Abstract
Background: Mnemonic strategy training (MST) has been shown to improve cognitive performance in amnestic mild cognitive impairment (a-MCI), however, several questions remain unresolved. The goal of the present study was to replicate earlier pilot study findings using a randomized controlled design and to evaluate transfer effects and changes in brain activation.Methods: Thirty patients with a-MCI were randomized into MST or education program. At baseline, participants completed clinical and neuropsychological assessments as well as structural and functional magnetic resonance imaging (fMRI). Interventions were administered individually and comprised four sessions, over 2 weeks. MST taught patients to use a three-step process to learn and recall face-name associations. Post-treatment assessment included fMRI, a separate face-name association task, neuropsychological tests, and measures of metamemory. Behavioral (i.e., non-fMRI) measures were repeated after one and 3-months.Results: Participants in the MST condition showed greater improvement on measures of face-name memory, and increased associative strategy use; effects that were accompanied by increased fMRI activation in the left anterior temporal lobe. While all participants reported greater contentment with their everyday memory following intervention, only the MST group reported significant improvements in their memory abilities. There was no clear indication of far-transfer effects to other neuropsychological tests.Conclusion: Results demonstrate that patients with a-MCI not only show stimulus specific benefits of MST, but that they appear capable of transferring training to at least some other cognitive tasks. MST also facilitated the use of brain regions that are involved in face processing, episodic and semantic memory, and social cognition, which are consonant with the cognitive processes engaged by training.
Highlights
The world population is aging, which leads to an increase of age-associated conditions such as Alzheimer’s disease (AD) and related dementias (Jorm and Jolley, 1998; Prince et al, 2013)
There were no differences in these volumes, and total brain volume, between the a-Mild cognitive impairment (MCI) treatment groups (Table 3)
Near-Transfer Effects Untrained stimuli (FNRT) Regarding accuracy, after 1-week there was no main effect of time [F(1,28) = 2.41, p = 0.13], or group [F(1,28) = 0.05, p = 0.81]; we observed a significant time-by-group interaction [F(1,28) = 4.04, p = 0.05; d = 0.35) (Figure 2A)
Summary
The world population is aging, which leads to an increase of age-associated conditions such as Alzheimer’s disease (AD) and related dementias (Jorm and Jolley, 1998; Prince et al, 2013). The clinical presentation of MCI is classified as amnestic or non-amnestic (Winblad et al, 2004), and those patients with amnestic MCI (a-MCI) are at increased risk of conversion to dementia (Espinosa et al, 2013), especially due to AD (Petersen et al, 2001; Jungwirth et al, 2012). There is a growing interest in non-pharmacologic treatments for MCI due to the limited benefits of existing pharmacologic agents (McGhee et al, 2016), and the recognition that cognitive interventions can promote brain plasticity and reduce cognitive impairment (Belleville et al, 2011). Older adults who are more engaged in cognitively stimulating activities present reduced risk of cognitive deterioration and dementia (Verghese et al, 2003; Barnes and Yaffe, 2011; Marioni et al, 2012), indicating that is it critical to develop effective cognitive interventions for this population. The goal of the present study was to replicate earlier pilot study findings using a randomized controlled design and to evaluate transfer effects and changes in brain activation
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