Neural correlates of cognitive intervention in persons at risk of developing Alzheimer's disease.

Cognitive training is an emergent approach that has begun to receive increased attention in recent years as a non-pharmacological, cost-effective intervention for Alzheimer's disease (AD). There has been increasing behavioral evidence regarding training-related improvement in cognitive performance in early stages of AD. Although these studies provide important insight about the efficacy of cognitive training, neuroimaging studies are crucial to pinpoint changes in brain structure and function associated with training and to examine their overlap with pathology in AD. In this study, we reviewed the existing neuroimaging studies on cognitive training in persons at risk of developing AD to provide an overview of the overlap between neural networks rehabilitated by the current training methods and those affected in AD. The data suggest a consistent training-related increase in brain activity in medial temporal, prefrontal, and posterior default mode networks, as well as increase in gray matter structure in frontoparietal and entorhinal regions. This pattern differs from the observed pattern in healthy older adults that shows a combination of increased and decreased activity in response to training. Detailed investigation of the data suggests that training in persons at risk of developing AD mainly improves compensatory mechanisms and partly restores the affected functions. While current neuroimaging studies are quite helpful in identifying the mechanisms underlying cognitive training, the data calls for future multi-modal neuroimaging studies with focus on multi-domain cognitive training, network level connectivity, and individual differences in response to training

The role of cognitive abilities in laparoscopic simulator training

Learning minimally invasive surgery (MIS) differs substantially from learning open surgery and trainees differ in their ability to learn MIS. Previous studies mainly focused on the role of visuo-spatial ability (VSA) on the learning curve for MIS. In the current study, the relationship between spatial memory, perceptual speed, and general reasoning ability, in addition to VSA, and performance on a MIS simulator is examined. Fifty-three laparoscopic novices were tested for cognitive aptitude. Laparoscopic performance was assessed with the LapSim simulator (Surgical Science Ltd., Gothenburg, Sweden). Participants trained multiple sessions on the simulator until proficiency was reached. Participants showed significant improvement on the time to complete the task and efficiency of movement. Performance was related to different cognitive abilities, depending on the performance measure and type of cognitive ability. No relationship between cognitive aptitude and duration of training or steepness of the learning curve was found. Cognitive aptitude mediates certain aspects of performance during training on a laparoscopic simulator. Based on the current study, we conclude that cognitive aptitude tests cannot be used for resident selection but are potentially useful for developing individualized training programs. More research will be performed to examine how cognitive aptitude testing can be used to design training programs

Six month durability of targeted cognitive training supplemented with social cognition exercises in schizophrenia.

Background:Deficits in cognition, social cognition, and motivation are significant predictors of poor functional outcomes in schizophrenia. Evidence of durable benefit following social cognitive training is limited. We previously reported the effects of 70 h of targeted cognitive training supplemented with social cognitive exercises (TCT + SCT) verses targeted cognitive training alone (TCT). Here, we report the effects six months after training. Methods:111 participants with schizophrenia spectrum disorders were randomly assigned to TCT + SCT or TCT-only. Six months after training, thirty-four subjects (18 TCT + SCT, 16 TCT-only) were assessed on cognition, social cognition, reward processing, symptoms, and functioning. Intent to treat analyses was used to test the durability of gains, and the association of gains with improvements in functioning and reward processing were tested. Results:Both groups showed durable improvements in multiple cognitive domains, symptoms, and functional capacity. Gains in global cognition were significantly associated with gains in functional capacity. In the TCT + SCT group, participants showed durable improvements in prosody identification and reward processing, relative to the TCT-only group. Gains in reward processing in the TCT + SCT group were significantly associated with improvements in social functioning. Conclusions:Both TCT + SCT and TCT-only result in durable improvements in cognition, symptoms, and functional capacity six months post-intervention. Supplementing TCT with social cognitive training offers greater and enduring benefits in prosody identification and reward processing. These results suggest that novel cognitive training approaches that integrate social cognitive exercises may lead to greater improvements in reward processing and functioning in individuals with schizophrenia

Training verbal working memory in children with mild intellectual disabilities: effects on problem-solving

This multiple case study explores the effects of a cognitive training program in children with mild to borderline intellectual disability. Experimental training effects were evaluated comparing pre-post-test changes after (a) a baseline phase versus a training phase in the same participant, (b) an experimental training versus either a no intervention phase or a control training in two pairs of children matched for cognitive profile. Key elements of the training program included (1) exercises and card games targeting inhibition, switching, and verbal working memory, (2) guided practice emphasizing concrete strategies to engage in exercises, and (3) a variable amount of adult support. The results show that both verbal working memory analyzed with the listening span test and problem-solving tested with the Raven’s matrices were significantly enhanced after the experimental trainin

