Online Cognitive Training Research Articles

Optimizing memory function in temporal lobe epilepsy

PurposeThe study aimed to assess whether engagement in a memory training programme and performing internet brain training exercises improve memory function in people with temporal lobe epilepsy (TLE). MethodsSeventy-seven people with TLE, complaining of memory difficulties, completed the study. Participants ranged in age from 19 to 67 years and 40 had left TLE. Participants were randomised to one of four conditions; Group 1: traditional memory training, Group 2: Lumosity, an on-line cognitive training programme, Group 3: traditional memory training and Lumosity, and Group 4: no training. Memory efficiency and mood were assessed at baseline and three months later. ResultsGroup analyses indicated improved verbal recall after training (p<0.001) and improved subjective ratings (p<0.007). More participants reported a lessening of the memory burden (p<0.007) after training; differences were significant between Groups 1 and 3 compared to Group 4. Lumosity use was not associated with changes in the memory outcome measures but there was a relationship with depression ratings and the number of memory games played (p<0.01). Conventional memory training, IQ, and post-surgical status were associated with positive memory outcomes. ConclusionsThe study indicates traditional memory rehabilitation techniques can help reduce the burden of memory impairment in TLE. There was no evidence that Lumosity the on-line cognitive training programme had specific advantages. Positive change was not universal and larger studies will be required to explore factors associated with successful outcomes.

Acceptance and Usage of an Online-based Cognitive Group Training for Older Adults

Abstract Age-related decline in cognitive capacity can lead to functional restriction in everyday life. Therefore, interventions that aim to maintain and facilitate the individual cognitive capacity are becoming increasingly important. Computer-based cognitive learning is a promising approach to combat age-related loss of functional capabilities. The publicly funded project LeVer was developed especially for older adults and consisted of an online virtual cognitive training platform that enabled older adults to train on their own and in groups. Apart from investigating how older adults interacted with the platform, acceptance towards computer-based group training and audio-video communication was also analyzed. During the 20 to 30 minutes long sessions of the group training, learning units that included memory strategies as well as everyday exercises to intensify those strategies were taught. The group training was divided into four modules. The content of each session was structured using evidence-based cognitive training methods and manuals. Of the 40 older adults who used the individual online cognitive training (IOCT), half of the participants (11♀, 9♂) took part in all of the four sessions of group training. 14 participants (9♀, 5♂) aged 62–77 years (M = 69.56; SD = 3.99) answered a proprietary evaluation questionnaire after all of the group sessions. The opinion of the participants about the content and design of the group training was rated on a 4 point Likert-scale with 43 items. Group training was generally rated as a positive experience. The online video communication was new for the majority of participants and was rated as enjoyable. The answers to the open questions in the evaluation questionnaire revealed that group size, topics covered during training and the exercises were seen mostly positive. Criticism was focused almost solely on technical problems, which occurred before or during the training sessions, such as loosing audio or video or an intermittent Internet connection. In this study online-based cognitive group training (OCGT) for older adults via video communication was confirmed by the participants to be a useful and positively received method to facilitate cognitive function. Participants that did not complete the training to the end did so due to time or technical problems. Since this type of training is rather cost effective and easily accessible and can be used at home, it is a favorable alternative to conventional face-to-face training. Training to better use these devices and technical support on hand is necessary to take care of participants during the group training.

The Effect of an Online Cognitive Training Package in Healthy Older Adults: An Online Randomized Controlled Trial

IntroductionCognitive training (CT) offers a potential approach for dementia prevention and maintenance of cognitive function in older adults. Online delivery provides a cost-effective means of implementing CT compared with in-person interventions, with the potential of providing an effective public health intervention for risk reduction. MethodsA double-blind 6-month online randomized controlled trial in adults older than 50 randomized to General CT, Reasoning CT, or control. The primary outcome was instrumental activities of daily living (IADL) in adults older than 60. Secondary outcomes were reasoning, verbal short-term memory, spatial working memory, verbal learning (VL), and digit vigilance in adults older than 50. Secondary analyses were performed with a group defined as showing age-associated impairment in reasoning according to baseline scores in this domain. ResultsA total of 2912 adults older than 60 (6742 > 50) participated. General and reasoning packages conferred benefit to IADL (P = .008, P = .011), reasoning (P < 0.0001, P < .0001), and VL (P = .007, P = .008) at 6 months. Benefit in reasoning was evident from 6 weeks. Other benefits developed over 6 months. Analysis of participants with age-associated impairment also showed the same pattern of benefit. A clear dose-response effect was seen. ConclusionsOnline CT confers significant benefit to cognition and function in older adults, with benefit favoring the Reasoning package. Scale of benefit is comparable with in-person training, indicating its potential as a public health intervention. Impact on the group with age-associated impairment indicates a particular sensitivity to this at-risk group, which merits further investigation.

