; Medicine Faculty, Complutense de Madrid University, Ramón y Cajal Sq., s/n, 28040 Madrid, Spain; Addictive Disorders Network, Carlos III Institute, Sinesio Delgado St., 4, 28029 Madrid, Spain
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McLaughlin PM, Curtis AF, Branscombe-Caird LM, Comrie JK, Murtha SJE. The Feasibility and Potential Impact of Brain Training Games on Cognitive and Emotional Functioning in Middle-Aged Adults. Games Health J 2017; 7:67-74. [PMID: 29189046 PMCID: PMC5797320 DOI: 10.1089/g4h.2017.0032] [Citation(s) in RCA: 8] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Objectives:To investigate whether a commercially available brain training program is feasible to use with a middle-aged population and has a potential impact on cognition and emotional well-being (proof of concept). Method: Fourteen participants (ages 46–55) completed two 6-week training conditions using a crossover (counterbalanced) design: (1) experimental brain training condition and (2) active control “find answers to trivia questions online” condition. A comprehensive neurocognitive battery and a self-report measure of depression and anxiety were administered at baseline (first time point, before training) and after completing each training condition (second time point at 6 weeks, and third time point at 12 weeks). Cognitive composite scores were calculated for participants at each time point. Results: Study completion and protocol adherence demonstrated good feasibility of this brain training protocol in healthy middle-aged adults. Exploratory analyses suggested that brain training was associated with neurocognitive improvements related to executive attention, as well as improvements in mood. Conclusion: Overall, our findings suggest that brain training programs are feasible in middle-aged cohorts. We propose that brain training games may be linked to improvements in executive attention and affect by promoting cognitive self-efficacy in middle-aged adults.
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Affiliation(s)
- Paula M McLaughlin
- 1 Ontario Neurodegenerative Disease Research Initiative (ONDRI), Western University , London, Canada .,2 York University , Department of Psychology, Toronto, Canada
| | - Ashley F Curtis
- 2 York University , Department of Psychology, Toronto, Canada
| | | | - Janna K Comrie
- 2 York University , Department of Psychology, Toronto, Canada
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Mohammed S, Flores L, Deveau J, Hoffing RC, Phung C, Parlett CM, Sheehan E, Lee D, Au J, Buschkuehl M, Zordan V, Jaeggi SM, Seitz AR. The Benefits and Challenges of Implementing Motivational Features to Boost Cognitive Training Outcome. J Cogn Enhanc 2017; 1:491-507. [PMID: 30221244 DOI: 10.1007/s41465-017-0047-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [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: 11/30/2022]
Abstract
In the current literature, there are a number of cognitive training studies that use N-back tasks as their training vehicle; however, the interventions are often bland, and many studies suffer from considerable attrition rates. An increasingly common approach to increase participant engagement has been the implementation of motivational features in training tasks; yet, the effects of such "gamification" on learning have been inconsistent. To shed more light on those issues, here, we report the results of a training study conducted at two Universities in Southern California. A total of 115 participants completed 4 weeks (20 sessions) of N-back training in the laboratory. We varied the amount of "gamification" and the motivational features that might make the training more engaging and, potentially, more effective. Thus, 47 participants trained on a basic color/identity N-back version with no motivational features, whereas 68 participants trained on a gamified version that translated the basic mechanics of the N-back task into an engaging 3D space-themed "collection" game (Deveau et al. Frontiers in Systems Neuroscience, 8, 243, 2015). Both versions used similar adaptive algorithms to increase the difficulty level as participants became more proficient. Participants' self-reports indicated that the group who trained on the gamified version enjoyed the intervention more than the group who trained on the non-gamified version. Furthermore, the participants who trained on the gamified version exerted more effort and also improved more during training. However, despite the differential training effects, there were no significant group differences in any of the outcome measures at post-test, suggesting that the inclusion of motivational features neither substantially benefited nor hurt broader learning. Overall, our findings provide guidelines for task implementation to optimally target participants' interest and engagement to promote learning, which may lead to broader adoption and adherence of cognitive training.
