Computer-based Cognitive Rehabilitation Research Articles

Efficacy of Nonpharmacological Interventions in Cognitive Impairment: Systematic Review And Network Meta-Analysis

There is currently no known cure for cognitive impairment, which highlights the need to explore other ways of managing this condition. This topic has recently become an area of active research. However, the availability of nonpharmacological options poses a challenge when trying to determine the best treatment for improving cognitive function. We conducted a systematic review and a Bayesian network meta-analysis to compare the effects of nonpharmacological interventions on global cognition in patients with mild cognitive impairment and dementia. The nonpharmacological interventions were classified as aerobic exercise, strength exercise, multicomponent physical exercise, other physical exercises, tai chi, mind-body exercises, traditional cognitive rehabilitation, computer-based cognitive rehabilitation, occupational therapy, music therapy, physical-cognitive rehabilitation, and reminiscence therapy. Physical-cognitive rehabilitation emerged as the most effective nonpharmacological intervention for enhancing global cognition in patients with unspecified cognitive impairment and dementia, whereas occupational therapy focused on dual-task interventions was found to be the most effective nonpharmacological intervention for mild cognitive impairment. These results underscore the importance of adopting a dual approach to managing cognitive impairment, integrating both cognitive and physical rehabilitation within the same intervention.

A comparative study of the effectiveness of Non-computer and Computer-based Cognitive Rehabilitation Interventions on Auditory/Visual Working Memory of Stroke Patients

A comparative study of the effectiveness of Non-computer and Computer-based Cognitive Rehabilitation Interventions on Auditory/Visual Working Memory of Stroke Patients

Comparing the Effectiveness of Computer-Based and Task-Oriented Cognitive Rehabilitation Programs on Epileptic Children’s Attention in Tehran

Background: There are important cognitive issues in patients with epilepsy, which can be referred to as impairment in executive functions such as attention. Objectives: This research aims to compare the effectiveness of computer-based cognitive rehabilitation programs and task-oriented cognitive rehabilitation programs on attention in children with epilepsy in Tehran. Methods: The present research was a semi-experimental study with a pre-test and post-test design with a control group. The statistical population of the study included all children with epilepsy who were referred to the neurology clinic of Mofid Children's Hospital in 2021. Using the purposeful sampling method, 45 eligible children were included in the study and were randomly divided into 2 experimental groups and 1 control group (15 people in each group). The Integrated Visual and Auditory Continuous Performance Test (IVA2) of Sohlberg and Mateer (2001) was used for data collection. The experimental groups underwent the intervention of the computerized cognitive rehabilitation program of the Cambridge Neuropsychological Test (1980) (12 sessions of 45 minutes) and the task-oriented cognitive rehabilitation program (12 sessions of 45 minutes). The control group did not receive any intervention. SPSS 20 software was used for data analysis. Univariate covariance analysis (ANCOVA) was performed using a significance level of 0.05. Results: The results demonstrated that both computer-based cognitive rehabilitation programs and task-based cognitive rehabilitation were effective in increasing the attention of epileptic children in Tehran (P < 0.001). There was no significant difference between the effectiveness of computer-based cognitive rehabilitation programs and task-based cognitive rehabilitation in increasing the attention of epileptic children (P = 0.67). Conclusions: It can be concluded that computer-based and task-oriented cognitive rehabilitation programs can be used to increase attention and executive functions in children with epilepsy.

Effectiveness of Eye Movement Desensitization and Reprocessing Therapy and Computer-Based Cognitive Rehabilitation on the Cognitive Bias of Veterans with Post-traumatic Stress Disorder

Background: People with post-traumatic stress disorder (PTSD) from war have more severe symptoms when combined with other chronic disorders, worsening their condition. Objectives: The present study aimed to investigate the effects of eye movement desensitization and reprocessing (EMDR) therapy and computer-based cognitive rehabilitation on the cognitive bias of veterans with PTSD. Methods: This was a quasi-experimental study with pretest, posttest, follow-up, and a control group. The statistical population included all the veterans under the Foundation of Martyrs and Veterans Affairs coverage of Ahvaz, Iran, in 2021. After the necessary examinations, 45 eligible participants were randomly assigned to two experimental groups and one control group (15 participants per group) after the necessary coordination. The experimental groups separately received EMDR therapy and computer-based cognitive rehabilitation, whereas the control group received no intervention. Repeated measures ANOVA in SPSS-24 was used for data analysis. Results: The results showed that compared to the control group, EMDR and computer-based cognitive rehabilitation interventions significantly influenced the cognitive bias of veterans with PTSD (P < 0.001). Moreover, cognitive bias scores from the posttest and follow-up significantly differed from those from the pretest (P < 0.001). Conclusions: Since EMDR and computer-based cognitive rehabilitation improved cognitive bias in veterans with PTSD, these methods are recommended for improving their psychological characteristics.

Comparing the Effectiveness of Task-Oriented Cognitive Rehabilitation and Computer-Based Cognitive Rehabilitation Programs on Cognitive Flexibility in Children with Epilepsy

Comparing the Effectiveness of Task-Oriented Cognitive Rehabilitation and Computer-Based Cognitive Rehabilitation Programs on Cognitive Flexibility in Children with Epilepsy

Preliminary Study on the Effects of Virtual Reality-based Cognitive Rehabilitation and Computer-based Cognitive Rehabilitation on Function and Prefrontal Cortex in Convalescent Stroke Patients

Preliminary Study on the Effects of Virtual Reality-based Cognitive Rehabilitation and Computer-based Cognitive Rehabilitation on Function and Prefrontal Cortex in Convalescent Stroke Patients

The effect of computerized cognitive rehabilitation on visual-spatial ability and processing speed of students with a specific mathematical learning disorder

This study aimed to investigate the effectiveness of computer-based cognitive rehabilitation on visual-spatial ability and processing speed of students with a specific mathematical learning disorder. The research design was quasi-experimental, pretest-posttest with the control group, and a two-month follow-up. Among the fourth-grade male students with a specific mathematical learning disorder in Karaj, 40 people were selected by a convenience random sampling method, and with random replacement, they were divided into experimental and control groups. The subjects in the experimental group received the Captain's Log cognitive rehabilitation program individually for 12 sessions of 50-60 minutes. Data were collected by The Advanced Reaction Time Test, The Rey-Osterrieth Complex Figure Test, and the Iran KeyMath Diagnostic Tests. Covariance analysis was used to analyze the data. Computerized cognitive rehabilitation caused the experimental group to show shorter reaction time and more visual-spatial ability in the post-test and follow-up stages than the control group (p<0.05). Therefore, computerized cognitive rehabilitation programs can improve students' visual-spatial ability and processing speed with a specific mathematical learning disorder.

Combined Effect of Repetitive Transcranial Magnetic Stimulation and Cognitive Rehabilitation on Working Memory of Patients with Chronic Stroke

Background: Working memory is one of the cognitive aspects that may be damaged in patients suffering from a stroke. According to evidence, repetitive Transcranial Magnetic Stimulation (rTMS) and cognitive interventions could affect cognitive function in healthy individuals or patients with neurological diseases. Objectives: This study aimed to evaluate the combined effect of high-frequency rTMS in the left Dorsolateral Prefrontal Cortex (DLPFC) region of the brain and cognitive rehabilitation on the working memory of stroke patients. Methods: In this double-blind, randomized clinical trial with a pretest-posttest design, 18 post-stroke chronic patients aged 55 to 75 years were randomly divided into two experimental and control groups. The working memory score was measured using the N-back test in the two groups before the interventions. Then, both groups participated in rTMS intervention sessions, except that in the control group, changing the coil angle prevented the waves from reaching the brain. The rTMS interventions were performed for each patient in 15 sessions of six minutes, three days a week. In addition, both groups received computer-based cognitive rehabilitation therapy immediately after each rTMS session for 30 to 40 minutes. These practices included working memory rehabilitation in Captain's Log software used at the adult level. Each level had 15 steps, and the difficulty of the exercises increased with increasing steps. Finally, the working memory was remeasured after the intervention sessions. Results: The use of rTMS on the left DLPFC region significantly improved the working memory of stroke people in the experimental group compared to the control group (P = 0.027). In addition, the difference before and after the interventions in both groups was significant for this variable (P < 0.001), which indicates the positive effect of cognitive rehabilitation on reducing cognitive problems. Conclusions: Although cognitive rehabilitation using software is effective on working memory, using rTMS along with cognitive rehabilitation in the left DLPFC area has a more significant effect on improving working memory in people with chronic stroke.

