Abstract
BackgroundMild cognitive impairment (MCI) is a transition state between asymptomatic stage and dementia. Amnestic MCI (aMCI) patients who mainly present with memory deficits are highly likely to progress to Alzheimer’s disease (AD). At present, no broadly effective drug therapy is available to prevent the progression from memory deficit to dementia. Cognitive control training, which has transfer effects on multiple cognitive capacities including memory function in healthy old adults, has not yet been applied to aMCI.Methods/DesignIn this single-center, randomized double-blind placebo-controlled study, 70 aMCI patients will be recruited and randomly assigned to the training and control groups. The intervention is an Internet-based cognitive control training program performed for 30 min daily, five days per week, for 12 consecutive weeks. Neuropsychological assessment and structural and functional magnetic resonance imaging (MRI) will be performed at baseline and outcome. Primary outcomes are changes of episodic memory retrieval function. Secondary outcome measures are neuroplasticity changes measured by functional and structural MRI.DiscussionIn this study, an Internet-based cognitive control training program is adopted to investigate whether cognitive control training can enhance the retrieval of episodic memory in aMCI patients. The combination of multi-modal MRI and neuropsychological tests could have a good sensitivity in evaluating the effects of cognitive control training and could also uncover the underlying neural underpinning.Trial registrationClinicalTrials.gov, NCT03133052. Registered on 21 April 2017.
Highlights
Mild cognitive impairment (MCI) is a transition state between asymptomatic stage and dementia
In this study, an Internet-based cognitive control training program is adopted to investigate whether cognitive control training can enhance the retrieval of episodic memory in Amnestic MCI (aMCI) patients
(1) Age > 55 years; (2) Elementary school education or higher; (3) Chief complaint of memory impairment confirmed by relatives; (4) Ability to read a computer screen; (5) Normal overall cognitive function as evidenced by Clinical Dementia Rating-global (CDR-global) = 0.5, Mini-mental State Examination (MMSE) score ≥ 22 with a concurrent Montreal Cognitive Assessment (MoCA) score ≤ 20 for those with elementary educational level and MMSE score ≥ 26 with a MoCA score ≤ 25 for those with junior educational level or above; (6) Auditory Verbal Learning Test-Huashan version (AVLT-H) scores 1.5 standard deviations lower than age-matched controls; (7) Activities of Daily Living assessment-20 (ADL-20) ≤ 23; (8) Do not comply with Alzheimer’s disease (AD) diagnostic criteria proposed by the International Statistical
Summary
This is the first study to assess the effects of cognitive control training on episodic memory retrieval function in aMCI patients. First, we will examine the efficacy of cognitive control training on episodic memory of aMCI patients by using neuropsychological tests. Abbreviations 3D-MPRAGE: Three-dimensional (3D) magnetization-prepared rapid acquisition with gradient echo; AD: Alzheimer’s disease; ADL: Activities of Daily Living; aMCI: Amnestic mild cognitive impairment; AVLT-H: Auditory Verbal Learning Test-Huashan version; BNT: Boston Naming Test; CDR: Clinical Dementia Rating; CONSORT: Consolidated Standards of Reporting Trials; DTI: Diffusion tensor imaging; DTS: DIGIT span test; EPI: Echo-planar imaging; fMRI: Functional magnetic resonance imaging; GDS: Geriatric Depression Scale; HIS: Hachinski Ischemia Scale; ICD-10: International Statistical Classification of Diseases and Related Health Problems, 10th Revision; MCI: Mild cognitive impairment; MMSE: Mini-mental State Examination; MoCA: Montreal Cognitive Assessment; MRI: Magnetic resonance imaging; NINCDS-ADRDA: National Institute of Neurological and Communicative Disorders and Stroke and Alzheimer’s Disease and Related Disorders Association; TMT: TRAIL Making Test
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