A pilot study of the neuropsychological benefits of computerized cognitive rehabilitation in Ugandan children with HIV.

Boivin, Michael J.; Busman, Rachelle A.; Parikh, Sujal M.; Bangirana, Paul; Page, Connie; Opoka, Robert O.; Giordani, Bruno

doi:10.1037/a0019312

Cited by 107 publications

(101 citation statements)

References 19 publications

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“…Collectively, these studies indicate that adaptive WMT may be more efficacious in patients with nonprogressive WM deficits than in those with ongoing brain injury, such as our participants without HAND. The improved WM after adaptive WMT in our HIV participants also parallels the improved maze learning and attention in a pilot study of HIV‐infected children in Africa, using Captain's Log computerized cognitive rehabilitation therapy configured for attention and memory skills 37. However, an active control group was not included in this pediatric study, and the children also did not show improvements on some of the WM and learning tasks, which was attributed to the low number of training sessions 37.…”

Section: Discussionsupporting

confidence: 66%

“…The improved WM after adaptive WMT in our HIV participants also parallels the improved maze learning and attention in a pilot study of HIV‐infected children in Africa, using Captain's Log computerized cognitive rehabilitation therapy configured for attention and memory skills 37. However, an active control group was not included in this pediatric study, and the children also did not show improvements on some of the WM and learning tasks, which was attributed to the low number of training sessions 37. In addition to the improved WM from the program, our participants also improved on several nontrained, near‐transfer WM tests (Digit‐Span and Spatial‐Span tests) at 1 month and mostly maintained at 6 months after adaptive WMT, similar to the patients with brain injury18 or WM deficits 17…”

Section: Discussionsupporting

confidence: 66%

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Adaptive working memory training improved brain function in human immunodeficiency virus–seropositive patients

Chang

Løhaugen

Andres

et al. 2016

Annals of Neurology

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ObjectiveWe aimed to evaluate the effectiveness of an adaptive working memory (WM) training (WMT) program, the corresponding neural correlates, and LMX1A‐rs4657412 polymorphism on the adaptive WMT, in human immunodeficiency virus (HIV) participants compared to seronegative (SN) controls.MethodsA total of 201 of 206 qualified participants completed baseline assessments before randomization to 25 sessions of adaptive WMT or nonadaptive WMT. A total of 74 of 76 (34 HIV, 42 SN) completed adaptive WMT and all 40 completed nonadaptive WMT (20 HIV, 20 SN) and were assessed after 1 month, and 55 adaptive WMT participants were also assessed after 6 months. Nontrained near‐transfer WM tests (Digit‐Span, Spatial‐Span), self‐reported executive functioning, and functional magnetic resonance images during 1‐back and 2‐back tasks were performed at baseline and each follow‐up visit, and LMX1A‐rs4657412 was genotyped in all participants.ResultsAlthough HIV participants had slightly lower cognitive performance and start index than SN at baseline, both groups improved on improvement index (>30%; false discovery rate [FDR] corrected p < 0.0008) and nontrained WM tests after adaptive WMT (FDR corrected, p ≤ 0.001), but not after nonadaptive WMT (training by training type corrected, p = 0.01 to p = 0.05) 1 month later. HIV participants (especially LMX1A‐G carriers) also had poorer self‐reported executive functioning than SN, but both groups reported improvements after adaptive WMT (Global: training FDR corrected, p = 0.004), and only HIV participants improved after nonadaptive WMT. HIV participants also had greater frontal activation than SN at baseline, but brain activation decreased in both groups at 1 and 6 months after adaptive WMT (FDR corrected, p < 0.0001), with normalization of brain activation in HIV participants, especially the LMX1A‐AA carriers (LMX1A genotype by HIV status, cluster‐corrected‐p < 0.0001).InterpretationAdaptive WMT, but not nonadaptive WMT, improved WM performance in both SN and HIV participants, and the accompanied decreased or normalized brain activation suggest improved neural efficiency, especially in HIV‐LMX1A‐AA carriers who might have greater dopaminergic reserve. These findings suggest that adaptive WMT may be an effective adjunctive therapy for WM deficits in HIV participants. ANN NEUROL 2017;81:17–34

