Dataset Information

Structural brain changes after traditional and robot-assisted multi-domain cognitive training in community-dwelling healthy elderly.

ABSTRACT: The purpose of this study was to investigate if multi-domain cognitive training, especially robot-assisted training, alters cortical thickness in the brains of elderly participants. A controlled trial was conducted with 85 volunteers without cognitive impairment who were 60 years old or older. Participants were first randomized into two groups. One group consisted of 48 participants who would receive cognitive training and 37 who would not receive training. The cognitive training group was randomly divided into two groups, 24 who received traditional cognitive training and 24 who received robot-assisted cognitive training. The training for both groups consisted of daily 90-min-session, five days a week for a total of 12 weeks. The primary outcome was the changes in cortical thickness. When compared to the control group, both groups who underwent cognitive training demonstrated attenuation of age related cortical thinning in the frontotemporal association cortices. When the robot and the traditional interventions were directly compared, the robot group showed less cortical thinning in the anterior cingulate cortices. Our results suggest that cognitive training can mitigate age-associated structural brain changes in the elderly.ClnicalTrials.gov NCT01596205.

SUBMITTER: Kim GH

PROVIDER: S-EPMC4405358 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Structural brain changes after traditional and robot-assisted multi-domain cognitive training in community-dwelling healthy elderly.

Kim Geon Ha GH Jeon Seun S Im Kiho K Kwon Hunki H Lee Byung Hwa BH Kim Ga Young GY Jeong Hana H Han Noh Eul NE Seo Sang Won SW Cho Hanna H Noh Young Y Park Sang Eon SE Kim Hojeong H Hwang Jung Won JW Yoon Cindy W CW Kim Hee Jin HJ Ye Byoung Seok BS Chin Ju Hee JH Kim Jung-Hyun JH Suh Mee Kyung MK Lee Jong Min JM Kim Sung Tae ST Choi Mun-Taek MT Kim Mun Sang MS Heilman Kenneth M KM Jeong Jee Hyang JH Na Duk L DL

PloS one 20150421 4

<h4>Unlabelled</h4>The purpose of this study was to investigate if multi-domain cognitive training, especially robot-assisted training, alters cortical thickness in the brains of elderly participants. A controlled trial was conducted with 85 volunteers without cognitive impairment who were 60 years old or older. Participants were first randomized into two groups. One group consisted of 48 participants who would receive cognitive training and 37 who would not receive training. The cognitive train ...[more]

PMID: 25898367

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Project description:BackgroundAlongside physiological cognitive ageing, nowadays there is an alarming increase in the incidence of dementia that requires communities to invest in its prevention. The engagement in cognitively stimulating activities and strong social networks has been identified among those protective factors promoting successful cognitive ageing. One aspect regarding cognitive stimulation concerns the relevance of the frequency of an external intervention. For this reason, the aim of this study was to evaluate the efficacy of a 3-month cognitive training program, once per week, in a group of healthy elderly aged over 60 years old. Their results were compared with those of a passive control group.MethodsThe training consisted of a weekly session of multi-domain and ecological cognitive exercises performed in small homogenous (i.e. same cognitive level) groups. The scores obtained in a neuropsychological assessment by the experimental and control groups were compared at pre- and post-training. In addition, by means of a questionnaire, we also evaluated the indirect effect of the program on participants' mood, socialization and perceived impact on everyday activities.ResultsOverall, the experimental group showed a general improvement in cognitive functioning following the training program, even with the frequency of once per week. Greater improvements were observed mainly on executive functions and short-term memory, but general cognitive functioning and non-verbal reasoning also showed a tendency to an improvement. It is noteworthy that a majority of the participants reported to have subjectively experienced an improvement in their everyday life and a positive influence on both mood and socialization.ConclusionsThese results show that even a low-intensity training program is able to promote some of the protective factors that support successful cognitive ageing. Moreover, this multi-domain approach proved to be an excellent training method to transfer gains not only to other cognitive domains, but also to everyday living.Trial registrationNCT03771131 ; the study was retrospectively registered on December 7th 2018.

Project description:BackgroundRobot-assisted gait training (RAGT) is expected to be an effective rehabilitative intervention for patients with gait disturbances. However, the monotonous gait pattern provided by robotic guidance tends to induce sleepiness, and the resultant decreased arousal during RAGT may negatively affect gait training progress. This study assessed electroencephalography (EEG)-based, objective sleepiness during RAGT and examined whether verbal or nonverbal warning sounds are effective stimuli for counteracting such sleepiness.MethodsTwelve healthy men walked on a treadmill for 6 min, while being guided by a Gait-Assistance Robot, under 3 experimental conditions: with sine-wave sound stimulation (SS), verbal sound stimulation (VS), and no sound stimulation (NS). The volunteers were provided with warning sound stimulation at 4 min (ST1), 4 min 20 s (ST2), 4 min 40 s (ST3), and 5 min (ST4) after the start of RAGT. EEGs were recorded at the central (Cz) and occipital (O1 and O2) regions (International 10-20 system) before and during RAGT, and 4-s segments of EEG data were extracted from the filtered data during the 8 experimental periods: middle of the eyes-closed condition; middle of the eyes-open condition; beginning of RAGT; immediately before ST1; immediately after ST1, ST2, ST3, and ST4. According to the method used in the Karolinska drowsiness test, the power densities of the theta, alpha 1, and alpha 2 bands were calculated as indices of objective sleepiness.ResultsComparisons of the findings between baseline and before ST showed that the power densities of the alpha 1 and 2 bands tended to increase, whereas the theta power density increased significantly (P?<?.05). During NS, the power densities remained at a constant high level until after ST4. During SS and VS, the power densities were attenuated immediately to the same degree and maintained at a constant low level until after ST4.ConclusionsThis study is the first to demonstrate that EEG-measured arousal levels decrease within a short time during RAGT, but are restored and maintained by intermittent warning sound stimulation.