Transcranial electric stimulation and cognitive training improves face perception

Recently, there has been much interest the effectiveness of cognitive training programmes across a variety of cognitive and perceptual domains. Some evidence suggests that combining training programmes with noninvasive brain stimulation techniques such as transcranial random noise stimulation (tRNS) can enhance training gains, but to date this has only been examined in numerosity and arithmetic tasks. In this study, we examined whether tRNS modulated the effects of a face recognition training programme. Participants completed a face discrimination training task for an hour per day over five days. Each day, training was preceded by twenty minutes of active high frequency tRNS or sham stimulation, targeted at the posterior temporal cortices or the inferior frontal gyri (IFG). Participants who received active stimulation to the posterior temporal cortices showed significant improvement on a facial identity discrimination task (the Cambridge Face Perception Test) after training, whereas those receiving sham or IFG stimulation showed no performance change. There was no evidence of an effect of stimulation on a face memory task (the Cambridge Face Memory Test). These results suggest that tRNS can enhance the effectiveness of cognitive training programmes, but further work is needed to establish whether perceptual gains can be generalised to face memory

Investigating the influence of music training on verbal memory

Previous research has shown that musical training is associated with enhanced verbal memory. The current study investigated the generality of this association by presenting undergraduates who had received musical training (n = 20) and undergraduates with no formal music training (n = 20) with four types of word list; high visual imagery, high auditory imagery, high tactile imagery, and abstract. Those who had received music training showed enhanced memory for all word lists, suggesting that music training leads to a general enhancement in verbal memory that is not restricted to specific types of words (e.g., those invoking auditory imagery). The findings support previous research in showing that music training enhances cognitive skills beyond those that are specific to the domain of music. The possible cognitive and neural factors underpinning this effect are discussed

Evaluating the effects of self-practice/self-reflection on cognitive flexibility, empathy, insight, self-compassion, self-monitoring, and stress in postgraduate cognitive behaviour therapy trainees : a thesis presented in fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Albany, New Zealand

There is considerable evidence to suggest that cognitive behaviour therapy (CBT) training programs can effectively enhance therapists’ CBT knowledge and skills. In response, research is now beginning to establish which specific training strategies are most effective in developing which CBT skills and competencies. Self-practice/self-reflection (SP/SR) is an experiential training strategy used to enhance CBT training and the ongoing professional development of CBT practitioners. Self-practice/self-reflection provides therapists with a structured experience of using CBT on themselves (self-practice) and reflecting on that experience (self-reflection). In order to build on previous SP/SR research, the aim of the current study was to explore the effects of SP/SR on six specific dimensions of CBT therapist competence: cognitive flexibility, empathy, insight, self-compassion, self-monitoring, and stress, among postgraduate CBT trainees. Seven students completing a SP/SR program as part of the Postgraduate Diploma in Cognitive Behaviour Therapy at Massey University were recruited to participate in the study. Quantitative data using six self-report measures of therapist competence was collected at five critical time points pertaining to the participants’ SP/SR program: baseline, pre-intervention, midpoint, post-intervention, and follow-up. Qualitative data was collected from participants’ written reflections. A mixed method design using descriptive quantitative and qualitative thematic analysis provided valuable quantitative (and some qualitative) support for the use of SP/SR as a CBT training and development strategy, particularly when targeting these six dimensions of CBT therapist competence

