Working-memory training following neonatal critical illness

Abstract

__Objective__ To test the immediate and long-term effectiveness of Cogmed Working-Memory Training (CWMT) following ECMO and/or CDH. __Design__ A nationwide randomized controlled trial assessing neuropsychological outcome immediately and one year post-CWMT, conducted between October 2014-June 2017. Researchers involved in the follow-up assessments were blinded to group allocation. __Setting__ Erasmus MC-Sophia Children’s Hospital, Rotterdam and Radboud University Medical Center, Nijmegen, the Netherlands. __Patients__ Eligible participants were neonatal ECMO and/or CDH survivors (8-12 years) with an IQ ≥ 80 and a z-score ≤ -1.5 on at least one (working)memory test at first assessment. __Interventions__ CWMT, comprising 25 sessions of 45 minutes for five consecutive weeks at home. __Measurements and Main Results__ Participants were randomized to CWMT (n = 19) or no intervention (n = 24) (two dropped out after T0). Verbal working-memory (estimated coefficient = 0.87; p = .002) and visuospatial working-memory (estimated coefficient = 0.96, p = .003) had significantly improved in the CWMT group at T1, but was similar between groups at T2 (verbal, p = .902; visuospatial, p = .416). Improvements were found at T2 on long-term visuospatial memory following CWMT (estimated coefficient = 0.95, p = .003). Greater improvements in this domain at T2 following CWMT were associated with better self-rated school functioning (r = .541, p = .031) and parent-rated attention (r = .672, p = .006). __Conclusions__ Working-memory improvements after CWMT disappeared one year post-training in neonatal ECMO and/or CDH survivors. Gains in visuospatial memory persisted one year post-intervention. CWMT may be beneficial for survivors with visuospatial memory deficits