Query: Cognitive training

title: Placebo effects in cognitive training
abstract: Placebo effects pose problems for some intervention studies, particularly those with no clearly identified mechanism. Cognitive training falls into that category, and yet the role of placebos in cognitive interventions has not yet been critically evaluated. Here, we show clear evidence of placebo effects after a brief cognitive training routine that led to significant fluid intelligence gains. Our goal is to emphasize the importance of ruling out alternative explanations before attributing the effect to interventions. Based on our findings, we recommend that researchers account for placebo effects before claiming treatment effects. Although a large body of research shows that general cognitive ability is heritable and stable in young adults, there is recent evidence that fluid intelligence can be heightened with cognitive training. Many researchers, however, have questioned the methodology of the cognitive training studies reporting improvements in fluid intelligence: specifically, the role of placebo effects. We designed a procedure to intentionally induce a placebo effect via overt recruitment in an effort to evaluate the role of placebo effects in fluid intelligence gains from cognitive training. Individuals who self selected into the placebo group by responding to a suggestive flyer showed improvements after a single, 1 h session of cognitive training that equates to a 5 to 10 point increase on a standard IQ test. Controls responding to a nonsuggestive flyer showed no improvement. These findings provide an alternative explanation for effects observed in the cognitive training literature and the brain training industry, revealing the need to account for confounds in future research.

title: Ten Year Effects of the Advanced Cognitive Training for Independent and Vital Elderly Cognitive Training Trial on Cognition and Everyday Functioning in Older Adults
abstract: To determine the effects of cognitive training on cognitive abilities and everyday function over 10 years.

title: The Effects of Physical Exercise and Cognitive Training on Memory and Neurotrophic Factors
abstract: This study examined the combined effect of physical exercise and cognitive training on memory and neurotrophic factors in healthy, young adults. Ninety five participants completed 6 weeks of exercise training, combined exercise and cognitive training, or no training (control) Both the exercise and combined training groups improved performance on a high interference memory task, whereas the control group did not. In contrast, neither training group improved on general recognition performance, suggesting that exercise training selectively increases high interference memory that may be linked to hippocampal function. Individuals who experienced greater fitness improvements from the exercise training (i.e. high responders to exercise) also had greater increases in the serum neurotrophic factors brain derived neurotrophic factor and insulin like growth factor 1. These high responders to exercise also had better high interference memory performance as a result of the combined exercise and cognitive training compared with exercise alone, suggesting that potential synergistic effects might depend on the availability of neurotrophic factors. These findings are especially important, as memory benefits accrued from a relatively short intervention in high functioning young adults.

title: No Effect of Commercial Cognitive Training on Brain Activity, Choice Behavior, or Cognitive Performance
abstract: Increased preference for immediate over delayed rewards and for risky over certain rewards has been associated with unhealthy behavioral choices. Motivated by evidence that enhanced cognitive control can shift choice behavior away from immediate and risky rewards, we tested whether training executive cognitive function could influence choice behavior and brain responses. In this randomized controlled trial, 128 young adults (71 male, 57 female) participated in 10 weeks of training with either a commercial web based cognitive training program or web based video games that do not specifically target executive function or adapt the level of difficulty throughout training. Pretraining and post training, participants completed cognitive assessments and functional magnetic resonance imaging during performance of the following validated decision making tasks: delay discounting (choices between smaller rewards now vs larger rewards in the future) and risk sensitivity (choices between larger riskier rewards vs smaller certain rewards) Contrary to our hypothesis, we found no evidence that cognitive training influences neural activity during decision making; nor did we find effects of cognitive training on measures of delay discounting or risk sensitivity. Participants in the commercial training condition improved with practice on the specific tasks they performed during training, but participants in both conditions showed similar improvement on standardized cognitive measures over time. Moreover, the degree of improvement was comparable to that observed in individuals who were reassessed without any training whatsoever. Commercial adaptive cognitive training appears to have no benefits in healthy young adults above those of standard video games for measures of brain activity, choice behavior, or cognitive performance.  Engagement of neural regions and circuits important in executive cognitive function can bias behavioral choices away from immediate rewards. Activity in these regions may be enhanced through adaptive cognitive training. Commercial brain training programs claim to improve a broad range of mental processes; however, evidence for transfer beyond trained tasks is mixed. We undertook the first randomized controlled trial of the effects of commercial adaptive cognitive training (Lumosity) on neural activity and decision making in young adults (N 128) compared with an active control (playing on line video games) We found no evidence for relative benefits of cognitive training with respect to changes in decision making behavior or brain response, or for cognitive task performance beyond those specifically trained.