Design of VR app applied to cognitive training

L’objectiu principal d’aquest projecte és el disseny d’una aplicació de realitat virtual per millorar el tractament dels pacients amb deteriorament cognitiu lleu, així com estudiar els possibles avantatges que aquesta tecnologia pot proporcionar en aquest camp. Es va escollir la realitat virtual perquè permet augmentar la sensació d’immersió pel que fa a les tecnologies actuals. Actualment la realitat virtual s’està utilitzant amb aquest tipus de tractament i està aconseguint gran resultats amb els pacients. A més, mitjançant l’ús d’aquesta tècnica d’immersió visual, s’espera que ajudi a millorar la capacitat dels pacients davant nous problemes, com pot ser la iniciació a la realitat virtual, una qüestió fonamental que ajuda a la millora dels pacients que es troben en les primeres etapes de la malaltia. L’aplicació consisteix en un entorn de supermercat virtual on el pacient pot realitzar diverses proves. En aquesta hi haurà diferents nivells amb diverses complexitats, sempre després d’haver realitzat un tutorial previ. L’aplicació s’ha realitzat en dues fases diferents: primer es va crear el guió, amb col·laboració amb la unitat d’Alzheimer de l’Hospital Clínic. Els nivells de l’aplicació es van definir aquí. El següent va ser la realització de l’aplicació amb col·laboració amb la companyia Vysion 360. Per a la seva utilització per la unitat d’Alzheimer de l’Hospital Clínic, l’aplicació tenia que complir diferents criteris. En primer lloc, els nivells de dificultat tenen que ser suficients per realitzar un tractament a llarg termini. En segon lloc, per crear una bona experiència de immersió, l’entorn creat té que ser el més realista possible. Finalment, s’ha creat una base de dades local per guardar la informació de totes les sessions, utilitzat posteriorment en l’anàlisi de evolució dels pacients. Amb aquesta aplicació, s’espera que els resultats en els pacients amb deteriorament cognitiu lleu milloren respecte a les tècniques anteriors. Especialment gràcies a la gran experiència d’immersió aconseguida amb la realitat virtual, la qual ajuda a la concentració dels pacients durant el tractament

Brain enhancement through cognitive training: A new insight from brain connectome

Owing to the recent advances in neurotechnology and the progress in understanding of brain cognitive functions, improvements of cognitive performance or acceleration of learning process with brain enhancement systems is not out of our reach anymore, on the contrary, it is a tangible target of contemporary research. Although a variety of approaches have been proposed, we will mainly focus on cognitive training interventions, in which learners repeatedly perform cognitive tasks to improve their cognitive abilities. In this review article, we propose that the learning process during the cognitive training can be facilitated by an assistive system monitoring cognitive workloads using electroencephalography (EEG) biomarkers, and the brain connectome approach can provide additional valuable biomarkers for facilitating leaners' learning processes. For the purpose, we will introduce studies on the cognitive training interventions, EEG biomarkers for cognitive workload, and human brain connectome. As cognitive overload and mental fatigue would reduce or even eliminate gains of cognitive training interventions, a real-time monitoring of cognitive workload can facilitate the learning process by flexibly adjusting difficulty levels of the training task. Moreover, cognitive training interventions should have effects on brain sub-networks, not on a single brain region, and graph theoretical network metrics quantifying topological architecture of the brain network can differentiate with respect to individual cognitive states as well as to different individuals' cognitive abilities, suggesting that the connectome is a valuable approach for tracking the learning progress. Although only a few studies have exploited the connectome approach for studying alterations of the brain network induced by cognitive training interventions so far, we believe that it would be a useful technique for capturing improvements of cognitive function

Internet-delivered cognitive control training as a preventive intervention for remitted depressed patients : protocol for a randomized controlled trial

Background: Preventing recurrence of depression forms an important challenge for current treatments. Cognitive control impairments often remain present during remission of depression, putting remitted depressed patients at heightened risk for new depressive episodes by disrupting emotion regulation processes. Importantly, research indicates that cognitive control training targeting working memory functioning shows potential in reducing maladaptive emotion regulation and depressive symptomatology in clinically depressed patients and at-risk student samples. The current study aims to test the effectiveness of cognitive control training as a preventive intervention in a remitted depressed sample, exploring effects of cognitive control training on rumination and depressive symptomatology, along with indicators of adaptive emotion regulation and functioning. Methods/design: We present a double blind randomized controlled design. Remitted depressed adults will complete 10 online sessions of a cognitive control training targeting working memory functioning or a low cognitive load training (active control condition) over a period of 14 days. Effects of training on primary outcome measures of rumination and depressive symptomatology will be assessed pre-post training and at three months follow-up, along with secondary outcome measure adaptive emotion regulation. Long-term effects of cognitive control training on broader indicators of functioning will be assessed at three months follow-up (secondary outcome measures). Discussion: This study will provide information about the effectiveness of cognitive control training for remitted depressed adults in reducing vulnerability for depression. Furthermore, this study will address key questions concerning the mechanisms underlying the effects of cognitive control training, will take into account the subjective experience of the patients (including a self-report measure for cognitive functioning), and explore whether these effects extend to broad measures of functioning such as Quality of Life and disability