Implementation of a Brain Training Pilot Study For People With Mild Cognitive Impairment

Abstract

ObjectiveA pilot study to determine the feasibility of recruiting patients with MCI to test for cognitive interventions.MethodThirty patients with amnestic MCI were to be divided into two intervention arms and one control group. Participants went to local sites and completed brain training for one hour three times per week for nine weeks. Outcome measures were: recruitment, computer abilities, compliance, task performance, neuropsychological tests, and electroencephalography.ResultsAfter six months, only 20 participants had been recruited. Seventeen were allocated to one of the two intervention groups. Compliance was good and computer skills were not an obstacle. Participants improved their abilities in the modules, but there were no statistically significant changes on neuropsychological tests or EEG.ConclusionsRecruitment of MCI participants for extensive cognitive intervention is challenging, but achievable. This pilot study was not powered to detect clinical changes. Future trials should consider recruitment criteria, intervention duration, scheduling, and study location.

Computerized Cognitive Training in Amnestic Mild Cognitive Impairment: A Randomized Clinical Trial

“…For the current study, no treatment effects were observed for the cognitive secondary outcome, Total Scale score on the RBANS, which was the primary outcome in Barnes et al 7 and Knoefel et al 10 . It may not be surprising that this secondary outcome did not improve with training, as this RBANS score is a global composite of memory, attention, visual perception and construction, and language, and the exercises in BrainHQ primarily engage more focused cognitive skills (e.g., auditory attention and memory).…”

“…For example, Barnes et al 7 failed to find an immediate treatment effect on their primary cognitive outcome in 47 subjects with MCI. Similarly, Gooding et al 9 and Knoefel et al 10 reported minimal improvements on cognitive tests for their experimental conditions compared to active control groups. However, the current results are at odds with recent meta-analyses that have shown small to medium effects of various cognitive interventions in patients with MCI.…”

“…Styliadis et al 8 found no cognitive benefit of this computerized cognitive training program (auditory processing and working memory tasks) in 14 seniors with MCI compared to other active interventions and active and passive control groups. Gooding et al 9 and Knoefel et al 10 also reported no/ minimal improvements on cognitive tests in the training condition (attention, brain speed, memory) compared to control groups. Conversely, in a randomized trial of 21 patients with amnestic MCI, Lin et al 11 found improvements in visual attention, processing speed, and working memory for those using the BrainHQ program (vision-based speed of processing tasks), but not for those doing computer games.…”

A Game a Day Keeps Cognitive Decline Away? A Systematic Review and Meta-Analysis of Commercially-Available Brain Training Programs in Healthy and Cognitively Impaired Older Adults

“…The authors for one study were contacted for additional data as their original article data were not suitable for analysis (combined means and standard deviations across training and control group). As no further information was provided, the study was included in the review but not the meta-analysis (Knoefel et al, 2018).…”

“…206). Knoefel et al (2018) identified and recruited participants through review of memory clinic data; three authors of the study then confirmed diagnosis of MCI after baseline testing, but the criteria used were not reported. All other studies applied similar diagnostic criteria to establish a diagnosis of MCI: i) self-or informant-reports of memory complaints, ii) objective memory impairments (assessed via performance on neuropsychological tests), iii) does not meet diagnostic criteria for dementia, and iv) preserved activities of daily living.…”