Cognitive Training for Fragile X Syndrome

Study Overview
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Brief Summary
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Individuals with fragile X syndrome (FXS) demonstrate profound executive function deficits that interfere with learning, socialization and emotion regulation. Extensive research focused on the animal models of FXS show that targeted pharmacological agents can normalize synaptic connectivity and reverse cognitive and behavioral deficits. This translational work has led to multiple national and international controlled trials in humans with FXS now underway. However, in contrast to the heavy focus on medication treatments, there have been no controlled trials to empirically-validate cognitive or behavioral interventions for FXS. The proposed study, the first non-pharmacological controlled trial for FXS, will evaluate the efficacy of Cogmed, a cognitive training program proven to enhance working memory and executive/frontal function in a variety of clinical populations. Demonstration of effective Cogmed training for FXS would represent a major advance in the field, one that may also generalize to other forms of intellectual disability. Furthermore, it is critical to determine whether the targeted pharmacological treatments can accelerate learning and cognitive development. Thus, the validation of Cogmed for FXS will provide a paradigm for testing hypotheses focused on combined efficacy of medication and cognitive training.

Official Title
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Cognitive Training for Fragile X Syndrome

Conditions
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Fragile X Syndrome

Intervention / Treatment
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* Other: Working Memory Training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: fragile X full mutation normal or corrected vision English or Spanish speaking ability to pass three-span items following completion of a Cogmed training session at baseline parental agreement to maintain adherence to the training schedule and to not alter other treatments during the study unless medically necessary Exclusion Criteria: previous Cogmed training significant medical problems that would interfere with the study or significant brain trauma

Ages Eligible for Study
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Minimum Age: 8 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Adaptive Cogmed<br>5 days per week for 5-6 weeks of parent aided visual working memory training, consisting of adaptive Cogmed | Other: Working Memory Training<br> <br> * Other names: Cogmed;|
| Other: Non-Adaptive Cogmed<br>5 days per week for 5-6 weeks of parent aided visual working memory training, consisting of non-adaptive Cogmed | Other: Working Memory Training<br> <br> * Other names: Cogmed;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Composite of Stanford Binet, Fifth Edition Block Span and Leiter-R Spatial Working Memory | Average of z scores obtained from Block Span and Leiter-R Spatial Working Memory | 5-6 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Wechsler Intelligence Scale for Children-IV Digit Span |  | 5-6 weeks | 
| Wechsler Intelligence Scale for Children-IV Digit Span |  | 3 month followup | 
| Kiddie Test of Attentional Performance (KiTAP) |  | 5-6 weeks | 
| Kiddie Test of Attentional Performance (KiTAP) |  | 3 month followup | 
| Behavior Rating Inventory Rating of Executive Function (BRIEF; Teacher and Caregiver Reports) |  | 5-6 weeks | 
| Behavior Rating Inventory Rating of Executive Function (BRIEF; Teacher and Caregiver Reports) |  | 3 month followup | 
| Swanson, Nolan and Pelham (SNAP-IV) |  | 5-6 weeks | 
| Swanson, Nolan and Pelham (SNAP-IV) |  | 3 month followup |