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Affiliation(s)
- Shafee Mohammed
- School of Education, University of California, Irvine, Irvine, CA 92617, USA
| | - Lauren Flores
- Department of Psychology, University of California, Riverside, 900 University Avenue, Riverside, CA 92521, USA
| | - Jenni Deveau
- Department of Psychology, University of California, Riverside, 900 University Avenue, Riverside, CA 92521, USA
| | - Russell Cohen Hoffing
- Department of Psychology, University of California, Riverside, 900 University Avenue, Riverside, CA 92521, USA
| | - Calvin Phung
- Department of Psychology, University of California, Riverside, 900 University Avenue, Riverside, CA 92521, USA
| | - Chelsea M Parlett
- School of Education, University of California, Irvine, Irvine, CA 92617, USA
| | - Ellen Sheehan
- School of Education, University of California, Irvine, Irvine, CA 92617, USA
| | - David Lee
- School of Education, University of California, Irvine, Irvine, CA 92617, USA
| | - Jacky Au
- School of Education, University of California, Irvine, Irvine, CA 92617, USA
| | - Martin Buschkuehl
- MIND Research Institute, 111 Academy Dr., Suite 100, Irvine, CA 92617, USA
| | - Victor Zordan
- School of Computing, Clemson University, 307 McAdams Hall, Clemson, SC 29634, USA
| | - Susanne M Jaeggi
- School of Education, University of California, Irvine, Irvine, CA 92617, USA
| | - Aaron R Seitz
- Department of Psychology, University of California, Riverside, 900 University Avenue, Riverside, CA 92521, USA
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13
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Bloom R, Schnaider-Beeri M, Ravona-Springer R, Heymann A, Dabush H, Bar L, Slater S, Rassovsky Y, Bahar-Fuchs A. Computerized cognitive training for older diabetic adults at risk of dementia: Study protocol for a randomized controlled trial. Alzheimers Dement (N Y) 2017; 3:636-650. [PMID: 29234725 PMCID: PMC5716953 DOI: 10.1016/j.trci.2017.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Older adults with type 2 diabetes are at high risk of cognitive decline and dementia and form an important target group for dementia risk reduction studies. Despite evidence that computerized cognitive training (CCT) may benefit cognitive performance in cognitively healthy older adults and those with mild cognitive impairment, whether CCT may benefit cognitive performance or improve disease self-management in older diabetic adults has not been studied to date. In addition, whether adaptive difficulty levels and tailoring of interventions to individuals' cognitive profile are superior to generic training remains to be established. Methods Ninety community-dwelling older (age ≥ 65) diabetic adults are recruited and randomized into a tailored and adaptive computerized cognitive training condition or to a generic, nontailored, or adaptive CCT condition. Both groups complete an 8-week training program using the commercially available CogniFit program. The intervention is augmented by a range of behavior-change techniques, and participants in each condition are further randomized into a global or cognition-specific phone-based self-efficacy (SE) condition, or a no-SE condition. The primary outcome is global cognitive performance immediately after the intervention. Secondary outcomes include diabetes self-management, meta-memory, mood, and SE. Discussion This pilot study is the first trial evaluating the potential benefits of home-based tailored and adaptive CCT in relation to cognitive and disease self-management in older diabetic adults. Methodological strengths of this trial include the double-blind design, the clear identification of the proposed active ingredients of the intervention, and the use of evidence-based behavior-change techniques. Results from this study will indicate whether CCT has the potential to lower the risk of diabetes-related cognitive decline. The outcomes of the trial will also advance our understanding of essential intervention parameters required to improve or maintain cognitive function and enhance disease self-management in this at-risk group.
