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A randomized controlled trial of combined executive function and memory training on the cognitive and noncognitive function of individuals with mild cognitive impairment: Study rationale and protocol design.

ABSTRACT: Introduction:Cognitive training has attracted considerable attention as a safe, economical, and scalable nonpharmacologic intervention in patients with mild cognitive impairment (MCI). However, no study has yet placed sufficient emphasis on the training of executive function. The present study aimed to evaluate whether memory training combined with executive training could lead to improved cognitive and noncognitive performance in patients with MCI. Furthermore, we will explore the neural correlates underlying the changed performances. Methods:The proposed study is a randomized controlled trial that will include 120 patients with MCI. The eligible patients will be randomized to either an intervention group or a waitlist control group. The intervention group will receive computerized combined training (executive function and memory) for 96 sessions for more than 24 weeks. The control group will receive no intervention during the research period. Behavior data collection and a magnetic resonance imaging/electroencephalogram/near-infrared spectroscopy scan will be performed at baseline and after 24 weeks of intervention. Results:The study is currently ongoing. Recruitment began in July 2017 and will conclude in December 2018. Discussion:If combined training results in positive changes to cognitive function and noncognitive function in patients with MCI, this might represent a new approach to delay the cognitive decline or even provide a potential method for dementia prevention. Furthermore, the evaluation of any training-related structural changes or functional changes will help to reveal the mechanisms underlying the combined cognitive training. Trial registration:This study was registered with Clinicaltrials.gov (Identifier: NCT03232047, August 18, 2017).

SUBMITTER: Zhang H

PROVIDER: S-EPMC6205116 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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A randomized controlled trial of combined executive function and memory training on the cognitive and noncognitive function of individuals with mild cognitive impairment: Study rationale and protocol design.

Zhang Haifeng H Wang Jing J Sun Tingting T Wang Zhijiang Z Lyu Xiaozhen X Yu Xin X Wang Huali H

Alzheimer's & dementia (New York, N. Y.) 20181015

<h4>Introduction</h4>Cognitive training has attracted considerable attention as a safe, economical, and scalable nonpharmacologic intervention in patients with mild cognitive impairment (MCI). However, no study has yet placed sufficient emphasis on the training of executive function. The present study aimed to evaluate whether memory training combined with executive training could lead to improved cognitive and noncognitive performance in patients with MCI. Furthermore, we will explore the neura ...[more]

PMID: 30386820

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Project description:BackgroundAdaptive computerized working memory (WM) training has shown favorable effects on cerebral cortical thickness as compared to non-adaptive training in healthy individuals. However, knowledge of WM training-related morphological changes in mild cognitive impairment (MCI) is limited.ObjectiveThe primary objective of this double-blind randomized study was to investigate differences in longitudinal cortical thickness trajectories after adaptive and non-adaptive WM training in patients with MCI. We also investigated the genotype effects on cortical thickness trajectories after WM training combining these two training groups using longitudinal structural magnetic resonance imaging (MRI) analysis in Freesurfer.MethodMagnetic resonance imaging acquisition at 1.5 T were performed at baseline, and after four- and 16-weeks post training. A total of 81 individuals with MCI accepted invitations to undergo 25 training sessions over 5 weeks. Longitudinal Linear Mixed effect models investigated the effect of adaptive vs. non-adaptive WM training. The LME model was fitted for each location (vertex). On all statistical analyzes, a threshold was applied to yield an expected false discovery rate (FDR) of 5%. A secondary LME model investigated the effects of LMX1A and APOE-ε4 on cortical thickness trajectories after WM training.ResultsA total of 62 participants/patients completed the 25 training sessions. Structural MRI showed no group difference between the two training regimes in our MCI patients, contrary to previous reports in cognitively healthy adults. No significant structural cortical changes were found after training, regardless of training type, across all participants. However, LMX1A-AA carriers displayed increased cortical thickness trajectories or lack of decrease in two regions post-training compared to those with LMX1A-GG/GA. No training or training type effects were found in relation to the APOE-ε4 gene variants.ConclusionThe MCI patients in our study, did not have improved cortical thickness after WM training with either adaptive or non-adaptive training. These results were derived from a heterogeneous population of MCI participants. The lack of changes in the cortical thickness trajectory after WM training may also suggest the lack of atrophy during this follow-up period. Our promising results of increased cortical thickness trajectory, suggesting greater neuroplasticity, in those with LMX1A-AA genotype need to be validated in future trials.

Dataset Information

A randomized controlled trial of combined executive function and memory training on the cognitive and noncognitive function of individuals with mild cognitive impairment: Study rationale and protocol design.

Publications

A randomized controlled trial of combined executive function and memory training on the cognitive and noncognitive function of individuals with mild cognitive impairment: Study rationale and protocol design.

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