title: Mismatch Negativity is a Sensitive and Predictive Biomarker of Perceptual Learning During Auditory Cognitive Training in Schizophrenia
abstract: Computerized cognitive training is gaining empirical support for use in the treatment of schizophrenia (SZ) Although cognitive training is efficacious for SZ at a group level when delivered in sufficiently intensive doses (eg, 30 50 h) there is variability in individual patient response. The identification of biomarkers sensitive to the neural systems engaged by cognitive training interventions early in the course of treatment could facilitate personalized assignment to treatment. This proof of concept study was conducted to determine whether mismatch negativity (MMN) an event related potential index of auditory sensory discrimination associated with cognitive and psychosocial functioning, would predict gains in auditory perceptual learning and exhibit malleability after initial exposure to the early stages of auditory cognitive training in SZ. MMN was assessed in N=28 SZ patients immediately before and after completing 1 h of a speeded time order judgment task of two successive frequency modulated sweeps (Posit Science 'Sound Sweeps' exercise) All SZ patients exhibited the expected improvements in auditory perceptual learning over the 1 h training period (p<0.001) consistent with previous results. Larger MMN amplitudes recorded both before and after the training exercises were associated with greater gains in auditory perceptual learning (r= 0.5 and r= 0.67, respectively, p's<0.01) Significant pretraining vs posttraining MMN amplitude reduction was also observed (p<0.02) MMN is a sensitive index of the neural systems engaged in a single session of auditory cognitive training in SZ. These findings encourage future trials of MMN as a biomarker for individual assignment, prediction, and/or monitoring of patient response to procognitive interventions, including auditory cognitive training in SZ.

title: Individual Differences and Long term Consequences of tDCS augmented Cognitive Training
abstract: A great deal of interest surrounds the use of transcranial direct current stimulation (tDCS) to augment cognitive training. However, effects are inconsistent across studies, and meta analytic evidence is mixed, especially for healthy, young adults. One major source of this inconsistency is individual differences among the participants, but these differences are rarely examined in the context of combined training/stimulation studies. In addition, it is unclear how long the effects of stimulation last, even in successful interventions. Some studies make use of follow up assessments, but very few have measured performance more than a few months after an intervention. Here, we utilized data from a previous study of tDCS and cognitive training [Au, J. Katz, B. Buschkuehl, M. Bunarjo, K. Senger, T. Zabel, C. et al. Enhancing working memory training with transcranial direct current stimulation. Journal of Cognitive Neuroscience, 28, 1419 1432, 2016] in which participants trained on a working memory task over 7 days while receiving active or sham tDCS. A new, longer term follow up to assess later performance was conducted, and additional participants were added so that the sham condition was better powered. We assessed baseline cognitive ability, gender, training site, and motivation level and found significant interactions between both baseline ability and motivation with condition (active or sham) in models predicting training gain. In addition, the improvements in the active condition versus sham condition appear to be stable even as long as a year after the original intervention.

title: Cognitive Training and Noninvasive Brain Stimulation for Cognition in Parkinson's Disease: A Meta analysis
abstract: Many people with Parkinson's disease (PD) experience cognitive decline. It is not known whether cognitive training or noninvasive brain stimulation are effective at alleviating cognitive deficits in PD.  To examine cognitive training and non invasive brain stimulation interventions for cognition in PD.  An extensive search was conducted of published and unpublished studies in online databases. Studies were selected if they were controlled trials examining standard (not individualized) or tailored (individualized) cognitive training, repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) in PD, with outcomes measured by standardized neuropsychological tests.  Fourteen controlled trials met inclusion criteria. For executive function, the pooled effect size (Hedges' g) for cognitive training (standard and tailored combined) was small (g 0.42) but statistically significant (95% CI 0.15 0.68) The pooled effect for standard cognitive training (alone) was medium (g 0.51) and significant (95% CI 0.16 0.85) For attention/working memory, small pooled effect sizes were found when combining standard and tailored cognitive training (g 0.23; 95% CI 0.02 0.44) and for standard cognitive training alone (g 0.29; 95% CI 0.04 0.53) both significant. For memory, small but significant pooled effect sizes were also found when combining standard and tailored cognitive training and for standard cognitive training alone.  The results suggest that standard and tailored cognitive training may improve executive function, attention/working memory, and memory in PD. Future studies must adopt randomized controlled trial designs to explore the therapeutic potential of these interventions.

