Training-induced white matter microstructure changes in survivors of neonatal critical illness: A randomized controlled trial.

ABSTRACT: In a nationwide randomized controlled trial, white matter microstructure was assessed before and immediately after Cogmed Working-Memory Training (CWMT) in school-age neonatal critical illness survivors. Eligible participants were survivors (8-12 years) with an IQ???80 and a z-score of ? -1.5 on (working)memory test at first assessment. Diffusion Tensor Imaging was used to assess white matter microstructure. Associations between any training-induced changes and improved neuropsychological outcome immediately and one year post-CWMT were evaluated as well. The trial was conducted between October 2014-June 2017 at Erasmus MC-Sophia, Rotterdam, Netherlands. Researchers involved were blinded to group allocation. Participants were randomized to CWMT(n?=?14) or no-intervention(n?=?20). All children completed the CWMT. Global fractional anisotropy(FA) increased significantly post-CWMT compared to no-intervention(estimated-coefficient?=?.007, p?=?.015). Increased FA(estimated coefficient?=?.009, p?=?.033) and decreased mean diffusivity(estimated-coefficient?=?-.010, p?=?.018) were found in the left superior longitudinal fasciculus(SFL) post-CWMT compared no-intervention. Children after CWMT who improved with >1SD on verbal working-memory had significantly higher FA in the left SLF post-CWMT(n?=?6; improvement?=?.408?±?.01) than children without this improvement post-CWMT(n?=?6; no-improvement?=?.384?±?.02), F(1,12)?=?6.22, p?=?.041, ?_p²?=?.47. No other structure-function relationships were found post-CWMT. Our findings demonstrate that white matter microstructure and associated cognitive outcomes are malleable by CWMT in survivors of neonatal critical illness.

SUBMITTER: Schiller RM 

PROVIDER: S-EPMC6969347 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature