Cognitive Training Interventions Research Articles

Development of Virtual Reality-Based Left Brain System

This paper proposes a virtual reality based Left Brain System named BrainUp World to improve left brain thinking. The left-brain system was employed with mobile virtual reality technology, hand motion tracking and haptic feedback system. The implementation of these systems is to enhance the experience and sense of embodiment. BrainUp World includes virtual reality-based brain training games to improve a person’s attention level, reasoning skill, auditory cognition, arithmetic skill, sequencing skill and memory. The hand tracking system was utilized with an IR camera to capture the hand orientation and return the gesture data to the VR application. A low-cost and lightweight haptic glove was invented which provides the sense of touch using vibrations while interacting with VR contents. An experimental study was conducted to assess the efficacy of BrainUp World compared to traditional PC-based training approaches. Participants were randomly assigned to either the VR-based or PC-based training group and underwent 6 different games to test a person’s attention level, reasoning skill, auditory cognition, arithmetic skill, sequencing skill, and memory. The results revealed a statistically significant improvement in left brain function in the VR-based training group compared to the PC-based group, with a T-score growth of 4.73. Analysis using ANOVA confirmed the significance of this difference (p-Value = 0.04). Notably, the study also identified age-related differences in thinking fluency, highlighting the importance of personalized cognitive training interventions. In conclusion, BrainUp World demonstrates the potential of VR technology in promoting left brain development, as evidenced by empirical findings from the conducted study. By offering immersive and interactive cognitive training experiences, VR-based systems hold promise for enhancing various aspects of cognitive function associated with left hemisphere dominance. Further research in this area is encouraged to explore the full potential of VR-based interventions for cognitive enhancement.

Tunisian Adolescents at CHR for Psychosis: A Pilot Study of Cognitive Remediation in a LMIC.

Clinical high risk (CHR) youth are known to exhibit cognitive deficits at similar levels to their more severally ill counter parts. Cognitive training (CT) programs offer a promising method for early intervention and the prevention of further cognitive decline in this vulnerable population. However, there are few structured CT intervention programs addressing the needs of CHR youth in LMICs of the Middle East. We conducted a study in the Child and Adolescent Psychiatry Department of Razi University Hospital. Patients were assessed by trained raters with the "Comprehensive Assessment of At-Risk Mental States" to confirm their CHR status. Cognitive Training (CT) was combined with the Neuropsychological Educational Approach to Remediation (CT-NEAR) as part of a social rehabilitation program. We enrolled 25 CHR patients and examined several domains of cognitive functioning and evaluated daily functioning prior to starting the intervention and after completion. There were 20 patients who completed the study. The CT-NEAR group (n = 10) completed an average number 28.33 sessions over 12 weeks, which were matched for therapist time with the TAU group (n = 10). We found statistically significant improvements in CT-NEAR versus TAU in several cognitive domains; such as cognitive flexibility, memory-short and long-term, and verbal fluency. Also, CT-NEAR versus TAU patients improved in global functioning. Our findings indicate that cognitive remediation versus TAU for Tunisian CHR youth is feasible and effective especially in improving cognitive functioning when delivered in a social rehabilitation context (Bridging Group) and extends to global level of functioning.

The Relationship Between 10-year Changes in Cognitive Ability and Subsequent Mortality: Findings from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) Trial.

Cognitive ability and cognitive decline are related to mortality in older adults. Cognitive interventions have been found to improve cognitive performance and slow cognitive decline in later life. However, the longitudinal effects of cognitive interventions on mortality in older adults remain unclear. Using twenty-year follow-up data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial, we examined the association between cognitive trajectory (i.e., intercept, slope, and retest effect) and mortality, using shared growth-survival models. We evaluated the effect of ACTIVE cognitive training (memory, reasoning, and speed of processing) on mortality risk. Among the 2,802 participants, 2,021 died on or before the year 2019 (72.1%). Higher baseline, slower decline, and greater retest effects in general cognitive performance were associated with lower mortality risk after adjusting for covariates. Associations with mortality were similar contrasting general and domain-specific cognitive abilities. We did not observe any significant effects of ACTIVE cognitive training in memory, reasoning, or speed of processing on all-cause mortality. Our findings suggest cognitive training interventions do not have a significant effect on cognitive trajectory and mortality among older adults; rather, older adults with higher education tend to incur greater survival benefits from memory training.