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Affiliation(s)
- Rachel Bloom
- Joseph Sagol Neuroscience Centre, Sheba Medical Center, Ramat Gan, Israel.,School of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Michal Schnaider-Beeri
- Joseph Sagol Neuroscience Centre, Sheba Medical Center, Ramat Gan, Israel.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - Hai Dabush
- Joseph Sagol Neuroscience Centre, Sheba Medical Center, Ramat Gan, Israel
| | - Lior Bar
- Joseph Sagol Neuroscience Centre, Sheba Medical Center, Ramat Gan, Israel
| | - Shirel Slater
- Joseph Sagol Neuroscience Centre, Sheba Medical Center, Ramat Gan, Israel
| | - Yuri Rassovsky
- School of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Alex Bahar-Fuchs
- Joseph Sagol Neuroscience Centre, Sheba Medical Center, Ramat Gan, Israel.,Center for Research on Aging, Health, and Wellbeing, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia.,The Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Australia
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14
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Yoncheva YN, Hardy KK, Lurie DJ, Somandepalli K, Yang L, Vezina G, Kadom N, Packer RJ, Milham MP, Castellanos FX, Acosta MT. Computerized cognitive training for children with neurofibromatosis type 1: A pilot resting-state fMRI study. Psychiatry Res 2017; 266:53-58. [PMID: 28605662 PMCID: PMC5582983 DOI: 10.1016/j.pscychresns.2017.06.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 06/02/2017] [Accepted: 06/03/2017] [Indexed: 12/19/2022]
Abstract
In this pilot study, we examined training effects of a computerized working memory program on resting state functional magnetic resonance imaging (fMRI) measures in children with neurofibromatosis type 1 (NF1). We contrasted pre- with post-training resting state fMRI and cognitive measures from 16 participants (nine males; 11.1 ± 2.3 years) with NF1 and documented working memory difficulties. Using non-parametric permutation test inference, we found significant regionally specific differences (family-wise error corrected) in two of four voxel-wise resting state measures: fractional amplitude of low frequency fluctuations (indexing peak-to-trough intensity of spontaneous oscillations) and regional homogeneity (indexing local intrinsic synchrony). Some cognitive task improvement was observed as well. These preliminary findings suggest that regionally specific changes in resting state fMRI indices may be associated with treatment-related cognitive amelioration in NF1. Nevertheless, current results must be interpreted with caution pending independent controlled replication.
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Affiliation(s)
- Yuliya N Yoncheva
- Department of Child and Adolescent Psychiatry, NYU Langone Medical Center, New York, NY, USA
| | - Kristina K Hardy
- Department of Pediatrics and Neurology, George Washington University, School of Medicine, Washington, DC, USA; Children's National Health System, Washington, DC, USA
| | - Daniel J Lurie
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA
| | | | - Lanbo Yang
- Department of Child and Adolescent Psychiatry, NYU Langone Medical Center, New York, NY, USA
| | - Gilbert Vezina
- Children's National Health System, Washington, DC, USA; Department of Diagnostic Imaging and Radiology, Children's National Health System, Washington, DC, USA
| | - Nadja Kadom
- Department of Radiology and Imaging Sciences, Children's Healthcare of Atlanta (Egleston), Atlanta, GA, USA
| | - Roger J Packer
- Department of Pediatrics and Neurology, George Washington University, School of Medicine, Washington, DC, USA; Children's National Health System, Washington, DC, USA
| | - Michael P Milham
- Child Mind Institute, New York, NY, USA; Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - F Xavier Castellanos
- Department of Child and Adolescent Psychiatry, NYU Langone Medical Center, New York, NY, USA; Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Maria T Acosta
- Department of Pediatrics and Neurology, George Washington University, School of Medicine, Washington, DC, USA; Children's National Health System, Washington, DC, USA.
