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

Abstract

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

Locating neural transfer effects of n-back training on the central executive: a longitudinal fMRI study

“…Importantly, the decreases observed after training persisted with no change after five weeks without training. Previous research found stability effects on the trained task (n-back; 29,40 ), but this is the first time the stability of neural transfer effects has been demonstrated.…”

Working Memory Training in Amnestic and Non-amnestic Patients With Mild Cognitive Impairment: Preliminary Findings From Genotype Variants on Training Effects

“…The association of allelic frequencies of the LMX1A and neurological diseases has been studied only to a limited extent ( Bergman et al, 2010 ; Rolstad et al, 2015 ). For instance, LMX1A -AA carriers with HIV-associated neurocognitive disorders showed greater WM training gain than non-carriers ( Chang et al, 2017 ), whereas conflicting results exist in cognitively normal individuals ( Bellander et al, 2011 , 2015 ).…”

Altered Associations between Pain Symptoms and Brain Morphometry in the Pain Matrix of HIV-Seropositive Individuals

“…A total 106 participants were screened and were randomly but consecutively chosen from 206 participants who were being enrolled in a larger neuroimaging study of brain changes after cognitive training (Chang et al, 2016; Chang et al, 2017). However, 66 (31 HIV+ and 35 SN) of these participants agreed to be co-enrolled in the current study to evaluate the neuroimaging signature of pain (between June 20 th 2013 to December 15 th , 2015.)…”