Remote delivered cognitive rehabilitation programs in Acquired Brain Injury: a systematic review of methods and outcomes

AbstractRemote delivered cognitive rehabilitation programs (r-CRP) are increasingly recognized as alternative and complementary intervention approaches to traditional cognitive rehabilitation (CR) in the context of several neurological conditions, including acquired brain injuries (ABI). This systematic review examines the methodological characteristics of currently available r-CRP for ABI patients and investigates their impact on cognitive and noncognitive outcomes. A systematic search was performed on EBSCOhost, PubMed, and Web of Science, complemented by a manual search. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Cochrane Collaboration Guidelines were followed. Out of 1624 studies, a total of 19 studies were included. The results demonstrate that most r-CRP were administered to middle-aged community-dwelling chronic stroke survivors and that there was no consensus regarding assessment and intervention protocols. Moreover, most r-CRP were delivered through information and communication technologies (ICTs), primarily relying on cognitive training (CT) interventions addressing multiple cognitive domains (e.g., attention, memory). These ICT-based CT programs included tasks with low ecological validity, i.e., tasks with limited real-world application (e.g., cancelation tasks with artificial stimuli), and were asynchronous, meaning that participants performed the sessions at their own pace, without real-time monitoring from a therapist. In terms of the impact of r-CRP, class I studies reported mixed and inconsistent results regarding the effect of this mode of delivery on cognitive and noncognitive outcomes of ABI patients while supporting its high feasibility and acceptability among patients. Specific recommendations for future research are provided to improve the methodological quality of clinical studies and establish the evidence base for r-CRP.

Immersive Virtual Reality Cognitive Training for Improving Cognition and Depressive Symptoms Among Older Adults. Current Evidence and Future Recommendations. A Systematic Review.

Older adults, particularly impacted by the pandemic, are anticipated to face considerable challenges to their cognitive and psychological health. Various cognitive training methods have been proposed to improve their cognitive decline through regular practice. Immersive virtual reality (IVR) offers a promising avenue to bolster cognitive and mental health care accessibility for older adults and has shown potential in augmenting traditional cognitive training methods. This systematic review aims to assess the efficacy of IVR-based cognitive training on improving cognitive impairments and depressive symptoms among older adults, irrespective of their level of cognitive decline. Systematic searches were conducted across MEDLINE-PubMed, EMBASE, and Web of Science databases from inception to December 2022. Only peer-reviewed articles reporting results from randomized controlled trials and pilot studies, focusing on the effects of VR-based cognitive training on adults aged 55 or older, were deemed eligible. Using the Cochrane Handbook for Systematic Reviews of Interventions, the risk of bias was appraised for each selected study. Out of 3,835 studies identified, 9 met the inclusion criteria. The qualitative analyses concluded that IVR cognitive training interventions enhanced certain cognitive functions and well-being among older adults, notably those with mild cognitive impairments. These interventions were particularly effective in boosting memory, visuospatial abilities, and measures related to depressive symptoms and overall well-being. However, enhancements were less pronounced for executive functions, attention, and global cognition. Based on these findings, we propose a set of tailored, inclusive, and evidence-based recommendations to adapt emerging technologies to better accommodate the needs of older adults.

A meta-analysis of the effects of transcranial direct current stimulation combined with cognitive training on working memory in healthy older adults.

Working memory (WM) loss, which can lead to a loss of independence, and declines in the quality of life of older adults, is becoming an increasingly prominent issue affecting the ageing population. Transcranial direct current stimulation (tDCS), a non-invasive brain stimulation technique, is emerging as a potential alternative to pharmacological treatments that shows promise for enhancing WM capacity and May enhance the effects of cognitive training (CT) interventions. The purpose of this meta-analysis was to explore how different tDCS protocols in combination with CT enhanced WM in healthy older adults. Randomized controlled trials (RCTs) exploring the effects of tDCS combined with CT on WM in healthy older adults were retrieved from the Web of Science, PubMed, Embase, Scopus and the Cochrane Library databases. The search time period ranged from database inception to January 15, 2024. Methodological quality of the trials was assessed using the risk-of-bias criteria for RCTs from the Cochrane Collaboration Network, and RevMan 5.3 (Cochrane, London, United Kingdom) was used for the meta-analysis of the final literature outcomes. Six RCTs with a total of 323 participants were ultimately included. The results of the meta-analysis show that tDCS combined with CT statistically significantly improves WM performance compared to the control sham stimulation group in healthy older adults [standard mean difference (SMD) = 0.35, 95% CI: 0.11-0.59, I 2 = 0%, Z = 2.86, p = 0.004]. The first subgroup analysis indicated that, when the stimulus intensity was 2 mA, a statistically significant improvement in WM performance in healthy older adults was achieved (SMD = 0.39, 95% CI: 0.08-0.70, I 2 = 6%, Z = 2.46, p = 0.01). The second subgroup analysis showed that long-term intervention (≥ 10 sessions) with tDCS combined with CT statistically significantly improved WM compared to the control group in healthy older adults (SMD = 0.72, 95% CI: 0.22-1.21, I 2 = 0%, Z = 2.85, p = 0.004). tDCS combined with CT statistically significantly improves WM in healthy older adults. For the stimulus parameters, long-term interventions (≥ 10 sessions) with a stimulation intensity of 2 mA are the most effective.