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15
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Pickersgill M, Broer T, Cunningham-Burley S, Deary I. Prudence, pleasure, and cognitive ageing: Configurations of the uses and users of brain training games within UK media, 2005-2015. Soc Sci Med 2017; 187:93-100. [PMID: 28668726 PMCID: PMC5529213 DOI: 10.1016/j.socscimed.2017.06.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 06/16/2017] [Accepted: 06/19/2017] [Indexed: 11/26/2022]
Abstract
The use of ‘brain training’ games is often regarded as relating to wider ideals of self-improvement and youthfulness. Hence, use is intertwined with discourses of ‘active’ ageing. This paper analyzes how the use and users of brain training games were configured in the UK media, from 2005 to 2015, and examines how notions of active ageing relate to these representations. Game users were rarely constructed solely as gamers, and were more often presented as prudent individuals focused on a serious goal. This configuration related to assumed and enjoined motivations for brain training; specifically, users were commonly framed as seeking to enhance cognition and limit/delay cognitive decline. Scientific evidence about brain training was often deployed to explain how games might work; sometimes, however, it was used to undermine the utility of games and assert the significance and cognitive health-benefits of other activities. A minority of texts explicitly critiqued ideals of self-improvement, arguing that game playing was important for its own sake. Yet, even the pleasure associated with gaming was occasionally instrumentalized as a mechanism for ensuring prudent life choices. The analysis casts fresh light on how debates around health, ageing, and science correspond to configurations of technology uses and users. It presents evidence of the widespread cultural circulation of enjoiners regarding self-care and healthy ageing within British society. However, the paper also provides indications of the limits to such imperatives: discourses of pleasure co-exist with and perhaps supplant logics of prudence in (accounts of) practices ostensibly aimed at ageing ‘well’. This article analyses UK newspaper coverage of brain training games from 2005 to 2015. It interrogates how the uses and users of brain training games are configured. It examines these configurations against a backdrop of active ageing and self-care. Scientific evidence is drawn on in coverage to support and to refute brain training. Coverage links to responsibilization but challenges it through a discourse of pleasure.
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Affiliation(s)
- Martyn Pickersgill
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, United Kingdom.
| | - Tineke Broer
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, United Kingdom.
| | - Sarah Cunningham-Burley
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, United Kingdom.
| | - Ian Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, United Kingdom.
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16
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Harvie DS, Smith RT, Hunter EV, Davis MG, Sterling M, Moseley GL. Using visuo-kinetic virtual reality to induce illusory spinal movement: the MoOVi Illusion. PeerJ 2017; 5:e3023. [PMID: 28243537 PMCID: PMC5324774 DOI: 10.7717/peerj.3023] [Citation(s) in RCA: 16] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 01/24/2017] [Indexed: 12/16/2022] Open
Abstract
Background Illusions that alter perception of the body provide novel opportunities to target brain-based contributions to problems such as persistent pain. One example of this, mirror therapy, uses vision to augment perceived movement of a painful limb to treat pain. Since mirrors can’t be used to induce augmented neck or other spinal movement, we aimed to test whether such an illusion could be achieved using virtual reality, in advance of testing its potential therapeutic benefit. We hypothesised that perceived head rotation would depend on visually suggested movement. Method In a within-subjects repeated measures experiment, 24 healthy volunteers performed neck movements to 50o of rotation, while a virtual reality system delivered corresponding visual feedback that was offset by a factor of 50%–200%—the Motor Offset Visual Illusion (MoOVi)—thus simulating more or less movement than that actually occurring. At 50o of real-world head rotation, participants pointed in the direction that they perceived they were facing. The discrepancy between actual and perceived direction was measured and compared between conditions. The impact of including multisensory (auditory and visual) feedback, the presence of a virtual body reference, and the use of 360o immersive virtual reality with and without three-dimensional properties, was also investigated. Results Perception of head movement was dependent on visual-kinaesthetic feedback (p = 0.001, partial eta squared = 0.17). That is, altered visual feedback caused a kinaesthetic drift in the direction of the visually suggested movement. The magnitude of the drift was not moderated by secondary variables such as the addition of illusory auditory feedback, the presence of a virtual body reference, or three-dimensionality of the scene. Discussion Virtual reality can be used to augment perceived movement and body position, such that one can perform a small movement, yet perceive a large one. The MoOVi technique tested here has clear potential for assessment and therapy of people with spinal pain.