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Section: Discussionsupporting

confidence: 66%

Section: Discussionsupporting

confidence: 66%

Adaptive working memory training improved brain function in human immunodeficiency virus–seropositive patients

Chang

Løhaugen

Andres

et al. 2016

Annals of Neurology

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“…10 Preliminary studies of the neurocognitive benefits of CCRT with Captain's Log in Ugandan Children with HIV documented generalization improvements on standardized tests of simple attention and maze learning. 11 Similar improvements were noted for Captain's Log CCRT with children surviving severe malaria. 12,13 Although CCRT had an immediate effect on cognitive outcomes pertaining to attention and some aspects of learning, the evidence was inconclusive in terms of neuropsychological or psychosocial behavioral benefit at school or in the home.…”

mentioning

confidence: 61%

“…We used the same configuration of Captain's Log that was used in our preliminary studies. 10,11 A Uganda psychology team led by M.J.B. and B.G.…”

Section: Computerized Cognitive Rehabilitation Trainingmentioning

confidence: 99%

“…This computerized neurocognitive assessment was used in our prior CCRT studies. 13,[25][26][27] A 30-min session is presented, which includes playing cards in a game-like manner to assess memory, attention, discrimination learning, and executive function that is nonlanguage dependent. It does so with card detection (simple reaction time), identification (choice reaction time), one-back WM, and one-card learning.…”

Section: Assessments For Neuropsychological Outcomesmentioning

confidence: 99%

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A Randomized Controlled Trial to Evaluate if Computerized Cognitive Rehabilitation Improves Neurocognition in Ugandan Children with HIV

Boivin

Nakasujja

Sikorskii

et al. 2016

AIDS Research and Human Retroviruses

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Objectives: Clinically stable children with HIV can have neuromotor, attention, memory, visual-spatial, and executive function impairments. We evaluated neuropsychological and behavioral benefits of computerized cognitive rehabilitation training (CCRT) in Ugandan HIV children. Design: One hundred fifty-nine rural Ugandan children with WHO Stage I or II HIV disease (6 to 12 years; 77 boys, 82 girls; M = 8.9, SD = 1.86 years) were randomized to one of three treatment arms over a 2-month period. Methods: The CCRT arm received 24 one-hour sessions over 2 months, using Captain's Log (BrainTrain Corporation) programmed for games targeting working memory, attention, and visual-spatial analysis. These games progressed in difficulty as the child's performance improved. The second arm was a ''limited CCRT'' with the same games rotated randomly from simple to moderate levels of training. The third arm was a passive control group receiving no training. All children were assessed at enrollment, 2 months (immediately following CCRT), and 3 months after CCRT completion. Results: The CCRT group had significantly greater gains through 3 months of follow-up compared to passive controls on overall Kaufman Assessment Battery for Children-second edition (KABC-II) mental processing index ( p < .01), planning ( p = .04), and knowledge ( p = .03). The limited CCRT group performed better than controls on learning ( p = .05). Both CCRT arms had significant improvements on CogState Groton maze learning ( p < .01); although not on CogState attention/memory, TOVA/impulsivity, or behavior rating inventory for executive function and child behavior checklist (psychiatric behavior/symptom problems) ratings by caregiver. Conclusions: CCRT intervention can be effective for neurocognitive rehabilitation in children with HIV in lowresource settings, especially in children who are clinically stable on ARV treatment.

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Treatment of Psychiatric Disorders in HIV

Ferrara¹,

Valero

Moore

et al. 2014

HIV and Psychiatry

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A pilot study of the neuropsychological benefits of computerized cognitive rehabilitation in Ugandan children with HIV.

Abstract: CCRT was feasible with our study population and improved maze learning and attention on a detection task. This supports previous findings by our group with cerebral malaria survivors (Bangirana, Giordani, et al., 2009).

Cited by 107 publications

References 19 publications

Adaptive working memory training improved brain function in human immunodeficiency virus–seropositive patients

Adaptive working memory training improved brain function in human immunodeficiency virus–seropositive patients

A Randomized Controlled Trial to Evaluate if Computerized Cognitive Rehabilitation Improves Neurocognition in Ugandan Children with HIV

Treatment of Psychiatric Disorders in HIV

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