scholarly journals Testing a Computerized Cognitive Training Protocol in Adults Aging With HIV-Associated Neurocognitive Disorders: Randomized Controlled Trial Rationale and Protocol

2017 ◽  
Vol 6 (4) ◽  
pp. e68 ◽  
Author(s):  
David Vance ◽  
Pariya Fazeli ◽  
John Shacka ◽  
William Nicholson ◽  
Peggy McKie ◽  
...  
10.2196/14489 ◽  
2019 ◽  
Vol 8 (10) ◽  
pp. e14489
Author(s):  
Jacobus Gidion Louw ◽  
Leana Olivier ◽  
Sarah Skeen ◽  
Alastair van Heerden ◽  
Mark Tomlinson

Background Fetal alcohol spectrum disorder (FASD) is one of the most common causes of preventable intellectual disability, and the key associated deficits are in executive function (EF). Aspects of EF can be improved using cognitive training interventions. The highest prevalence of FASD globally (at a rate of 135.1 per 1000) has been found in a South African population in the Western Cape province. There is a shortage of specialized health service personnel, and there are limited remedial services. Computer-based cognitive training, if age and culturally appropriate, could be an effective way to provide the interventions with minimal need for skilled personnel and other resources. The Foundation for Alcohol Related Research has developed such a program for the South African context. Objective This protocol aimed to evaluate whether it is feasible to use computerized cognitive training in a resource-poor context to improve cognitive function in children exposed to alcohol in utero. Methods We are conducting a randomized controlled trial in the Saldanha Bay Municipal area, evaluating a custom-developed cognitive training program to improve the cognitive function of children aged between 4 and 6 years who were exposed to alcohol in the prenatal stage. Participants will be recruited from local Early Childhood Development centers. Community workers will interview biological mothers to identify alcohol-exposed pregnancies. Alcohol-exposed children will be randomized into an intervention or a control group of 40 participants each using block randomization. A group of 40 children not exposed to alcohol will be included in a normative group using individual randomization. The intervention group will play the game for 6 months (40 sessions). Normative and control groups will receive no intervention. Neurodevelopmental assessments will be done at baseline and upon completion of the study with all participants. Results The intervention has started, and all baseline assessments have been done at the time of submission. Conclusions This study will provide insight into whether computerized cognitive training is viable and effective in the South African context. It has the potential to provide a means of intervention globally and in other resource-poor context and expand the knowledge base regarding executive functioning and FASD. This paper presents the research protocol and intervention design of the study. Trial Registration ISRCTN Registry ISRCTN17244156; http://www.isrctn.com/ISRCTN17244156. International Registered Report Identifier (IRRID) DERR1-10.2196/14489


2021 ◽  
Vol 80 (4) ◽  
pp. 1525-1537
Author(s):  
Lisanne F. Ten Brinke ◽  
Chun Liang Hsu ◽  
Kirk I. Erickson ◽  
Todd C. Handy ◽  
Teresa Liu-Ambrose

Background: Evidence suggests that computerized cognitive training (CCT) can improve cognitive function in older adults, particularly executive functions. However, the underlying mechanisms by which CCT may improve executive functions are not well established. Objective: To determine: 1) inter-network functional connectivity correlates of changes in executive functions; and 2) the effect of CCT on these functional connectivity correlates. Methods: This secondary analysis included a subset of 124 adults aged 65–85 years enrolled in an 8-week randomized controlled trial of CCT. Participants were randomized to either: 1) group-based CCT 3x/week for 1 hour plus 3x/week home-based training; 2) group-based CCT preceded by brisk walking (Ex+CCT) 3x/week for 1 hour plus 3x/week home-based training; or 3) group-based balanced and toned (BAT) classes 3x/week for 1 hour (control). At baseline and trial completion, 65 of the 124 participants completed resting-state functional magnetic resonance imaging and neuropsychological tests of executive functions, specifically the Stroop Colour-Word Test and Flanker Test. Results: Improved performance on the Stroop Colour-Word Test and Flanker Test were associated with decreased correlation between the default mode network (DMN) and the fronto-parietal network (FPN) (p < 0.05). Compared with BAT, CCT alone significantly decreased correlation between the left dorsolateral prefrontal cortex and both the left and right medial temporal gyrus (–0.143, 95%CI [–0.256,–0.030], p = 0.014, and –0.123, 95%CI [–0.242,–0.004], p = 0.043, respectively). Conclusion: Decreased correlation between DMN and FPN, indicating less connection between these networks, may be an underlying mechanism by which CCT improves executive functions. Future studies are needed to replicate this finding.


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