Predicting Adherence to Computer-Based Cognitive Training Programs Among Older Adults: Study of Domain Adaptation and Deep Learning.

Cognitive impairment and dementia pose a significant challenge to the aging population, impacting the well-being, quality of life, and autonomy of affected individuals. As the population ages, this will place enormous strain on health care and economic systems. While computerized cognitive training programs have demonstrated some promise in addressing cognitive decline, adherence to these interventions can be challenging. The objective of this study is to improve the accuracy of predicting adherence lapses to ultimately develop tailored adherence support systems to promote engagement with cognitive training among older adults. Data from 2 previously conducted cognitive training intervention studies were used to forecast adherence levels among older participants. Deep convolutional neural networks were used to leverage their feature learning capabilities and predict adherence patterns based on past behavior. Domain adaptation (DA) was used to address the challenge of limited training data for each participant, by using data from other participants with similar playing patterns. Time series data were converted into image format using Gramian angular fields, to facilitate clustering of participants during DA. To the best of our knowledge, this is the first effort to use DA techniques to predict older adults' daily adherence to cognitive training programs. Our results demonstrated the promise and potential of deep neural networks and DA for predicting adherence lapses. In all 3 studies, using 2 independent datasets, DA consistently produced the best accuracy values. Our findings highlight that deep learning and DA techniques can aid in the development of adherence support systems for computerized cognitive training, as well as for other interventions aimed at improving health, cognition, and well-being. These techniques can improve engagement and maximize the benefits of such interventions, ultimately enhancing the quality of life of individuals at risk for cognitive impairments. This research informs the development of more effective interventions, benefiting individuals and society by improving conditions associated with aging.

A - 31 The Interaction of Cognitive Reserve and Multi-Modal Cognitive Training on the Cognitive Functioning of Older Adults at Risk for Dementia

Abstract Objective Multi-modal cognitive training improves cognition among those at risk for dementia. Although the mechanism is likely via improved cognitive flexibility, conceptually central cognitive reserve, it remains unclear whether cognitive reserve moderates cognitive training effects. The objective of this study was to determine whether baseline cognitive reserve moderates cognitive improvement following cognitive training. Methods Forty-one older adults (M = 72.7+/−4.9 years, 65.1% female, 17% non-white) with self-reported memory loss and baseline TICS score of 24–37 participated in a 6-month cognitive training intervention consisting of weekly computer-administered piano lesson and 30 minutes of daily homework. Cognition was assessed pre and post-intervention using CNS-Vital Signs. Specific domains tested were cognitive flexibility, psychomotor speed, and executive functioning. Cognitive reserve was operationalized as years of education. Results Significant post-training improvements occurred in all three cognitive domains (cognitive flexibility t = −6.34, p < 0.001; psychomotor speed t = −2.62, p = 0.01; executive functioning t = −6.49, p < 0.001). Years of education significantly moderated improvements in executive functioning (b = −0.06, SE(b) = 0.03, t(37) = −2.07, p = 0.045), but neither cognitive flexibility nor psychomotor speed. Specifically, participants with lower education improved most in executive functioning (b = 1.60, t = 2.78, p = 0.008). Conclusions Findings suggest that participants with lower cognitive reserve may benefit more from far-transfer effects of cognitive training on executive functioning. This was not observed in domains closely related (cognitive flexibility) and relatively unrelated (psychomotor speed) to cognitive reserve.

