Computerized Cognitive Training in Multiple Sclerosis: A Systematic Review and Meta-analysis

Lampit, Amit; Heine, J.; Finke, Carsten; Barnett, Michael; Valenzuela, Michael; Wolf, Anna; Leung, Isabella Hoi Kei; Hill, Nicole T. M.

doi:10.1177/1545968319860490

Cited by 62 publications

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“…No restrictions on language or type of publication were applied. The electronic search was complemented by hand-searching the references of included articles and previous reviews of CCT [16][17][18]23,24 as well as clinical trial registries. The full search strategy is shown in eTable 2 in the Supplement.…”

Section: Information Sources and Study Selectionmentioning

confidence: 99%

“…CCT is appealing as it can be adapted to individual needs, provides ongoing feedback and can be delivered inexpensively in both clinical and community settings. Support for CCT has been found for cognitive and functional outcomes across many clinical and non-clinical populations [13][14][15][16][17][18] , however, efficacy varies across populations, outcomes and design factors such as dose and supervision 13,14,17 .…”

Section: Introductionmentioning

confidence: 99%

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Computerized Cognitive Training in People with Depression: A Systematic Review and Meta-analysis of Randomized Clinical Trials

Launder

Minkov

Davey

et al. 2021

Preprint

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Importance: Cognitive impairment is a common feature of both symptomatic and remitted states of depression that is associated with poorer psychosocial outcomes and treatment non-response. As such, finding treatments to maintain or enhance cognition in people with depression is imperative. Objective: To investigate the efficacy of computerized cognitive training (CCT) on cognitive and functional outcomes in people with depression. Data Sources: MEDLINE, EMBASE and PsycINFO databases were screened through the Ovid interface for eligible studies from inception to 29 June 2020, with no language or publication type restrictions. Study Selection: Two independent reviewers conducted duplicate study screening and assessed against the following inclusion criteria: (1) adults with depression, (2) CCT with minimum three hours practice, (3) active or passive control group, (4) cognitive and/or functional outcomes measured at baseline and post-intervention, (5) randomized controlled trials. Of 3666 identified studies, 24 met selection criteria. Data Extraction and Synthesis: The methods used followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Data extraction and risk of bias assessment using the revised Cochrane Risk of Bias Tool (RoB2) was conducted independently by two reviewers. Analysis of the pooled results was conducted using robust variance estimation (RVE) based on a correlational dependence model. Main Outcomes and Measures: The primary outcome was change from baseline to post-intervention in overall cognition. Secondary outcomes were depressive symptoms, psychiatric symptoms, psychosocial functioning, daily functioning, subjective cognition, global cognition and domain-specific cognitive function. Results: Twenty-four studies encompassing 28 comparisons and 1,141 unique participants met inclusion criteria. The pooled effect size of CCT for overall cognition was small and significant (g=0.26; 95% CI 0.15 to 0.36; P<.001; τ2=0.057; I2=37%; prediction interval -0.25 to 0.76) and for depressive symptoms was small and significant (g=0.24; 95% CI 0.04 to 0.45; P=.02; τ2=0.075; I2=46%; prediction interval -0.37 to 0.86). Evidence of small-study effect was found for both overall cognition and depressive symptoms, with trim-and-fill analysis imputing two studies for each. Sensitivity analyses of overall cognition and depressive symptoms revealed the main analyses to be robust. Benefits of CCT were also found for psychosocial functioning and domain-specific cognitive function in abstract reasoning, learning/encoding efficiency, retrieval fluency, high working memory, low working memory, inhibition and processing speed. No significant effect was found for psychiatric symptoms, subjective cognition, global cognition or domain-specific cognitive function in short-term memory and shifting. No separate pooled analyses were conducted for daily functioning or verbal reasoning, updating and visual processing domains due to two or less studies reporting outcomes for each. A moderating effect of dose was found for overall cognition, with larger doses of CCT associated with greater effect size estimates. Conclusions and Relevance: This systematic review and meta-analysis indicates that CCT is an efficacious intervention for overall cognition, depressive symptoms, psychosocial functioning and domain-specific cognitive function for people with depression.