Combined Effect of Repetitive Transcableranial Magnetic Stimulation and Cognitive Rehabilitation on Working Memory of Patients with Chronic Stroke

Background: Working memory is one of the cognitive aspects that may be damaged in patients suffering from a stroke. According to evidence, repetitive Transcranial Magnetic Stimulation (rTMS) and cognitive interventions could affect cognitive function in healthy individuals or patients with neurological diseases. Objectives: This study aimed to evaluate the combined effect of high-frequency rTMS in the left Dorsolateral Prefrontal Cortex (DLPFC) region of the brain and cognitive rehabilitation on the working memory of stroke patients. Methods: In this double-blind, randomized clinical trial with a pretest-posttest design, 18 post-stroke chronic patients aged 55 to 75 years were randomly divided into two experimental and control groups. The working memory score was measured using the N-back test in the two groups before the interventions. Then, both groups participated in rTMS intervention sessions, except that in the control group, changing the coil angle prevented the waves from reaching the brain. The rTMS interventions were performed for each patient in 15 sessions of six minutes, three days a week. In addition, both groups received computer-based cognitive rehabilitation therapy immediately after each rTMS session for 30 to 40 minutes. These practices included working memory rehabilitation in Captain's Log software used at the adult level. Each level had 15 steps, and the difficulty of the exercises increased with increasing steps. Finally, the working memory was remeasured after the intervention sessions. Results: The use of rTMS on the left DLPFC region significantly improved the working memory of stroke people in the experimental group compared to the control group (P = 0.027). In addition, the difference before and after the interventions in both groups was significant for this variable (P < 0.001), which indicates the positive effect of cognitive rehabilitation on reducing cognitive problems. Conclusions: Although cognitive rehabilitation using software is effective on working memory, using rTMS along with cognitive rehabilitation in the left DLPFC area has a more significant effect on improving working memory in people with chronic stroke.

Effects of computer-based cognitive rehabilitation on working memory in patients with acquired brain injury in the chronic phase, a pilot-study

ABSTRACT Background Working memory impairment is common in patients in the chronic phase after acquired brain injury (ABI), and there is a need to develop efficacious rehabilitation methods. This trial explored the effects of two different computer-based cognitive rehabilitation (CBCR) programmes on working memory in the chronic phase after ABI, as well as the role of continuous support versus no support from a health professional on the efficacy of CBCR. Methods A total of 72 patients were randomized into four different groups for a 12-week intervention: Two groups trained with the CBCR-programmes ‘Cogmed’ and ‘Brain+ Health,’ respectively, and one group completed active-control training. All three groups received continuous support from a health professional. The last group trained with the CBCR programme ‘Brain+ Health’ but received no support. Before and after the intervention, patients were tested with a neuropsychological battery of working memory, attention and executive functions. Results Both CBCR-programmes improved working memory when administered with support from a health professional. The programmes improved different sub-components of working memory, possibly because of their individual content and design. None of the CBCR-programmes were more efficacious than sham-training with support. CBCR without support did not improve working memory in patients.