The effectiveness of brief workplace compassion-focussed training in improving wellbeing of stressed school employees

Australian teachers and school employees report high levels of stress-related mental health problems. Previous theory and research show that workplace training in strategies to manage stress can improve organisational productivity as well as employee wellbeing. Theory suggests that self-compassion strategies may produce better outcomes, than standard cognitive behavioural training interventions, due to activation of self-soothing. This pilot randomised controlled trial evaluated whether inclusion of a brief compassion-focussed therapy (CFT) training workshop was more effective in reducing stress-related mental health problems of school employees, than the standard professional development (PD) workshop that incorporated cognitive behavioural therapy and mindfulness strategies. School employees (103) were recruited and randomly allocated to either the standard PD alone or to also participate in a brief CFT workshop. There were very large reductions in burnout and clinically significant improvements in mental health problems under both conditions. The results provide preliminary evidence that CFT-enhanced training improves secondary traumatic stress and compassion satisfaction; further research needs to be conducted with a larger sample. These results may also be relevant to other occupations with a high emotional load. JEL Classification: I310

The clinical value of nonpharmacological interventions for preventing postoperative delirium: a narrative review.

Postoperative delirium (POD) is a prevalent perioperative complication among elderly individuals and is a cause of significant detrimental consequences for both individuals and society. Pharmacological and nonpharmacological prevention methods/therapies have been proposed to mitigate the risk of POD. Nevertheless, the efficacy of pharmacological interventions is controversial, and some of them cause side effects. Therefore, numerous studies have explored the effectiveness of nonpharmacological interventions in mitigating POD and have recommended the use of nonpharmacological multicomponent interventions by an interdisciplinary team as primary interventions. However, dedicated units aimed at promoting comanagement are rare and are only present in academic hospitals. Therefore, there is increasing interest in nonpharmacological mono-component interventions for preventing POD, which offer advantages such as easy application, cost-effectiveness, patient acceptability and noninvasiveness. These interventions are divided into cognitive training and noncognitive interventions. The former is aimed at increasing cognitive reserve, thus decreasing the incidence rate of POD. Noncognitive interventions, including sensory stimuli (music therapy, odor enrichment), improving sleep disturbances, physical activity, acupuncture and transcranial magnetic/direct current stimulation, are aimed at decreasing the risk factors for POD. This review provides a comprehensive overview of recently reported nonpharmacological mono-component interventions for preventing POD and briefly describes their clinical value.

Nonpharmacological treatment for older adults with mild cognitive impairment: Considerations for culturally informed clinical practice and research.

Numerous nonpharmacological treatments (NPTs) have been developed for older adults with mild cognitive impairment (MCI). Two forms of cognition-focused NPTs, cognitive rehabilitation (CR) and cognitive training (CT), demonstrate cognitive benefit, but limitations remain regarding the contribution of cultural and demographic factors to study outcome heterogeneity, generalizability to diverse populations, and feasibility. This article aimed to review demographic and culturally informed NPTs and provides recommendations for culturally informed clinical practice and research. We conducted a PubMed review to identify CR and CT interventions that incorporated cultural adaptations. Results from the review, combined with the authors' clinical expertise, were used to identify methodological, demographic, social, cultural, and systemic variables relevant to NPTs. Existing CR and CT studies that included cultural adaptations adopted modifications to language, measures (cognition, function), and lifestyle factors (diet, physical activity) among others. In addition, provider, patient, and group-level factors were then raised to promote inclusivity and increase NPT generalizability. Nevertheless, there is a paucity of research considering cultural and demographic factors when delivering cognition-focused NPTs. Recommendations were generated that incorporated current literature as well as the authors' clinical and research experiences. Culturally informed NPTs are understudied. Social, demographic, and cultural factors may contribute to the heterogeneity of outcomes, lack of generalizability of findings to diverse groups, and application of intervention to said groups. Several tools are available and can focus on broadening collection of information regarding patients' identities, social network, adapting to literacy level and linguistic diversity needs, and responding to social and structural determinants of health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Effects of computerized working memory training on neuroplasticity in healthy individuals: A combined neuroimaging and neurotransmitter study

