Neurocognitive Training Research Articles

P: 29 Contributors to Balance Impairment in Adults With Cirrhosis and Hepatic Encephalopathy

BACKGROUND: Falls are common and associated with significant morbidity for persons with cirrhosis and hepatic encephalopathy. In order to intervene with targeted rehabilitation efforts to reduce and prevent falls, a better understanding of mechanisms underlying balance deficits is needed. To this end, unipedal stance time (UST) is a useful measure of balance as it requires the integration of sensory, neurocognitive, and muscular factors. METHODS: We prospectively enrolled 119 outpatients with cirrhosis and history of hepatic encephalopathy from the hepatology clinic at Michigan Medicine. The primary outcome was UST. Each patient was evaluated for demographic and clinical factors [Child Turcotte Pugh (CTP) class, MELD score], physical function (grip-strength and hip-strength using lateral plank time), neurocognitive factors [Numbers Connection Test (NCT) A and B, recognition reaction time accuracy - ability to catch or inhibit catching an instrumented stick under 'lights on' and 'lights off' conditions within 400 ms], and sensory factors (lower limb vibratory sensation and visual contrast). Falls self-efficacy, perceived ability to perform different tasks without falling, was also assessed. We evaluated bivariate Pearson correlations and developed a linear regression model to identify significant contributors to balance impairment. RESULTS: Participants were 50% female, aged 62.9 + 7.3 years, 80% CTP A, 18% CTP B, 2% CTP C, with MELD 11 + 5. The mean UST was 12.7 + 9.9 seconds (median = 9.42 seconds, IQR = 19.26). In bivariate analyses, UST was most highly correlated with lateral plank time (r = 0.61), followed by recognition reaction time accuracy [total, percent correct in lights on, and in lights off conditions (r = 0.47, r = .36, r = .33)] and NCT A and B tests (each r = 0.27). In multivariable regression, 54% of variance in UST was explained by significant factors of plank time, recognition reaction time accuracy, falls self-efficacy, age, and CTP. Based on standardized beta coefficients, plank time, CTP of B or C, and recognition reaction time accuracy were the strongest predictors. For every second increase of plank time, UST increases by 0.26 seconds on average. If classified by CTP of B or C, UST decreases by 5.8 seconds. For each additional percent correct on recognition reaction time accuracy, UST increases by 0.12 seconds. CONCLUSIONS: The strongest factors associated with diminished balance, as indicated by UST, in this high fall-risk cirrhosis population are hip strength, clinical disease severity, and neurocognitive capacity. These findings support a rehabilitation approach that targets strengthening as well as neurocognitive training to address balance impairment.

Impact of a Neuro-Cognitive Intervention on Students’ Cognitive Functions: Assessments in a Government School Setting in South India

Evidence indicates that cognitive deficits can affect students’ performance in schools. An effort to enhance cognitive skills through integration of a neuro-cognitive training called ‘Brighter Minds’, was made in the government schools of South India during 2017-18. 110 students went through a pre and post training evaluation, using a mixed methods study design to assess changes in attention, observation and memory. Tools such as Make a Trail and Stroop test to assess attention, Word Recall and Visual stimulus tests for memory and acustomized tool to assess changes in observation were used. Focus group discussions were conducted to understand teachers’ experience and acceptance of the training. Paired t-tests demonstrated statistically significant gains in all the three cognitive traits. The average time taken to complete the trail tests significantly reduced after the training (Trail A: 59.3 s to 47.5 s; Trail B: 156 s to 120 s. p < 0.001). The average number of correct items read out in the Stroop test improved significantly. More students were able to observe deeper aspects of the test object (23 Vs 40, p < 0.001). On intuition tests, average score of correct observations went up significantly from 6.7 to 9.6 objects. Memory assessments revealed significant improvements in verbal recall (both immediate and delayed) and visual recognition, but marginal improvements in visual retention. The teachers reported changes in student’s motivation, discipline and participation. The training was seamlessly rolled out by the teachers during regular hours and led to improvements in students' cognitive abilities. The cognitive trainings offer promise to complement current efforts in enhance learning outcomes among students.

An Investigation of Computer-based Brain Training on the Cognitive and EEG Performance of Employees.