title: Cognitive Training Using a Novel Memory Game on an iPad in Patients with Amnestic Mild Cognitive Impairment (aMCI)
abstract: Cognitive training is effective in patients with mild cognitive impairment but does not typically address the motivational deficits associated with older populations with memory difficulties.  We conducted a randomized controlled trial of cognitive training using a novel memory game on an iPad in 42 patients with a diagnosis of amnestic mild cognitive impairment assigned to either the cognitive training (n=21; 8 hours of gameplay over 4 weeks) or control (n=21; clinic visits as usual) groups.  Significant time by pattern by group interactions were found for cognitive performance in terms of the number of errors made and trials needed on the Cambridge Neuropsychological Test Automated Battery Paired Associates Learning task (P=.044; P=.027) Significant time by group interactions were also found for the Cambridge Neuropsychological Test Automated Battery Paired Associates Learning first trial memory score (P=.002) Mini Mental State Examination (P=.036) the Brief Visuospatial Memory Test (P=.032) and the Apathy Evaluation Scale (P=.026) Within group comparisons revealed highly specific effects of cognitive training on episodic memory. The cognitive training group maintained high levels of enjoyment and motivation to continue after each hour of gameplay, with self confidence and self rated memory ability improving over time.  Episodic memory robustly improved in the cognitive training group. "Gamified" cognitive training may also enhance visuospatial abilities in patients with amnestic mild cognitive impairment. Gamification maximizes engagement with cognitive training by increasing motivation and could complement pharmacological treatments for amnestic mild cognitive impairment and mild Alzheimer's disease. Larger, more controlled trials are needed to replicate and extend these findings.

title: Cognitive Training for Attention Deficit/Hyperactivity Disorder: Meta Analysis of Clinical and Neuropsychological Outcomes From Randomized Controlled Trials
abstract: The authors performed meta analyses of randomized controlled trials to examine the effects of cognitive training on attention deficit/hyperactivity disorder (ADHD) symptoms, neuropsychological deficits, and academic skills in children/adolescents with ADHD.  The authors searched Pubmed, Ovid, Web of Science, ERIC, and CINAHAL databases through May 18, 2014. Data were aggregated using random effects models. Studies were evaluated with the Cochrane risk of bias tool.  Sixteen of 695 nonduplicate records were analyzed (759 children with ADHD) When all types of training were considered together, there were significant effects on total ADHD (standardized mean difference [SMD] 0.37, 95% CI 0.09 0.66) and inattentive symptoms (SMD 0.47, 95% CI 0.14 0.80) for reports by raters most proximal to the treatment setting (i.e. typically unblinded) These figures decreased substantially when the outcomes were provided by probably blinded raters (ADHD total: SMD 0.20, 95% CI 0.01 0.40; inattention: SMD 0.32, 95% CI 0.01 to 0.66) Effects on hyperactivity/impulsivity symptoms were not significant. There were significant effects on laboratory tests of working memory (verbal: SMD 0.52, 95% CI 0.24 0.80; visual: SMD 0.47, 95% CI 0.23 0.70) and parent ratings of executive function (SMD 0.35, 95% CI 0.08 0.61) Effects on academic performance were not statistically significant. There were no effects of working memory training, specifically on ADHD symptoms. Interventions targeting multiple neuropsychological deficits had large effects on ADHD symptoms rated by most proximal assessors (SMD 0.79, 95% CI 0.46 1.12)  Despite improving working memory performance, cognitive training had limited effects on ADHD symptoms according to assessments based on blinded measures. Approaches targeting multiple neuropsychological processes may optimize the transfer of effects from cognitive deficits to clinical symptoms.

title: Influence of combined physical and cognitive training on cognition: a systematic review
abstract: BackgroundNumerous daily activities require simultaneous application of motor and cognitive skills (dual tasking) The execution of such tasks is especially difficult for the elderly and for people with (neuro degenerative disorders. Training of physical and cognitive abilities helps prevent or slow down the age related decline of cognition. The aim of this review is to summarise and assess the role of combined physical and cognitive training characteristics in improving cognitive performance and to propose an effective training scheme within the frame of a suitable experimental design.MethodsA systematic electronic literature search was conducted in selected databases. The following criteria were compulsory for inclusion in the study: 1. A (Randomized) Controlled Trial (RCT or CT) design; 2. Implementation of combined physical and cognitive training, either simultaneously (dual task) or subsequently at least one hour per weekly over four weeks or more; 3. Cognitive outcomes as a study's endpoint.ResultsTwenty articles met the inclusion criteria. It appears that either simultaneous or subsequently combined physical and cognitive training is more successful compared to single physical or single cognitive exercise. Training characteristics like length, frequency, duration, intensity and level of task difficulty seem to determine cognitive performance. However, the articles show that cognitive improvement seems to remain somewhat confined to trained cognitive functions rather than generalising to other cognitive or daily living skills.ConclusionDue to methodological heterogeneity among studies, results need to be treated with caution. We critically discuss the role of training characteristics and propose a potentially effective training intervention within an appropriate experimental design.