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Affiliation(s)
- Daniel S Harvie
- Recover Injury Research Centre, Centre of Research Excellence in Road Traffic Injury, Menzies Health Institute QLD, Griffith University, Griffith University , Gold Coast , Australia
| | - Ross T Smith
- Wearable Computer Lab, University of South Australia , Adelaide , Australia
| | - Estin V Hunter
- Recover Injury Research Centre, Centre of Research Excellence in Road Traffic Injury, Menzies Health Institute QLD, Griffith University, Griffith University , Gold Coast , Australia
| | - Miles G Davis
- Wearable Computer Lab, University of South Australia , Adelaide , Australia
| | - Michele Sterling
- Recover Injury Research Centre, Centre of Research Excellence in Road Traffic Injury, Menzies Health Institute QLD, Griffith University, Griffith University , Gold Coast , Australia
| | - G Lorimer Moseley
- Sansom Institute for Health Research, University of South Australia, Adelaide, Australia; Neuroscience Research Australia, Sydney, Australia
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17
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Shah TM, Weinborn M, Verdile G, Sohrabi HR, Martins RN. Enhancing Cognitive Functioning in Healthly Older Adults: a Systematic Review of the Clinical Significance of Commercially Available Computerized Cognitive Training in Preventing Cognitive Decline. Neuropsychol Rev 2017; 27:62-80. [PMID: 28092015 DOI: 10.1007/s11065-016-9338-9] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [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: 09/06/2016] [Accepted: 12/07/2016] [Indexed: 02/01/2023]
Abstract
Successfully assisting older adults to maintain or improve cognitive function, particularly when they are dealing with neurodegenerative disorders such as Alzheimer's disease (AD), remains a major challenge. Cognitive training may stimulate neuroplasticity thereby increasing cognitive and brain reserve. Commercial brain training programs are computerized, readily-available, easy-to-administer and adaptive but often lack supportive data and their clinical validation literature has not been previously reviewed. Therefore, in this review, we report the characteristics of commercially available brain training programs, critically assess the number and quality of studies evaluating the empirical evidence of these programs for promoting brain health in healthy older adults, and discuss underlying causal mechanisms. We searched PubMed, Google Scholar and each program's website for relevant studies reporting the effects of computerized cognitive training on cognitively healthy older adults. The evidence for each program was assessed via the number and quality (PEDro score) of studies, including Randomized Control Trials (RCTs). Programs with clinical studies were subsequently classified as possessing Level I, II or III evidence. Out of 18 identified programs, 7 programs were investigated in 26 studies including follow-ups. Two programs were identified as possessing Level I evidence, three programs demonstrated Level II evidence and an additional two programs demonstrated Level III evidence. Overall, studies showed generally high methodological quality (average PEDro score = 7.05). Although caution must be taken regarding any potential bias due to selective reporting, current evidence supports that at least some commercially available computerized brain training products can assist in promoting healthy brain aging.
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Affiliation(s)
- Tejal M Shah
- McCusker Alzheimer's Research Foundation, Hollywood Medical Centre, Nedlands, WA, Australia, 6009
- Centre of Excellence for Alzheimer's Disease Research & Care, School of Medical Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, Australia, 6027
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, Australia, 6009
| | - Michael Weinborn
- McCusker Alzheimer's Research Foundation, Hollywood Medical Centre, Nedlands, WA, Australia, 6009
- Centre of Excellence for Alzheimer's Disease Research & Care, School of Medical Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, Australia, 6027
- School of Psychology, University of Western Australia, Crawley, WA, Australia, 6009
| | - Giuseppe Verdile
- McCusker Alzheimer's Research Foundation, Hollywood Medical Centre, Nedlands, WA, Australia, 6009
- Centre of Excellence for Alzheimer's Disease Research & Care, School of Medical Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, Australia, 6027
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, Australia, 6009
- School of Biomedical Sciences, CHIRI Biosciences, Curtin University, Bentley, WA, Australia, 6102
| | - Hamid R Sohrabi
- McCusker Alzheimer's Research Foundation, Hollywood Medical Centre, Nedlands, WA, Australia, 6009
- Centre of Excellence for Alzheimer's Disease Research & Care, School of Medical Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, Australia, 6027
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, Australia, 6009
| | - Ralph N Martins
- McCusker Alzheimer's Research Foundation, Hollywood Medical Centre, Nedlands, WA, Australia, 6009.
- Centre of Excellence for Alzheimer's Disease Research & Care, School of Medical Sciences, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, Australia, 6027.
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, Australia, 6009.