Project description:Proprioception has a crucial role in promoting or hindering motor learning. In particular, an intact position sense strongly correlates with the chances of recovery after stroke. A great majority of neurological patients present both motor dysfunctions and impairments in kinesthesia, but traditional robot and virtual reality training techniques focus either in recovering motor functions or in assessing proprioceptive deficits. An open challenge is to implement effective and reliable tests and training protocols for proprioception that go beyond the mere position sense evaluation and exploit the intrinsic bidirectionality of the kinesthetic sense, which refers to both sense of position and sense of movement. Modulated haptic interaction has a leading role in promoting sensorimotor integration, and it is a natural way to enhance volitional effort. Therefore, we designed a preliminary clinical study to test a new proprioception-based motor training technique for augmenting kinesthetic awareness via haptic feedback. The feedback was provided by a robotic manipulandum and the test involved seven chronic hemiparetic subjects over 3?weeks. The protocol included evaluation sessions that consisted of a psychometric estimate of the subject's kinesthetic sensation, and training sessions, in which the subject executed planar reaching movements in the absence of vision and under a minimally assistive haptic guidance made by sequences of graded force pulses. The bidirectional haptic interaction between the subject and the robot was optimally adapted to each participant in order to achieve a uniform task difficulty over the workspace. All the subjects consistently improved in the perceptual scores as a consequence of training. Moreover, they could minimize the level of haptic guidance in time. Results suggest that the proposed method is effective in enhancing kinesthetic acuity, but the level of impairment may affect the ability of subjects to retain their improvement in time.

Project description:Backgrounds and aimsHealth trajectories in aging, rather than single time-point assessments, could be early indicators of the onset of conditions such as dementia. The aim of this study was to identify different aging trajectories and to investigate their influence on the cumulative incidence of dementia.MethodsWe evaluated data referring to 993 elders from the InveCe.Ab study cohort. All subjects were free from dementia at baseline and re-assessed on at least one other occasion thereafter. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), physical function using the Walking Speed Test (WST), and disability on the basis of the Activities of Daily Living (ADL) score. To describe the different courses of the three outcomes combined, the Group-Based Trajectory Model (GBTM) method was applied. We looked for differences in age, gender, education, ApoE-e4 carrier status and obesity, and then investigated the influence of the observed trajectories on the incidence of dementia.ResultsThree trajectories were identified: a "good" scenario was observed in 703 (70.2%) individuals, who showed substantially stable cognitive and physical function and no disability; an "intermediate" scenario in 248 subjects (25.5%), who recorded a longer walking time, lower MMSE score, and a one-point higher ADL score; and a "severe" scenario in 42 elders (4.3%), who recorded declines in all the outcomes. Female gender, obesity and low education were most represented in the "severe" group. ApoE-e4 carrier status showed no difference between groups. The estimated cumulative incidence of dementia was higher in the "severe" (37%) than in the "intermediate" (7%) and "good" (< 1%) scenarios.ConclusionsUsing simple measurements, we built different aging trajectories, and observed that the worst performers had the highest incidence of dementia. Better knowledge of trajectories of aging would be useful for preventive interventions aimed at promoting healthier aging.

Project description:BackgroundRehabilitation robotics is progressing towards developing robots that can be used as advanced tools to augment the role of a therapist. These robots are capable of not only offering more frequent and more accessible therapies but also providing new insights into treatment effectiveness based on their ability to measure interaction parameters. A requirement for having more advanced therapies is to identify how robots can 'adapt' to each individual's needs at different stages of recovery. Hence, our research focused on developing an adaptive interface for the GENTLE/A rehabilitation system. The interface was based on a lead-lag performance model utilising the interaction between the human and the robot. The goal of the present study was to test the adaptability of the GENTLE/A system to the performance of the user.MethodsPoint-to-point movements were executed using the HapticMaster (HM) robotic arm, the main component of the GENTLE/A rehabilitation system. The points were displayed as balls on the screen and some of the points also had a real object, providing a test-bed for the human-robot interaction (HRI) experiment. The HM was operated in various modes to test the adaptability of the GENTLE/A system based on the leading/lagging performance of the user. Thirty-two healthy participants took part in the experiment comprising of a training phase followed by the actual-performance phase.ResultsThe leading or lagging role of the participant could be used successfully to adjust the duration required by that participant to execute point-to-point movements, in various modes of robot operation and under various conditions. The adaptability of the GENTLE/A system was clearly evident from the durations recorded. The regression results showed that the participants required lower execution times with the help from a real object when compared to just a virtual object. The 'reaching away' movements were longer to execute when compared to the 'returning towards' movements irrespective of the influence of the gravity on the direction of the movement.ConclusionsThe GENTLE/A system was able to adapt so that the duration required to execute point-to-point movement was according to the leading or lagging performance of the user with respect to the robot. This adaptability could be useful in the clinical settings when stroke subjects interact with the system and could also serve as an assessment parameter across various interaction sessions. As the system adapts to user input, and as the task becomes easier through practice, the robot would auto-tune for more demanding and challenging interactions. The improvement in performance of the participants in an embedded environment when compared to a virtual environment also shows promise for clinical applicability, to be tested in due time. Studying the physiology of upper arm to understand the muscle groups involved, and their influence on various movements executed during this study forms a key part of our future work.

Dataset Information

Structural brain changes after traditional and robot-assisted multi-domain cognitive training in community-dwelling healthy elderly.

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Structural brain changes after traditional and robot-assisted multi-domain cognitive training in community-dwelling healthy elderly.

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