Abstract
Cognitive rehabilitation may compensate for cognitive deficits of children with acquired brain injury (ABI), capitalizing on the use-dependent plasticity of a developing brain. Remote computerized cognitive training (CCT) may be delivered to patients in ecological settings, ensuring rehabilitation continuity. This work evaluated cognitive and psychological adjustment outcomes of an 8-week multi-domain, home-based CCT (Lumosity Cognitive Training) in a sample of patients with ABI aged 11–16 years. Two groups of patients were engaged in five CCT sessions per week for eight weeks (40 sessions). According to a stepped-wedge research design, one group (Training-first Group) started the CCT immediately, whereas the other group (Waiting-first Group) started the CCT after a comparable time of waiting list. Changes after the training and after the waiting period were compared in the two groups. Both groups improved in visual-spatial working memory more after the training than after the waiting-list period. The Training-first group improved also in arithmetic calculation speed. Findings indicate that a multi-domain CCT can produce benefits in visual-spatial working memory, probably because, in accordance with previous research, computer games heavily tax visuo-spatial abilities. This suggests that the prolonged stimulation of the same cognitive ability may generate the greatest benefits in children with ABI.
Highlights
Cognitive rehabilitation may compensate for cognitive deficits of children with acquired brain injury (ABI), capitalizing on the use-dependent plasticity of a developing brain
In addition to estimate the overall effect of the computerized cognitive training (CCT) in the wide population of patients with brain injury, the trial aimed to test the effects of the CCT in different subgroups of patients based on a specific diagnosis, with the goal of studying how specific brain injured populations react to training administration and benefit from it
As depicted in the flowchart, the number of children assigned to the Training-first Group and Waiting-first Group was different, as for the main study participants were stratified based on etiology of the brain injury, but not on the classification of progressive/non-progressive ABI
Summary
Cognitive rehabilitation may compensate for cognitive deficits of children with acquired brain injury (ABI), capitalizing on the use-dependent plasticity of a developing brain. In view of the interdependence of different cognitive abilities[31,32] and based on previous studies on CCT conducted on healthy individuals[33,34,35,36,37], the simultaneous stimulation of different cognitive domains by the same training is expected to generate the greatest impact on cognitive outcomes and produce improvement across untrained cognitive domains This effect was found in adults with chronic mild-to-severe traumatic brain injury[38] but this still needs to be verified in pediatric individuals with ABI. This study aimed at testing, in a group of pediatric patients with non-progressive ABI, the effects of a remotely-delivered, multi-domain CCT, namely Lumosity Cognitive Training (Lumos Labs, Inc.), on the neurocognitive functioning and psychological adjustment. It rather allows for prompt publication of trial results, in keeping with the trial dissemination plan[47], as soon as they are available[48]
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