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18
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Cassarino M, Setti A. Environment as ' Brain Training': A review of geographical and physical environmental influences on cognitive ageing. Ageing Res Rev 2015; 23:167-82. [PMID: 26144974 DOI: 10.1016/j.arr.2015.06.003] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 06/19/2015] [Accepted: 06/29/2015] [Indexed: 12/15/2022]
Abstract
Global ageing demographics coupled with increased urbanisation pose major challenges to the provision of optimal living environments for older persons, particularly in relation to cognitive health. Although animal studies emphasize the benefits of enriched environments for cognition, and brain training interventions have shown that maintaining or improving cognitive vitality in older age is possible, our knowledge of the characteristics of our physical environment which are protective for cognitive ageing is lacking. The present review analyses different environmental characteristics (e.g. urban vs. rural settings, presence of green) in relation to cognitive performance in ageing. Studies of direct and indirect associations between physical environment and cognitive performance are reviewed in order to describe the evidence that our living contexts constitute a measurable factor in determining cognitive ageing.
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19
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Scharnowski F, Veit R, Zopf R, Studer P, Bock S, Diedrichsen J, Goebel R, Mathiak K, Birbaumer N, Weiskopf N. Manipulating motor performance and memory through real-time fMRI neurofeedback. Biol Psychol 2015; 108:85-97. [PMID: 25796342 PMCID: PMC4433098 DOI: 10.1016/j.biopsycho.2015.03.009] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [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: 06/17/2014] [Revised: 02/02/2015] [Accepted: 03/10/2015] [Indexed: 02/05/2023]
Abstract
Neurofeedback training of motor cortex shortens reaction times. Self-regulation of parahippocampal cortex activity interferes with memory encoding. Differential neurofeedback reveals double dissociation between neurofeedback target areas.
Task performance depends on ongoing brain activity which can be influenced by attention, arousal, or motivation. However, such modulating factors of cognitive efficiency are unspecific, can be difficult to control, and are not suitable to facilitate neural processing in a regionally specific manner. Here, we non-pharmacologically manipulated regionally specific brain activity using technically sophisticated real-time fMRI neurofeedback. This was accomplished by training participants to simultaneously control ongoing brain activity in circumscribed motor and memory-related brain areas, namely the supplementary motor area and the parahippocampal cortex. We found that learned voluntary control over these functionally distinct brain areas caused functionally specific behavioral effects, i.e. shortening of motor reaction times and specific interference with memory encoding. The neurofeedback approach goes beyond improving cognitive efficiency by unspecific psychological factors such as attention, arousal, or motivation. It allows for directly manipulating sustained activity of task-relevant brain regions in order to yield specific behavioral or cognitive effects.
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Affiliation(s)
- Frank Scharnowski
- Department of Radiology and Medical Informatics-CIBM, University of Geneva, Rue Gabrielle-Perret-G 4, CH-1211 Geneva 14, Switzerland; Institute of Bioengineering, Swiss Institute of Technology Lausanne (EPFL), STI-IBI Station 17, CH-1015 Lausanne, Switzerland.
| | - Ralf Veit
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Gartenstrasse 29, 72074 Tübingen, Germany
| | - Regine Zopf
- Perception in Action Research Centre, ARC Centre of Excellence in Cognition and its Disorders, Department of Cognitive Science, Macquarie University, Sydney 2109, NSW, Australia
| | - Petra Studer
- Department of Child & Adolescent Mental Health, University Hospital of Erlangen, Schwabachanlage 6+10, 91054 Erlangen, Germany
| | - Simon Bock
- Department of Child & Adolescent Psychiatry and Psychotherapy, Centre for Mental Health, Hospitals of Stuttgart, Prießnitzweg 24, 70374 Stuttgart
| | - Jörn Diedrichsen
- Institute of Cognitive Neuroscience, University College London, 17 Queen Square, London WC1 N 3AR, UK
| | - Rainer Goebel
- Department of Cognitive Neuroscience, Maastricht University, Maastricht 6200 MD, The Netherlands; Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences (KNAW), 1105 BA Amsterdam, The Netherlands
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany
| | - Niels Birbaumer
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Gartenstrasse 29, 72074 Tübingen, Germany; Ospedale San Camillo, Istituto di Ricovero e Cura a Carattere Scientifico, Venezia-Lido, Italy
| | - Nikolaus Weiskopf
- Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, University College London, 12 Queen Square, London WC1 N 3BG, UK
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