Neurocognitive skills (e.g., processing speed, attention and memory) were hypothesized to be critical for workplace performance and by extension for the work-life balance of employees. Twenty-one employee volunteers underwent a neurocognitive training program - which consisted of an initial pre-test assessment, a six week "boost" or intervention period, and then a re-assessment to track the progress of each participant. A median split of the group created two training groups: a long-training group that averaged 30 hours of total training during the boost period; and a short-training group that averaged 7 hours of training. On pre-training measures of neurocognitive performance, group differences in performance did not reach statistical significance. Following training participants experienced a positive impact from the program as measured in three ways: standardized higher behavioral metrics, improved cognitive state metrics using EEG and positive self-reported data. From a quantitative perspective, participants' cognitive efficiency increased by 12% for the high-training group and 5% for the low-training group (cognitive efficiency refers to a behavioral measure which combines accuracy and speed). Qualitatively, study participants reported improvements in their productivity and mental performance post-study.

Computerized neurocognitive training for improving dietary health and facilitating weight loss.

Nearly 70% of Americans are overweight, in large part because of overconsumption of high-calorie foods such as sweets. Reducing sweets is difficult because powerful drives toward reward overwhelm inhibitory control (i.e., the ability to withhold a prepotent response) capacities. Computerized inhibitory control trainings (ICTs) have shown positive outcomes, but impact on real-world health behavior has been variable, potentially because of limitations inherent in existing paradigms, e.g., low in frequency, intrinsic enjoyment, personalization, and ability to adapt to increasing ability. The present study aimed to assess the feasibility, acceptability, and efficacy of a gamified and non-gamified, daily, personalized, and adaptive ICT designed to facilitate weight loss by targeting consumption of sweets. Participants (N = 106) were randomized to one of four conditions in a 2 (gamified vs. non-gamified) by 2 (ICT vs. sham) factorial design. Participants were prescribed a no-added-sugar diet and completed 42 daily, at-home trainings, followed by two weekly booster trainings. Results indicated that the ICTs were feasible and acceptable. Surprisingly, compliance to the 44 trainings was excellent (88.8%) and equivalent across both gamified and non-gamified conditions. As hypothesized, the impact of ICT on weight loss was moderated by implicit preference for sweet foods [F(1,95) = 6.17, p = .02] such that only those with higher-than-average implicit preference benefited (8-week weight losses for ICT were 3.1% vs. 2.2% for sham). A marginally significant effect was observed for gamification to reduce the impact of ICT. Implications of findings for continued development of ICTs to impact health behavior are discussed.

Prevention of Early Postoperative Decline (PEaPoD): protocol for a randomized, controlled feasibility trial

BackgroundDelirium is associated with a significantly increased risk of postoperative morbidity and mortality. Furthermore, delirium has been associated with an increased risk of prolonged cognitive deficits and accelerated long-term cognitive decline. To date, experimental interventions for delirium have mainly focused on alternative pharmacologic and behavioral strategies in the postoperative period. Few studies have examined whether proactive strategies started before surgery can prevent delirium or reduce its sequelae. Neurocognitive training programs such as Lumosity have been shown to be effective in increasing cognitive performance in both elderly healthy volunteers and patients suffering from a myriad of acute and chronic medical conditions. When initiated in the preoperative period, such training programs may serve as interesting and novel patient-led interventions for the prevention of delirium and postoperative cognitive decline (POCD). We hypothesize that perioperative neurocognitive training is feasible in the older cardiac surgical population and are testing this hypothesis using a randomized controlled design.MethodsThe Prevention of Early Postoperative Decline (PEaPoD) study is a randomized, controlled trial with a target enrollment of 45 elderly cardiac surgical patients. Subjects will be randomized in a 1:1 ratio to undergo either at least 10 days of preoperative neurocognitive training, continued for 4 weeks postoperatively, or usual care control. The primary outcome, feasibility, will be assessed by study recruitment and adherence to protocol. Secondary outcomes will include potential differences in the incidence of postoperative in-hospital delirium and POCD up to 6 months, as determined by the Confusion Assessment Method and the Montreal Cognitive Assessment.DiscussionPEaPoD will be the first trial investigating the use of perioperative cognitive training to potentially reduce delirium and POCD in the cardiac surgical population. Information gleaned from this feasibility study will prove valuable in designing future efficacy studies aimed at determining whether this low-risk, patient-led intervention can reduce serious postoperative morbidity.Trial registrationClinicalTrials.gov, NCT02908464. Registered on 21 September 2016.

Towards personalized, brain-based behavioral intervention for transdiagnostic anxiety: Transient neural responses to negative images predict outcomes following a targeted computer-based intervention.

Clinical anxiety is prevalent, highly comorbid with other conditions, and associated with significant medical morbidity, disability, and public health burden. Excessive attentional deployment toward threat is a transdiagnostic dimension of anxiety seen at both initial and sustained stages of threat processing. However, group-level observations of these phenomena mask considerable within-group heterogeneity that has been linked to treatment outcomes, suggesting that a transdiagnostic, individual differences approach may capture critical, clinically relevant information. Seventy clinically anxious individuals were randomized to receive 8 sessions of attention bias modification (ABM; n = 41 included in analysis), a computer-based mechanistic intervention that specifically targets initial stages of threat processing, or a sham control (n = 21). Participants completed a mixed block/event-related functional MRI task optimized to discriminate transient from sustained neural responses to threat. Larger transient responses across a wide range of cognitive-affective regions (e.g., ventrolateral prefrontal cortex, anterior cingulate cortex, amygdala) predicted better clinical outcomes following ABM, in both a priori anatomical regions and whole-brain analyses; sustained responses did not. A spatial pattern recognition algorithm using transient threat responses successfully discriminated the top quartile of ABM responders with 68% accuracy. Neural alterations occurring on the relatively transient timescale that is specifically targeted by ABM predict favorable clinical outcomes. Results inform how to expand on the initial promise of neurocognitive treatments like ABM by fine-tuning their clinical indications (e.g., through personalized mechanistic intervention relevant across diagnoses) and by increasing the range of mechanisms that can be targeted (e.g., through synergistic treatment combinations and/or novel neurocognitive training protocols designed to tackle identified predictors of nonresponse). (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Cognitive Flexibility Predicts PTSD Symptoms: Observational and Interventional Studies.

Introduction: Post-Traumatic Stress Disorder (PTSD) is a prevalent, severe and tenacious psychopathological consequence of traumatic events. Neurobehavioral mechanisms underlying PTSD pathogenesis have been identified, and may serve as risk-resilience factors during the early aftermath of trauma exposure. Longitudinally documenting the neurobehavioral dimensions of early responses to trauma may help characterize survivors at risk and inform mechanism-based interventions. We present two independent longitudinal studies that repeatedly probed clinical symptoms and neurocognitive domains in recent trauma survivors. We hypothesized that better neurocognitive functioning shortly after trauma will be associated with less severe PTSD symptoms a year later, and that an early neurocognitive intervention will improve cognitive functioning and reduce PTSD symptoms.Methods: Participants in both studies were adult survivors of traumatic events admitted to two general hospitals’ emergency departments (EDs) in Israel. The studies used identical clinical and neurocognitive tools, which included assessment of PTSD symptoms and diagnosis, and a battery of neurocognitive tests. The first study evaluated 181 trauma-exposed individuals one-, six-, and 14 months following trauma exposure. The second study evaluated 97 trauma survivors 1 month after trauma exposure, randomly allocated to 30 days of web-based neurocognitive intervention (n = 50) or control tasks (n = 47), and re-evaluated all subjects three- and 6 months after trauma exposure.Results: In the first study, individuals with better cognitive flexibility at 1 month post-trauma showed significantly less severe PTSD symptoms after 13 months (p = 0.002). In the second study, the neurocognitive training group showed more improvement in cognitive flexibility post-intervention (p = 0.019), and lower PTSD symptoms 6 months post-trauma (p = 0.017), compared with controls. Intervention- induced improvement in cognitive flexibility positively correlated with clinical improvement (p = 0.002).Discussion: Cognitive flexibility, shortly after trauma exposure, emerged as a significant predictor of PTSD symptom severity. It was also ameliorated by a neurocognitive intervention and associated with a better treatment outcome. These findings support further research into the implementation of mechanism-driven neurocognitive preventive interventions for PTSD.

Effect of Neurocognitive Training for Children With ADHD at Improving Academic Engagement in Two Learning Settings

Objective: This preliminary study investigated effectiveness of neurocognitive training on academic engagement (AET) for children with ADHD. The training approach targeted working memory, inhibitory control, and attention/relaxation (via brain electrical activity). Method: A reversal design with a 2-week follow-up was used to assess the effectiveness of the treatment on two children with diagnosed ADHD in two learning settings. Direct observation was used to collect academic-related behavior. Results: Improvements in on-task expected behavior (ONT-EX) and general AET, as well as reductions in off-task motor activity (OFF-MA) and off-task passive behavior (OFF-PB) were observed for both students over baselines and across the settings. Moreover, differences in behavioral change were found between participants and settings. Conclusion: These findings support using the treatment for improving academic performance of children with ADHD. Future studies may investigate influences of contextual differences, nontreatment variables, or adult’s feedback during the training session on treatment effectiveness.

Current management tactics for patients with dementia

Dementia develops as a result of continuous long-term progression of less severe cognitive impairment (CI). Social and psychological methods (neurocognitive stimulation and neurocognitive training) are the mainstay of treatment for dementia. At the moment, there are no drugs both to cure dementia and to stop the degeneration of nerve tissue. Modern pharmacotherapy for dementia aims to maintain cognitive functions in the patient for as long as possible and to slow down disability, thus ensuring higher living standards. CI therapy most often consists of compensation for cognitive defect. Among the whole variety of pharmacological agents, the effective drugs to treat dementia are only two groups, such as acetylcholinesterase inhibitors and N-methyl-D-aspartate (NMDA) glutamate receptor antagonists. Atypical neuroleptics are employed for the treatment of psychotic disorders; antidepressants from a group of selective serotonin reuptake inhibitors are for depression. Cognitive behavioral therapy and cognitive stimulation deserve special attention. A high educational level and physical, social, and intellectual and activities can prevent dementia.

Evidence-based psychotherapy of addictive disorders

Addictive disorders form the group of the most common mental disorders. Awide range of psychotherapeutic treatment interventions exists; however, the proportion of patients receiving evidence-based interventions or psychotherapeutic treatment in outpatient care is very low. The aim of the present review was asystematic reassessment of the empirical evidence for the efficacy of the different forms of psychotherapeutic treatment, identification of new effective interventions and derivation of recommendations for treatment practitioners. Acomprehensive literature search in amultistage method in the relevant national and international data banks was conducted. Subsequent analysis of topical guidelines, systematic reviews and original studies about addictions and therapy was performed. Atotal of 3topical national guidelines, 2reviews and 16original studies could be identified. In particular, cognitive behavioral therapy, behavioral interventions and motivational interventions could be identified as evidence-based interventions for the treatment of addictive disorders. Hypnotherapy can be recommended alternatively for patients dependent on tobacco. Also interesting for practitioners could be new treatment methods, such as neurocognitive training and mindfulness-based interventions. At present, although of high quality, results from existing studies are sometimes inconsistent or are numerically insufficient with respect to special treatment options. Future studies are warranted with respect to different substance use disorders and further patient groups.