Working memory (WM) is an essential cognitive function that underpins various higher-order cognitive processes. Improving WM capacity through targeted training interventions has emergered as a potential approach for enhancing cognitive abilities. The present study employed an 8-week regimen of computerized WM training (WMT) to investigate its effect on neuroplasticity in healthy individuals, utilizing neuroimaging data gathered both before and after the training. The key metrics assessed included the amplitude of low-frequency fluctuations (ALFF), voxel-based morphometry (VBM), and the spatial distribution correlations of neurotransmitter. The results indicated that post-training, compared to baseline, there was a reduction in ALFF in the medial superior frontal gyrus and an elevation in ALFF in the left middle occipital gyrus within the training group. In comparison to the control group, the training group also exhibited decreased ALFF in the anterior cingulate cortex, angular gyrus, and superior parietal lobule, along with increased ALFF in the postcentral gyrus post-training. VBM analysis revealed a significant increase in gray matter volume (GMV) in the right dorsal superior frontal gyrus after the training period, compared to the initial baseline measurement. Furthermore, the training group showed GMV increases in the dorsal superior frontal gyrus, Rolandic operculum, precentral gyrus, and postcentral gyrus when compared to the control group. In addition, significant associations were identifed between neuroimaging measurements (AFLL and VBM) and the spatial patterns of neurotransmitters such as serotonin (5-HT), dopamine (DA), and N-methyl-D-aspartate (NMDA), providing insights into the underlying neurochemical processes. These findings clarify the neuroplastic changes caused by WMT, offering a deeper understanding of brain plasticity and highlighting the potential advantages of cognitive training interventions.

The effect of different exercise on physical fitness, cognition, and mental health in healthy older adults

ObjectiveThis study aimed to examine the effects of different exercise programs on physical fitness, cognition, and mental health in healthy older adults. MethodsA randomized controlled study was performed with 89 healthy older adults. They were separated into four groups: the control (Con; n = 20), physical activity (PA; n = 23), cognitive training (CT; n = 23), and physical activity coupled with cognitive training groups (PA + CT; n = 23). The subjects in PA, CT, and PA + CT groups received exercise programs that lasted 40 min daily, conducted at least three days a week for 20 weeks. The PA group received regular aerobic physical activity interventions, the CT group received cognitive training interventions, and the PA + CT group received physical activity combined with cognitive training interventions. Physical fitness (by chair stand, biceps curl, 2-min step, 8-step up and walk, and sit and reach tests), cognitive function (attention, simple reaction time, and spatial memory), and mental health (anxiety and depression status) were evaluated before and after 20 weeks. ResultsThe body composition results reveal no significant effects among the four groups after 20 weeks before and after aerobic exercise interventions (p > 0.05). Compared with Con, the PA, CT, and PA + CT groups significantly improved physical fitness parameters (p < 0.05). The post-hoc analysis demonstrated that the PA and PA + CT groups had higher fitness levels than the CT group. Similarly, a significant difference was observed in the cognitive index among the four groups (p < 0.05). As determined by post-hoc analysis, attention and simple reaction time differed sequentially between the Con, PA, CT, and PA + CT groups. The spatial memory was superior in the PA, CT, and PA + CT groups compared to the Con group (p < 0.05), with the PA + CT group exhibiting the highest level of performance. However, there was no significant difference in the mental health parameters among all the groups (p < 0.05). ConclusionA 20-week intervention involving different exercise methods can enhance physical fitness, cognition, and mental health in older adults. These methods include physical activity, cognitive training, and a combination of physical and cognitive training. The combined physical activity and cognitive training interventions yielded more favorable outcomes than individual physical or cognitive training interventions.

Prevention of Dementia Through Physical Exercise and Cognitive Training: A Narrative Review

Background: Dementia reduces the ability to live independently, thus deteriorating the patient’s quality of life and caregivers' mental health. Consequently, dementia indirectly affects economic and social growth. Dementia is also a major contributor to death worldwide. There is no effective treatment for dementia, but preventing physical and cognitive inactivity among the elderly could help. Studies show that the risk of dementia increases in the elderly with mild cognitive impairment (MCI). Methods: This review set out to compare the effects of physical exercise (PE) and cognitive training (CT) on cognitive performance among the elderly with MCI, by examining the evidence from published literature between 2013-2023. Four major electronic databases were used to search the relevant studies, resulting in 2782 articles. A total of fourteen articles were included in the review. Results: The findings showed that interventions with naturally combined cognitive and physical training not only improved cognitive performance, but also prevented the elderly from stress and fatigue. Integrating physical exercise and cognitive training interventions with the best combination method is crucial to ensure participant adherence. Therefore, the intervention can be incorporated effectively into healthcare policies and programs to support cognitive health in aging populations. Conclusion: Future studies should also explore the optimal duration of training sessions to maximise cognitive benefits and ensure participant adherence and motivation.

