Computer-Delivered Cognitive Training and Transcranial Direct Current Stimulation in Patients With HIV-Associated Neurocognitive Disorder: A Randomized Trial.

Raymond L Ownby,Jae Kim

doi:10.3389/fnagi.2021.766311

Abstract

Objective: HIV infection is associated with impaired cognition, and as individuals grow older, they may also experience age-related changes in mental abilities. Previous studies have shown that computer-based cognitive training (CCT) and transcranial direct current stimulation (tDCS) may be useful in improving cognition in older persons. This study evaluated the acceptability of CCT and tDCS to older adults with HIV-associated neurocognitive disorder, and assessed their impact on reaction time, attention, and psychomotor speed.Methods: In a single-blind randomized study, 46 individuals with HIV-associated mild neurocognitive disorder completed neuropsychological assessments and six 20-min training sessions to which they had been randomly assigned to one of the following conditions: (1) CCT with active tDCS; (2) CCT with sham tDCS, or (3) watching educational videos with sham tDCS. Immediately after training and again 1 month later, participants completed follow-up assessments. Outcomes were evaluated via repeated measures mixed effects models.Results: Participant ratings of the intervention were positive. Effects on reaction time were not significant, but measures of attention and psychomotor speed suggested positive effects of the intervention.Conclusion: Both CCT and tDCS were highly acceptable to older persons with HIV infection. CCT and tDCS may improve cognitive in affected individuals.Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [NCT03440840].

Highlights

While there has been significant progress in the treatment of HIV infection using multiple antiretroviral medications, HIV-association neurocognitive disorders (HANDs) continue to be seen in affected individuals, even when their viral loads are non-detectable (Heaton et al, 2010)
This study evaluated the acceptability of computer-delivered cognitive training (CCT) and transcranial direct current stimulation (tDCS) to older adults with HIV-associated neurocognitive disorder, and assessed their impact on reaction time, attention, and psychomotor speed
Effects on reaction time were not significant, but measures of attention and psychomotor speed suggested positive effects of the intervention. Both CCT and tDCS were highly acceptable to older persons with HIV infection

Summary

Introduction

While there has been significant progress in the treatment of HIV infection using multiple antiretroviral medications, HIV-association neurocognitive disorders (HANDs) continue to be seen in affected individuals, even when their viral loads are non-detectable (Heaton et al, 2010). Many programs created for CCT are not inherently interesting, reducing users’ motivations for continued use after completing a study for which they were compensated. Another approach may be to use computer gaming software that is already available as a CCT intervention (Zelinski and Reyes, 2009; Bonnechère et al, 2020). Existing games depend on sustained use by players for their commercial success. Games such as these are interesting to players and include elements that engage them. First-person shooters (in which players use weapons to shoot at fictional enemies) can affect sustained attention and reaction time (Green and Seitz, 2015), some players may object to this type of game’s violent content (Wu and Spence, 2013; Green and Seitz, 2015)

Methods

Results

Conclusion