Neurocognitive recovery of patients with paranoid schizophrenia

Background At present neurocognitive impairment is considered a core feature of schizophrenia. This statement is grounded on cognitive impairment stability, the persistence of cognitive impairment independently of the disease stage and other symptoms of schizophrenia. The relevance of the search for cognitive remediation methods is determined by the influence of cognitive functioning on the functional outcome in patients with schizophrenia. In order to solve this problem, scientists are actively investigating such direction in the treatment of patients with this psychopathology as «neurocognitive therapy» or neurocognitive training. Objective To evaluate the effectiveness of neurocognitive training in patients with paranoid schizophrenia Methods and materials The patients who matched inclusion criteria were assessed on Positive and Negative Syndrome Scale (PANSS), Personal and Social Performance scale (PSP), neuropsychological tests (Trail Making Test part A and B, Wisconsin Card Sorting Test, Luria test) at the baseline, 1st and 6th month. All patients who were included in the study were randomly assigned into two groups. The intervention group (n=40) underwent a standard supportive treatment and neurocognitive training. The control group (n=31) received supportive medication treatment alone. Results After 1st month, a statistically significant difference between the intervention and control groups was found both for the overall PANSS score improvement and improvement in several items, which represented the cognitive decline. Total PSP score increased significantly in the intervention group from 41-50 to 51-60 (р=0.0001). In Wisconsin Card Sorting Test the proportion of incorrect answers decreased by 31.4% (р=0.0001), perseverative errors by 20.1% (р=0.042), the number of completed categories increased by 33.5% (р=0.002). Conclusion The proposed neurocognitive training program showed positive results, which was reflected in a statistically significant improvement in PANSS score and cognitive tests performance in the intervention group compared to control group after treatment course and additional 5 months of the observation.

Training systems for correction of cognitive impairments in children and adolescents after antineoplastic therapy for malignant neoplasms of the central nervous system

Introduction. Previous research has documented the development of patients treated for malignant neoplasms (MN). Neurotoxicity of antineoplastic therapy leads to motor and cognitive impairments which affect memory and concentration. The present study attempts to test and evaluate the effectiveness of innovative methods of the correction of cognitive impairments using the Cognisens NeuroTracker training system.
 Materials and Methods. The study reviews (a) the methods of psychological testing of impairments, (b) the operating principle of training systems, (c) the options of training modes, and (d) clinical characteristics of the examined groups of patients. The pilot study involved 40 patients with the central nervous system (CNS) tumors at the age of 6–18 years. All the patients were treated in the Russkoe Pole (Russian Field) Rehabilitation Research Center of Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology, and Immunology of the Ministry of Health of the Russian Federation in 2016.
 Results. The study summarized the data obtained in psychological testing, the specificity of cognitive impairments, and the test of cognitive training systems in neurorehabilitation. The results of the complex clinical psychological diagnostics assessing cognitive and motor spheres determined the original status of patients. The present study assessed the validity and effectiveness of Cognisens NeuroTracker neurocognitive training system among patients with MN. The parameters of mental manipulation of visual and spatial images, solving problems of spatial orientation of moving objects, prediction and extrapolation have improved by the end of the training period consisted of 6 sessions. The results of memory and concentration training by the Cognisens NeuroTracker confirmed their effectiveness. These trainings improved the respondents’ effectiveness and success in these types of activity.
 Conclusion. The Cognisens NeuroTracker new cognitive training system was successfully approved. This new direction is perspective in the rehabilitation of patients treated for MN.
 Keywords: malignant neoplasms, neurotoxicity, children, cognitive disorders, psychological status, psychological testing, cognitive training systems, Cognisens NeuroTracker, rehabilitation

Moderators of Symptomatic Outcome in Metacognitive Training for Psychosis (MCT). Who Benefits and Who Does Not?

Metacognitive training (MCT) for psychosis is a group intervention targeted at reducing positive symptoms in schizophrenia through an improvement of cognitive biases in these patients. Despite evidence for its feasibility and efficacy, the recommendations for including or excluding patients from MCT have so far been largely based on anecdotal clinical wisdom rather than empirical evidence. Predictors and moderators of outcome are presently unknown. We reanalyzed data from a large randomized controlled trial, for which 150 patients were randomly assigned to either MCT or CogPack® (neurocognitive training) and followed up for up to 3 years. We explored which demographic variables, baseline symptoms, and cognitive biases would predict overall outcome and specific treatment benefits in MCT. Low self-esteem and social anxiety at baseline as well as positive appraisal of the intervention were consistently associated with improved outcome in MCT relative to CogPack®. Among other variables, improvement of cognitive biases and selective attention during the intervention period as well as number of sessions attended were general predictors of positive outcome, irrespective of the type of intervention. Patients with cognitive biases and psychological strain (e.g., low self-esteem and quality of life) paired with social problems may represent an ideal target group for MCT. The present findings await replication in independent samples and may not generalise to other forms of metacognitive training (e.g., MCT for depression) or individualized metacognitive intervention for psychosis (MCT+).