Effects of Computer-Based Cognitive Rehabilitation on Attention, Executive Functions, and Quality of Life in Patients with Parkinson’s Disease: A Randomized, Controlled, Single-Blinded Pilot Study

Background: Cognitive decline in Parkinson’s disease (PD) has become increasingly recognized in recent years, and there is a need to identify methods for cognitive rehabilitation in PD patients. Objective: The aim of this study was to explore the feasibility and effects of 2 different computer-based cognitive rehabilitation (CBCR) interventions on attention, executive functions, and quality of life (QoL) in PD patients. Methods: Thirty nondemented PD patients were randomly assigned to one of 3 groups: one passive control group and 2 intervention groups with 2 different CBCR programmes. The intervention period was 8 weeks with follow-up visits in clinic every second week. Before and after the intervention period, patients were tested with a neuropsychological battery of attention, executive functions, and QoL. Results: Twenty-four patients completed the study. Patients in one of the CBCR groups experienced a significant within-group increase on the primary measures of attention, executive functions, and QoL. However, this effect was not significant between groups. No significant differences were observed for the other CBCR group or the control group. Conclusions: CBCR is a feasible intervention for cognitive rehabilitation in nondemented PD patients. The effects of training were modest and should be further explored in larger clinical trials. Some CBCR programmes might be more effective than others for PD patients. The protocol for this study was published prospectively at ClinicalTrials.gov on September 18, 2017 with ID: NCT03285347.

Design, Development, and Analysis of Validity for a Computer-Based Cognitive Rehabilitation (Cbcr) Program for Children with Specific Learning Disorder (Sld) - Dyslexia: A Design-Based Approach

Design, Development, and Analysis of Validity for a Computer-Based Cognitive Rehabilitation (Cbcr) Program for Children with Specific Learning Disorder (Sld) - Dyslexia: A Design-Based Approach

Feasibility of Cognitive Training to Promote Recovery in Cancer-Related Cognitive Impairment in Adolescent and Young Adult Patients.

Background: Computer-based cognitive rehabilitation programs may help adolescent and young adult (AYA) patients with cancer-related cognitive impairment. This pilot study investigated the feasibility of cognitive rehabilitation as a preventive intervention for AYA patients receiving chemotherapy. Explorative objectives included the correlation of cognitive performance with serum brain-derived neurotrophic factor (BDNF). Methods: This pilot prospective study included English-speaking patients 12-25 years of age with a fist diagnosis of cancer requiring chemotherapy. Participants enrolled in the intervention arm participated in a computer-based neurocognitive training program for 20-30 minutes daily for 16 weeks. Outcome measures, including engagement with and completion of computerized neurocognitive testing and serum BDNF levels, were obtained within the first month following diagnosis, ∼16 and 24 weeks from enrollment. Results: Fourteen of 18 eligible patients provided consent, with 7 patients assigned to each the intervention arm and nonintervention arm. Seventy-one percent of the patients in the intervention arm completed at least 80% of the required activities. Compared to baseline, patients in the nonintervention arm demonstrated higher prevalence of impairment in four of the six cognitive domains (processing speed, visual attention, attention/working memory, and executive function) at the end of the study period. There was a nonstatistically significant reduction of serum BDNF levels over time, which was observed in both intervention and nonintervention arms. Conclusion: This pilot study provides some evidence that it is feasible for AYAs with new cancer diagnoses to receive standardized cognitive rehabilitation. Patients receiving cognitive activities experienced less impairment in numerous cognitive domains.

Effectiveness of Interpersonal and Social Rhythm Therapy with and Without Computer-based Cognitive Rehabilitation Therapy on Emotion Regulation and Response Inhibition in Methamphetamine Abusers

Background: Despite extensive evidence on cognitive deficits and difficulty in emotion regulation related to substance abuse, especially methamphetamine abuse, a few well-organized programs could have improved cognitive abilities and emotion regulation in drug users. Objectives: The present study aimed to investigate the effectiveness of Interpersonal and Social Rhythm therapy (IPSRT) alone and combined with Cognitive Rehabilitation therapy (CRT) on inhibitory response and emotion dysregulation in people with methamphetamine use disorder. Patients and Methods: The current quasi-experimental study with a pretest-posttest and follow-up design included two intervention groups. Forty methamphetamine abusers were selected based on the inclusion and exclusion criteria and assigned randomly to the IPSRT (n = 20) and IPSRT + CRT (n = 20) groups. The first group received IPSRT in 12 sessions, two 60 min sessions per week. The second group received IPSRT and 16 sessions of CRT. Subjects were assessed three times at pre-intervention, immediately after the intervention, and four weeks after the intervention. The Go/No-Go test (a neuro-cognitive task) and the Difficulties in Emotion Regulation Scale (DERS-36) was used to gather the data. Data was analyzed by descriptive statistics and mixed repeated ANOVA. Results: The results indicated that the two interventions had significant long-term effects on increasing the inhibitory response and decreasing emotion dysregulation. In addition, IPSRT with CRT was more effective than IPSRT alone in promoting executive functions and decreasing emotion dysregulation. Conclusions: The findings of this study provide evidence that adding CRT as an adjunct intervention to psychological interventions such as IPSRT can improve emotional and cognitive performance. Therefore, a combination of psychological interventions with CRT can be considered a useful intervention in addiction treatment centers.