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Section: Information Sources and Study Selectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Computerized Cognitive Training in People with Depression: A Systematic Review and Meta-analysis of Randomized Clinical Trials

Launder

Minkov

Davey

et al. 2021

Preprint

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“…This review updates and further specifies our previous systematic review on cognitive training in PD. 5 Eligibility criteria Consistent with our previous systematic reviews of CCT, [10][11][12] we will include studies that meet the following criteria:…”

Section: Methods and Analysismentioning

confidence: 99%

Computerised cognitive training in Parkinson’s disease: a protocol for a systematic review and updated meta-analysis

et al. 2020

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IntroductionCognitive impairment is recognised as an important non-motor symptom in Parkinson’s disease (PD) and there is a need for evidence-based non-pharmacological interventions that may prevent or slow cognitive decline in this patient group. One such intervention is computerised cognitive training (CCT), which has shown efficacious for cognition across older adult populations. This systematic review aims to investigate the efficacy of CCT across cognitive, psychosocial and functional domains for people with PD and examine study and intervention design factors that could moderate CCT effects on cognition.Methods and analysisRandomised controlled trials investigating the effects of CCT in patients with PD without dementia, on cognitive, psychosocial or functional outcomes, will be included. The primary outcome is overall cognitive function. Secondary outcomes are domain-specific cognitive function, psychosocial functioning and functional abilities. We systematically searched MEDLINE, Embase and PsycINFO through 14 May 2020 to identify relevant literature. Risk of bias will be assessed using the revised Cochrane Risk of Bias tool. Effect sizes will be calculated as standardised mean difference of baseline to postintervention change (Hedges’ g) with 95% CI for each eligible outcome measure. Pooling of outcomes across studies will be conducted using random-effects models, accounting for dependency structure of effect sizes within studies. Heterogeneity will be assessed using τ2 and I2 statistic. Potential moderators, based on key study and intervention design factors, will be investigated using mixed-effects meta-regression models.Ethics and disseminationNo ethical approval is required. The findings will be disseminated in a peer-reviewed scientific journal.PROSPERO registration numberCRD42020185386.

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“…Consistent with our previous systematic reviews of CCT [13,14,22] we will include studies that meet the following criteria:…”

Section: Eligibility Criteriamentioning

confidence: 99%

“…In studies reporting more than one outcome measure per category, all eligible outcome measures will be included and pooled within studies (see Data synthesis). The primary outcome will be overall cognitive performance, de ned as the mean effect size across all cognitive outcomes in a study [10,13,14,22]. Secondary outcomes are domain-speci c cognitive performance, classi ed according to the CHC-M framework [24], global cognition, subjective cognition, mood, other psychiatric symptoms, psychosocial functioning and daily function.…”

Section: Types Of Outcomesmentioning

confidence: 99%

Computerized Cognitive Training in People with Depression: A Protocol for a Systematic Review and Meta-Analysis

Lampit

Launder

Minkov

et al. 2020

Preprint

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Background People with depression often present with concurrent cognitive impairment. Computerized cognitive training (CCT) is safe and efficacious strategy to maintain or enhance cognitive performance in a range of clinical populations. However, its efficacy in people with depression and how it varies across populations and design factors is currently unclear. Methods We searched MEDLINE, EMBASE and PsycINFO from inception to 29 June 2020 for randomised controlled trials examining the efficacy of CCT vs any control condition on cognitive, mood, psychiatric symptoms, psychosocial functioning and daily function in adults with depression. Eligible samples include studies specifically targeting people with major depressive disorder as well as those with other diagnoses where at least 50% of the sample meets clinical criteria for depression, with the exception of major psychiatric disorders or dementia. The primary outcome is change in overall cognitive performance. Multivariate analyses will be used to examine effect sizes on each outcome category as well as possible effect modifiers and correlations between categories. Risk of bias will be assessed using the Cochrane risk of bias tool version 2. Discussion To the best of our knowledge, this will be the first systematic review and meta-analysis of narrowly-defined CCT across clinical populations with depression. We aim to investigate not only whether CCT is efficacious for cognition, but also how such effects vary across design factors, what other clinically relevant outcomes might respond to CCT and the extent to which they differ across populations. Systematic review registration: Submitted and pending evaluation with PROSPERO.

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Computerized Cognitive Training in Multiple Sclerosis: A Systematic Review and Meta-analysis

Cited by 62 publications

References 58 publications

Computerized Cognitive Training in People with Depression: A Systematic Review and Meta-analysis of Randomized Clinical Trials

Computerized Cognitive Training in People with Depression: A Systematic Review and Meta-analysis of Randomized Clinical Trials

Computerised cognitive training in Parkinson’s disease: a protocol for a systematic review and updated meta-analysis

Computerized Cognitive Training in People with Depression: A Protocol for a Systematic Review and Meta-Analysis

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