Effectiveness of Computerized Cognitive Training in the Elderly With Cognitive Impairment

Study Overview
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Brief Summary
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This study is to investigate the effectiveness of computerized cognitive training, and corresponding neural substrates through multimodal neuroimaging assessment, in the elderly with normal cognition, subjective cognitive impairment, and mild cognitive impairment.

Detailed Description
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Computerized cognitive training has the advantage of easy accessibility for community-dwelling elderly. It can be much cheaper than traditional neuropsychological training methods, which require trained neuropsychologists. Furthermore, it may be more fun and easier to be optimized to an individual patients' cognitive status than other traditional methods. Clinical efficacy of these kinds of cognitive training applications has been validated through several studies. A recent systematic review reported that the domains of working memory, executive function, and processing speed benefited the most by classic computerized cognitive training tasks, and that these benefits were comparable with traditional cognitive training methods. Apart from neuropsychological data, neuroimaging studies focusing on the effectiveness of computerized cognitive training are scant. There have been no previous studies investigating the possible neural substrates of computerized cognitive training using multimodal neuroimaging modalities simultaneously. Thus, we aimed to investigate the effectiveness of computerized cognitive training and corresponding neural substrates in subjects with mild cognitive impairment, subjective memory impairment, and normal controls through a multimodal approach.

Official Title
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Effectiveness of Computerized Cognitive Training Apparatus (CoCoTA) in the Elderly With Normal Cognition, Subjective Cognitive Impairment, Mild Cognitive Impairment

Conditions
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Mild Cognitive Impairment

Intervention / Treatment
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* Behavioral: Computerized Cognitive Training Apparatus


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Ages >50 to ≤70 Years of education ≥ 6 years No physical barrier preventing the dominant hand from using the computer mouse Exclusion Criteria: Subjects who had any structural lesions or psychiatric disorders that explained the memory deficits Subjects had to be able to undergo pre- and post-training evaluations such as electroencephalography (EEG), FDG-PET, and magnetic resonance imaging (MRI) Subjects who had scalp lesions, severe back pain, or claustrophobia that precluded pre- and post-training evaluations.

Ages Eligible for Study
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Minimum Age: 51 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Mild cognitive impairment<br>Intervention: Computerized Cognitive Training Apparatus | Behavioral: Computerized Cognitive Training Apparatus<br>* CoCoTA was developed through collaborative research with the Korean Institute of Science and Technology (KIST) and Primpo Co. Ltd. (www.primpo.com). It was designed to stimulate numerous cognitive domains simultaneously by using sounds and objects familiar to Korean elderly. Training themes and scenarios were developed and evaluated by six board-certified neurologists and three neuropsychologists who specialize in dementia. Each subject participated in a total of 24 sessions of cognitive training, which consisted of 40 minutes of training, twice per week. To assure the consistency of cognitive training, trained personnel stayed nearby the subjects to help throughout the training process.<br>* Other names: CoCoTA;|
| Experimental: Subjective cognitive impairment<br>Intervention: Computerized Cognitive Training Apparatus | Behavioral: Computerized Cognitive Training Apparatus<br>* CoCoTA was developed through collaborative research with the Korean Institute of Science and Technology (KIST) and Primpo Co. Ltd. (www.primpo.com). It was designed to stimulate numerous cognitive domains simultaneously by using sounds and objects familiar to Korean elderly. Training themes and scenarios were developed and evaluated by six board-certified neurologists and three neuropsychologists who specialize in dementia. Each subject participated in a total of 24 sessions of cognitive training, which consisted of 40 minutes of training, twice per week. To assure the consistency of cognitive training, trained personnel stayed nearby the subjects to help throughout the training process.<br>* Other names: CoCoTA;|
| Active Comparator: Normal controls<br>Intervention: Computerized Cognitive Training Apparatus | Behavioral: Computerized Cognitive Training Apparatus<br>* CoCoTA was developed through collaborative research with the Korean Institute of Science and Technology (KIST) and Primpo Co. Ltd. (www.primpo.com). It was designed to stimulate numerous cognitive domains simultaneously by using sounds and objects familiar to Korean elderly. Training themes and scenarios were developed and evaluated by six board-certified neurologists and three neuropsychologists who specialize in dementia. Each subject participated in a total of 24 sessions of cognitive training, which consisted of 40 minutes of training, twice per week. To assure the consistency of cognitive training, trained personnel stayed nearby the subjects to help throughout the training process.<br>* Other names: CoCoTA;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Clinical improvement in the follow-up neuropsychological tests | changes in memory and frontal domain subscores between the baseline and follow-up | 12 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cortical thickness changes between baseline and follow-up volumetric MRI | surface-based morphometry using freesurfer software | 12 weeks | 
| White matter integrities changes between baseline and follow-up diffusion tensor imaging | tract-based spatial statistics using fsl software | 12 weeks | 
| Spectral ratio changes between baseline and follow-up EEG | EEG spectral ratio analysis | 12 weeks | 
| local activation pattern changes between baseline and follow-up Fludeoxyglucose PET | local activation pattern analysis using SPM | 12 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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subjective cognitive impairment