Designing COROOR Computer-Based Cognitive Rehabilitation Program and Investigating its Effect on Spelling Efficacy and Visual-Phonological Processing in Students with Dyslexia – Dysorthographia

Designing COROOR Computer-Based Cognitive Rehabilitation Program and Investigating its Effect on Spelling Efficacy and Visual-Phonological Processing in Students with Dyslexia – Dysorthographia

Cognitive Improvement Effects of Electroacupuncture Combined with Computer-Based Cognitive Rehabilitation in Patients with Mild Cognitive Impairment: A Randomized Controlled Trial.

This outcome assessor-blinded, randomized controlled clinical trial investigated the effects of electroacupuncture combined with computer-based cognitive rehabilitation (EA-CCR) on mild cognitive impairment (MCI). A per-protocol analysis was employed to compare the efficacy of EA-CCR to that of computer-based cognitive rehabilitation (CCR). Thirty-two patients with MCI completed the trial (EA-CCR group, 16; CCR group, 16). Patients received EA-CCR or CCR treatment once daily three days per week for eight weeks. Outcome (primary, ADAS-K-cog; secondary, MoCA-K, CES-D, K-ADL, K-IADL, and EQ-5D-5L) measurements were performed at baseline (week 0), at the end of the intervention (week 8), and at 12 weeks after completion of the intervention (week 20). Both groups showed significant changes in ADAS-K-cog score (EA-CCR, p < 0.001; CCR, p < 0.001) and MoCA-K (EA-CCR, p < 0.001; CCR, p < 0.001). Only the EA-CCR group had a significant change in CES-D (p = 0.024). No significant differences in outcomes and in the results of a subanalysis based on age were noted between the groups. These results indicate that EA-CCR and CCR have beneficial effects on improving cognitive function in patients with MCI. However, electroacupuncture in EA-CCR showed no positive add-on effects on improving cognitive function, depression, activities of daily living, and quality of life in patients with MCI.

Computer-based cognitive rehabilitation program GRADIOR for mild dementia and mild cognitive impairment: new features

BackgroundThe growing number of older people and, with it, the increase of neurological impairments such as dementia has led to the implementation of the use of computer programs for cognitive rehabilitation in people with dementia. For 20 years, we have been developing the GRADIOR cognitive rehabilitation program and conducted several studies associated with its usability and effectiveness. This paper describes the development of the latest version of the GRADIOR computer-based cognitive rehabilitation program for people with different neurological etiologies, especially mild cognitive impairment and mild dementia.ResultsGRADIOR is a program that allows cognitive evaluation and rehabilitation of people affected by cognitive impairment. The new version of GRADIOR is characterized by a structure that is dynamic and flexible for both user and therapist, consisting of: Clinical Manager, Clinical History Manager, Treatment Manager and Report Manager. As a structure based on specific requirements, GRADIOR includes a series of modalities and sub-modalities, each modality comprising a series of exercises with different difficulty levels.DiscussionPrevious studies associated with earlier versions of GRADIOR have allowed the development of a new version of GRADIOR. Taking into account aspects associated with user experience, usability and effectiveness. Aspects that have made it possible to achieve a program that can meet the needs of older people with dementia.