Effects of peer social interaction on performance during computerized cognitive remediation therapy in patients with early course schizophrenia: A pilot study

BackgroundRecent studies show that computer-based training enhances cognition in schizophrenia; furthermore, socialization has also been found to improve cognitive functions. It is generally believed that non-social cognitive remediation using computer exercises would be a pre-requisite for therapeutic benefits from social cognitive training. However, it is also possible that social interaction by itself enhances non-social cognitive functions; this possibility has scarcely been explored in schizophrenia patients. This pilot study examined the effects of computer-based neurocognitive training, along with social interaction either with a peer (PSI) or without one (N-PSI). We hypothesized that PSI will enhance cognitive performance during computerized exercises in schizophrenia, as compared with N-PSI. MethodsSixteen adult participants diagnosed with schizophrenia or schizoaffective disorder participating in an ongoing trial of Cognitive Enhancement Therapy completed several computerized neurocognitive remediation training sessions (the Orientation Remedial Module©, or ORM), either with a peer or without a peer. ResultsWe observed a significant interaction between the effect of PSI and performance on the different cognitive exercises (p<0.05). More precisely, when patients performed the session with PSI, they demonstrated better cognitive performances than with N-PSI in the ORM exercise that provides training in processing speed, alertness, and reaction time (the standard Attention Reaction Conditioner, or ARC) (p<0.01, corrected). PSI did not significantly affect other cognitive domains such as target detection and spatial attention. ConclusionOur findings suggest that PSI could improve cognitive performance, such as processing speed, during computerized cognitive training in schizophrenia. Additional studies investigating the effect of PSI during cognitive remediation are needed to further evaluate this hypothesis.

Supplementing intensive targeted computerized cognitive training with social cognitive exercises for people with schizophrenia: An interim report.

Individuals with schizophrenia demonstrate cognitive, social cognitive, and motivational deficits that contribute to impairment in real-world functioning. In the current study, we investigated the effects of supplementing computerized neurocognitive training with social cognitive exercises, as compared with neurocognitive training alone. In this ongoing, double-blind, randomized controlled trial of 111 participants with psychosis, we compare the effects of supplementing intensive targeted cognitive training with social cognitive training exercises (TCT + SCT) with the effects of targeted cognitive training alone (TCT-only). Participants were assessed on cognition, symptoms, functional capacity, and functional outcomes, as well as social cognition and measures related to reward processing. Both treatment groups showed significant improvement in multiple cognitive domains and improvement in functional capacity. However, as predicted, TCT + SCT group participants showed significant improvement in prosody identification and reward processing relative to TCT-only participants. Our findings indicate that supplementing intensive computerized cognitive training with social cognitive exercises in people with psychosis confers greater benefits in prosody identification and reward processing relative to cognitive training alone, even though both approaches drive significant improvements in cognition and functional capacity. Impairments in both prosody identification and reward processing have been associated with greater negative symptoms and poorer functional outcomes in schizophrenia, raising the possibility that this form of treatment may lead to better long-term outcomes than traditional cognitive training approaches. Follow-up assessments will determine whether results are durable and generalize over time to improvements in symptoms and functioning. (PsycINFO Database Record