The feasibility and effectiveness of remote cognitive training on cognitive function and work performance in workers.

We aimed to determine whether remote cognitive training (CT) is feasible and has the potential to improve cognitive function and work performance in Japanese workers. From June to September 2020, this intervention time series study enrolled workers aged 18-65 years from 10 companies located in a metropolitan area of Japan. Cognitive function tests and self-administered questionnaires were completed by the participants three times: at baseline, after 12 weeks of CT, and after a further 12 weeks following cessation. We measured work performance with the question: "How would you rate your performance (compared with your optimum performance) over the past 4 weeks?" Responses were made via a visual analog scale (0-100). Cognitive function was assessed using the THINC-integrated tool, which is a brief, objective computerized cognitive assessment battery. For our computerized remote CT intervention, BrainHQ was used on the basis of our scientific rationale and the empirical literature. We recommended three 20-min sessions of BrainHQ per week and sent participants three reminders. In total, 119 participants were recruited to this study. Only 22.7% of the subjects achieved the recommended training time of 720 min over 12 weeks. The median training time was used to divide participants into long and short- training groups. The long-training group showed a greater improvement in attention and executive function than the short-training group but there was no significant improvement in work performance after CT compared to baseline. Our results suggest that although remote CT was not feasible enough, the effects on cognitive function can be expected by increasing training time and motivation.

Cognitive training and promoting a healthy lifestyle for individuals with isolated REM sleep behavior disorder: study protocol of the delayed-start randomized controlled trial CogTrAiL-RBD

BackgroundIsolated REM sleep behavior disorder (iRBD) is an early α-synucleinopathy often accompanied by incipient cognitive impairment. As executive dysfunctions predict earlier phenotypic conversion from iRBD to Parkinson’s disease and Lewy body dementia, cognitive training focusing on executive functions could have disease-modifying effects for individuals with iRBD.MethodsThe study CogTrAiL-RBD investigates the short- and long-term effectiveness and the feasibility and underlying neural mechanisms of a cognitive training intervention for individuals with iRBD. The intervention consists of a 5-week digital cognitive training accompanied by a module promoting a healthy, active lifestyle. In this monocentric, single-blinded, delayed-start randomized controlled trial, the intervention’s effectiveness will be evaluated compared to an initially passive control group that receives the intervention in the second, open-label phase of the study. Eighty individuals with iRBD confirmed by polysomnography will be consecutively recruited from the continuously expanding iRBD cohort at the University Hospital Cologne. The evaluation will focus on cognition and additional neuropsychological and motor variables. Furthermore, the study will examine the feasibility of the intervention, effects on physical activity assessed by accelerometry, and interrogate the intervention’s neural effects using magnetic resonance imaging and polysomnography. Besides, a healthy, age-matched control group (HC) will be examined at the first assessment time point, enabling a cross-sectional comparison between individuals with iRBD and HC.DiscussionThis study will provide insights into whether cognitive training and psychoeducation on a healthy, active lifestyle have short- and long-term (neuro-)protective effects for individuals with iRBD.Trial registrationThe study was prospectively registered in the German Clinical Trial Register (DRKS00024898) on 2022–03-11, https://drks.de/search/de/trial/DRKS00024898. Protocol version: V5 2023–04-24.

Cognitive Training Prevents Stress-Induced Working Memory Deficits

BackgroundWorking memory is a fundamental cognitive process that is critically involved in planning, comprehension, reasoning, and problem solving. Acute stress has been shown to impair working memory. This stress-induced working memory deficit has profound implications for cognitive functioning in everyday life as well as for stress-related mental disorders. Here, we tested whether a cognitive training intervention would make working memory more resistant to disruptive effects of acute stress. MethodsIn a preregistered, fully crossed between-subjects design with the factors stress (vs. control) and cognitive training (vs. sham), 123 healthy men and women (ages 18–35 years) completed a daily cognitive training program targeting working memory–related processes or a sham training over a period of 6 weeks. After this 6-week training intervention, participants underwent a standardized stress or control manipulation shortly before their working memory performance was tested. ResultsAs expected, the exposure to acute stress led to a significant working memory impairment in the sham training group. Critically, although the subjective, autonomic, and endocrine stress responses were comparable in the 2 training groups, this stress-induced working memory impairment was abolished in the intervention training group. ConclusionsThese results are the first to show that a cognitive training intervention directed at prefrontal and hippocampal functioning can prevent the detrimental effects of stressful events on working memory performance.