The Effect of Computer-based Cognitive Rehabilitation Therapy on Difficulties in Emotion-regulation among Students With Attention Deficit Hyperactivity Disorder

Objective: The aim of the present study is to investigate the effect of computer-based cognitive rehabilitation therapy on difficulties in emotional regulation among students with Attention Deficit Hyperactivity Disorder (ADHD). Methods: Participants were 24 students with ADHD (12 boys and 12 girls) studying in 6-9th grades during 2018-19 at schools located in District 7 of Tehran, Iran. They were selected using a purposive sampling method and based on inclusion/exclusion criteria and then randomly assigned into experimental and control groups. Data collection tool was the Difficulties in Emotion Regulation Scale (DERS) completed at pre-test, post-test, and follow-up phases. Experimental group received computer-based cognitive rehabilitation therapy for 10 weeks (20 sessions, two sessions per week, each for 30 minutes). Data were analyzed using repeated measure ANOVA in SPSS V. 26 software. Results: All subscales of DERS were significantly improved after intervention which had a medium-to-large effect size. Conclusion: Computer-based cognitive rehabilitation therapy can help treat difficulties in emotional regulation and improve performance of students with ADHD.

The Effects of Computer Based Cognitive Rehabilitation in Stroke Patients with Working Memory Impairment: A Systematic Review

ObjectivesTo evaluate benefits and harms for computer based cognitive rehabilitation (CBCR) on working memory impairment after stroke. MethodsPRISMA guidelines were followed. Four electronic databases were systematically searched: Embase, Pubmed/Medline, PsycInfo and Cochrane Library. Authors of relevant studies were contacted to detect unpublished data or articles not found by searching databases. Selection criteriaStudies were eligible for inclusion in the systematic review if they 1) investigated the effects of CBCR on working memory after acquired brain injury in a patient sample which consisted of at least 50% stroke-patients, 2) it was possible to isolate the effects of CBCR-training by comparison to passive or active control groups, and 3) if the outcome assessment included a quantitative working memory outcome measure either isolated or as part of a general outcome measure. Included studies were further eligible for the meta-analysis if 1) they were conducted as a randomized controlled trial, 2) they included only stroke patients, and 3) the effects of CBCR on working memory could be isolated. ResultsLiterature is limited and reported effects of CBCR on working memory after stroke are very heterogeneous. A meta-analysis was not performed as all studies used different measures of working memory. An additional analysis was performed in order to cautiously estimate the difference between the control interventions (whether passive or active) and CBCR interventions. The analysis revealed no meaningful differences in increase of working memory measures between control conditions and intervention conditions. However, this additional analysis should be interpreted with caution as it does not take the heterogeneity of outcome measures or the differences in sample sizes between studies into account. No harms were observed. ConclusionThere is insufficient evidence to conclude if CBCR is beneficial for patients with working memory deficits after stroke. Systematic review numberThis systematic review is registered in Prospero with registration ID: CRD42018087437.

The Effects of Computer-Based Cognitive Rehabilitation on Working Memory in Patients with Parkinson's Disease: A Systematic Review.

Deterioration of working memory(WM) is a common cognitive deficit in Parkinson's disease (PD), and severely influences the ability to lead an independent life. Interventions which can delay the impact of WM deficits could positively impact the independence and quality of life of patients. To evaluate effects of computer-based cognitive rehabilitation (CBCR) on WM in patients with PD. Pubmed, Embase, Psycinfo and Cochrane Library were systematically searched. Authors of included studies were contacted to detect unpublished data or articles not found by database-search. Broad selection criteria were applied because literature was expected to be limited. Studies were eligible for inclusion if they investigated the effects of CBCR on WM in a sample consisting of at least 50% PD patients, or in which the results of PD patients could be isolated. Studies were further eligible for inclusion in a planned meta-analysis if the effects of the CBCR intervention could be isolated, the CBCR intervention was compared to active or passive control groups consisting solely of PD patients, and the WM outcome measure could be isolated. Only six studies were included despite broad inclusion criteria. Study results were heterogeneous, and the risk of bias in study methodology was either unclear or high. Two studies were eligible for meta-analysis. A meta-analysis was not performed, because these studies used different measures of WM which were not rated as equally valid and reliable. Existing literature is sparse and provides insufficient evidence to conclude if CBCR benefits WM in PD patients.