215. Action-Based Cognitive Remediation: Pairing Cognitive Training With Skill Development and CBT Principles

Background: Most people with mental disorders experience a reduction of symptoms with treatment, but recovery of everyday functions is often delayed and incomplete. Cognitive Remediation is widely recognized as an efficacious treatment that improves attention, memory, and executive functions, but its ability to effectively promote behavior change is more limited and retention in treatment is often low. In response, we developed Action-Based Cognitive Remediation (ABCR) to build on intact procedural learning skills, pair neurocognitive training with skill-based training, and promote engagement in everyday behaviors considered cognitively challenging. We sought to determine if ABCR was more efficacious (improved neurocognition) and more effective (improved functional skills and vocational outcomes) than traditional cognitive remediation. Methods: In this study, we compared ABCR to a traditional form of cognitive remediation in 50 participants with severe mental disorders. Treatment was 10 weeks, twice per week, in a group format. Both treatments provided computerized cognitive training, discussions of how to monitor and flexibly adapt strategies when solving problems, and discussions of how cognitive skills and strategies can be used in everyday life. Compared to traditional cognitive remediation, ABCR also included role-plays in simulated work tasks and goal setting with an emphasis on seeking cognitive challenge in everyday life. Results: Cognitive response was moderate to large and statistically significant for both groups. and the ABCR group demonstrated larger improvements in a role-play measure of functional skills (P < .001). A statistical trend was observed for more participants in the ABCR group working at 6 months postintervention (P = .09) and, among those working, ABCR participants reported less job stress (P = .03). ABCR was more tolerable, with 83% retention rates compared to 57% for traditional cognitive remediation (P = .03). Conclusion: These results support the placing of cognitive training within a broader skill training and psychotherapeutic milieu that encourages approaching cognitively challenging activities and reducing withdrawal from social and instrumental tasks. Compared to the more passive experience of traditional cognitive remediation, ABCR challenges participants to engage with their environment and produces larger and more lasting changes in behavior.

Attention is associated with postural control in those with chronic ankle instability

Chronic ankle instability (CAI) is often debilitating and may be affected by a number of intrinsic and environmental factors. Alterations in neurocognitive function and attention may contribute to repetitive injury in those with CAI and influence postural control strategies. Thus, the purpose of this study was to determine if there was a difference in attentional functioning and static postural control among groups of Comparison, Coper and CAI participants and assess the relationship between them within each of the groups. Recruited participants performed single-limb balance trials and completed the CNS Vital Signs (CNSVS) computer-based assessment to assess their attentional function. Center of pressure (COP) velocity (COPv) and maximum range (COPr), in both the anteroposterior (AP) and mediolateral (ML) directions were calculated from force plate data. Simple attention (SA), which measures self-regulation and attention control was extracted from the CNSVS. Data from 45 participants (15 in each group, 27=female, 18=male) was analyzed for this study. No significant differences were observed between attention or COP variables among each of the groups. However, significant relationships were present between attention and COP variables within the CAI group. CAI participants displayed significant moderate to large correlations between SA and AP COPr (r=−0.59, p=0.010), AP COPv (r=−0.48, p=0.038) and ML COPr (r=−0.47, p=0.034). The results suggest a linear relationship of stability and attention in the CAI group. Attentional self-regulation may moderate how those with CAI control postural stability. Incorporating neurocognitive training focused on attentional control may improve outcomes in those with CAI.

Individual Case Study: Improved Memory Functioning following Neurocognitive Training in a Diagnosed TBI patient

Individual Case Study: Improved Memory Functioning following Neurocognitive Training in a Diagnosed TBI patient

The Benefits of Neurocognitive Training in a Diagnosed Dementia Population, an Ongoing Study since 2011

The Benefits of Neurocognitive Training in a Diagnosed Dementia Population, an Ongoing Study since 2011

Social cognitive interventions for people with schizophrenia: A systematic review.

Social cognition is the mental process which underpins social interactions. Increasingly, it has been recognized to be impaired in people with schizophrenia, resulting in functional problems. Correspondingly, the past ten years have seen huge developments in the study of interventions to ameliorate social cognitive deficits among people with schizophrenia. In the present review, we systematically reviewed published studies on social cognitive interventions from 2005 to 2015. Of the 61 studies included in this review, 20 were on broad-based social cognitive interventions, which incorporated neurocognitive training, specialized learning technique or virtual reality social skills training. On the other hand, 31 studies on targeted interventions either focused on specific social cognitive domains, or a range of domains. Improvements in emotion processing and theory of mind were often reported, while social perception and attributional style were less frequently measured. Both broad-based and targeted interventions achieved gains in social functioning, albeit inconsistently. Lastly, nine studies on the use of oxytocin and one study on transcranial direct current stimulation reported positive preliminary results in higher-order cognition and facial affect recognition respectively. This review revealed that a wide range of social cognitive interventions is currently available and most have shown some promise in improving social cognition outcomes. However, there is a need to use a common battery of measurements for better comparisons across interventions. Future research should examine combination therapies and the sustainability of gains beyond the intervention period.