The Effects of Prescribed Physical and Cognitive Exercise on Life Satisfaction, Self-Efficacy and Mood States in Adults with Down Syndrome: The MinDSets Study.

Down syndrome (DS) is characterised by a duplication of chromosome-21 and is linked to co-occurring physical and mental health conditions, including low self-efficacy and disturbed mood states. The purpose of this study was to investigate the effects of an eight-week prescribed physical and/or cognitive training intervention on measures of mood disturbance, life satisfaction and self-efficacy in a population of adults with DS. Eighty-three participants (age 27.1 ± 8.0 years) from across five continents volunteered. Participants were assigned using matched groups based upon performance in a modified six-minute walk test to either an exercise (EXE) 3 × 30 min of walking/jogging per week, cognitive training (COG) 6 × 20 min per week, a combined group (COM) or the control (CON) who did not complete any intervention. Profile of Mood States (POMS) were assessed using a five-point scale across 65 categories pre- and post-study as well as upon completion of each week of the intervention. In addition, Satisfaction with Life Scale (SWLS) and self-efficacy using the Generalised Self-Efficacy scale (GSE) were recorded before and after the intervention. GSE increased for all participants by 1.9 ± 5.2 (p = 0.002) from pre- to post-intervention, while POMS showed significant changes for the whole group from pre- to post-intervention for tension (p < 0.001), depression (p < 0.001) and for anger (p < 0.001). In addition, significant correlations were observed between SWLS and ΔTMD, Δtension, Δanger, and Δfatigue (p < 0.05) for EXE. Both COG and EXE provide a framework for empowering enhancements in life satisfaction, self-efficacy and mood states fostering improvements in quality of life.

Effects of cognitive training and behavior modification on aggressive behavior and sleep quality in schizophrenia.

Schizophrenia (SCZ) is linked to a heightened risk of impulsive aggression and disturbances in sleep patterns. Cognitive and social cognitive impairments have been connected to aggression, with social cognitive deficits appearing to play a more immediate role. In this investigation, we conducted a retrospective analysis of the impact of cognitive training and sleep interventions on aggressive behavior and the quality of sleep among individuals with SCZ who were hospitalized. This study divided 80 hospitalized patients into two groups according to medical advice, namely the normal group and the study group. The control group received routine drug treatment and education; The research group implemented cognitive training and sleep intervention based on the normal group. Collect basic clinical data, aggressive behavior indicators, and sleep quality indicators. There is no difference in the basic information statistics between the two groups. Both groups can reduce aggressive behavior and improve sleep quality. In the study group, there was a notable decrease in aggressive behavior compared to the control group. Furthermore, the sleep quality in the study group exhibited significant improvement when compared to the control group. Cognitive training and sleep intervention have been proven to be effective nonpharmacological treatments, effectively reducing aggressive behavior and improving sleep quality.

Comparative effectiveness of remote digital gamified and group CBT skills training interventions for anxiety and depression among college students: Results of a three-arm randomised controlled trial

Digital interventions can enhance access to healthcare in under-resourced settings. However, guided digital interventions may be costly for low- and middle-income countries, despite their effectiveness. In this randomised control trial, we evaluated the effectiveness of two digital interventions designed to address this issue: (1) a Cognitive Behavioral Therapy Skills Training (CST) intervention that increased scalability by using remote online group administration; and (2) the SuperBetter gamified self-guided CBT skills training app, which uses other participants rather than paid staff as guides. The study was implemented among anxious and/or depressed South African undergraduates (n = 371) randomised with equal allocation to Remote Group CST, SuperBetter, or a MoodFlow mood monitoring control. Symptoms were assessed with the Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9). Intention-to-treat analysis found effect sizes at the high end of prior digital intervention trials, including significantly higher adjusted risk differences (ARD; primary outcome) in joint anxiety/depression remission at 3-months and 6-months for Remote Group CST (ARD = 23.3–18.9%, p = 0.001–0.035) and SuperBetter (ARD = 12.7–22.2%, p = 0.047–0.006) than MoodFlow and mean combined PHQ-9/GAD-7 scores (secondary outcome) significantly lower for Remote Group CST and SuperBetter than MoodFlow. These results illustrate how innovative delivery methods can increase the scalability of standard one-on-one guided digital interventions. Preregistration international standard randomised controlled trial number (isrtcn) submission #47,089,643.