Feasibility of computerized working memory training in individuals with Huntington disease

<div><p>Objectives</p><p>Huntington disease (HD) is associated with a variety of cognitive deficits, with prominent difficulties in working memory (WM). WM deficits are notably compromised in early-onset and prodromal HD patients. This study aimed to determine the feasibility of a computerized WM training program (Cogmed QM), novel to the HD population.</p><p>Methods</p><p>Nine patients, aged 26–62, with early stage HD underwent a 25-session (5 days/week for 5 weeks) WM training program (Cogmed QM). Training exercises involved the manipulation and storage of verbal and visuospatial information, with difficulty adapted as a function of individual performance. Neuropsychological testing was conducted before and after training, and performance on criterion WM measures (Digit Span and Spatial Span), near-transfer WM measures (Symbol Span and Auditory WM), and control measures were evaluated. Post-training interviews about patient experience were thematically analyzed using NVivo software.</p><p>Results</p><p>Seven of nine patients demonstrated adherence to the training and completed all sessions within the recommended timeframe of 5 weeks. All adherent patients showed improvement on the Cogmed tasks as defined by the Improvement Index (<i>M</i> = 22.17, <i>SD</i> = 8.84, range = 13–36). All adherent patients reported that they found training helpful (<i>n = 7)</i>, and almost all felt that their memory improved (<i>n = 6)</i>. Participants also expressed that the training was difficult, sometimes frustrating, and time consuming.</p><p>Conclusions</p><p>This pilot study provides support for feasibility of computerized WM training in early-stage patients with HD. Results suggest that HD patients perceive benefits of intensive WM training, though a full-scale and controlled intervention project is needed to understand the size of the effect and reliability of changes over time.</p><p>Trial registration</p><p>ClinicalTrials.gov, Registry number <a href="https://clinicaltrials.gov/ct2/show/NCT02926820" target="_blank">NCT02926820</a></p></div

Flowchart of participant enrollment, inclusion, and involvement.

<p>Flowchart of participant enrollment, inclusion, and involvement.</p

Demographic and clinical characteristics for all participants (N = 9).

<p>Demographic and clinical characteristics for all participants (N = 9).</p

Neuropsychological outcomes for criterion, near-transfer, and far transfer tasks using raw scores.

<p>Neuropsychological outcomes for criterion, near-transfer, and far transfer tasks using raw scores.</p

Feasibility outcomes on Cogmed QM for all participants (N = 9).

<p>Feasibility outcomes on Cogmed QM for all participants (N = 9).</p

Participant inclusion and exclusion criteria.

<p>Participant inclusion and exclusion criteria.</p