Enhancing Cognitive Abilities with Comprehensive Training: A Large, Online, Randomized, Active-Controlled Trial.

BackgroundA variety of studies have demonstrated gains in cognitive ability following cognitive training interventions. However, other studies have not shown such gains, and questions remain regarding the efficacy of specific cognitive training interventions. Cognitive training research often involves programs made up of just one or a few exercises, targeting limited and specific cognitive endpoints. In addition, cognitive training studies typically involve small samples that may be insufficient for reliable measurement of change. Other studies have utilized training periods that were too short to generate reliable gains in cognitive performance.MethodsThe present study evaluated an online cognitive training program comprised of 49 exercises targeting a variety of cognitive capacities. The cognitive training program was compared to an active control condition in which participants completed crossword puzzles. All participants were recruited, trained, and tested online (N = 4,715 fully evaluable participants). Participants in both groups were instructed to complete one approximately 15-minute session at least 5 days per week for 10 weeks.ResultsParticipants randomly assigned to the treatment group improved significantly more on the primary outcome measure, an aggregate measure of neuropsychological performance, than did the active control group (Cohen’s d effect size = 0.255; 95% confidence interval = [0.198, 0.312]). Treatment participants showed greater improvements than controls on speed of processing, short-term memory, working memory, problem solving, and fluid reasoning assessments. Participants in the treatment group also showed greater improvements on self-reported measures of cognitive functioning, particularly on those items related to concentration compared to the control group (Cohen’s d = 0.249; 95% confidence interval = [0.191, 0.306]).ConclusionTaken together, these results indicate that a varied training program composed of a number of tasks targeted to different cognitive functions can show transfer to a wide range of untrained measures of cognitive performance.Trial RegistrationClinicalTrials.gov NCT-02367898

The effect of computer-based cognitive flexibility training on recovery of executive function after stroke: rationale, design and methods of the TAPASS study.

BackgroundStroke survivors frequently suffer from executive impairments even in the chronic phase after stroke, and there is a need for improved rehabilitation of these functions. One way of improving current rehabilitation treatment may be by online cognitive training. Based on a review of the effectiveness of computer-based cognitive training in healthy elderly, we concluded that cognitive flexibility may be a key element for an effective training, which results in improvements not merely on trained tasks but also in untrained tasks (i.e., far transfer). The aim of the current study was to track the behavioral and neural effects of computer-based cognitive flexibility training after stroke. We expected that executive functioning would improve after the cognitive flexibility training, and that neural activity and connectivity would normalize towards what is seen in healthy elderly.Methods/designThe design was a multicenter, double blind, randomized controlled trial (RCT) with three groups: an experimental intervention group, an active control group who did a mock training, and a waiting list control group. Stroke patients (3 months to 5 years post-stroke) with cognitive complaints were included. Training consisted of 58 half-hour sessions spread over 12 weeks. The primary study outcome was objective executive function. Secondary measures were improvement on training tasks, cognitive flexibility, objective cognitive functioning in other domains than the executive domain, subjective cognitive and everyday life functioning, and neural correlates assessed by both structural and resting-state functional Magnetic Resonance Imaging. The three groups were compared at baseline, after six and twelve weeks of training, and four weeks after the end of the training. Furthermore, they were compared to healthy elderly who received the same training.DiscussionThe cognitive flexibility training consisted of several factors deemed important for effects that go beyond improvement on merely the training task themselves. Due to the presence of two control groups, the effects of the training could be compared with spontaneous recovery and with the effects of a mock training. This study provides insight into the potential of online cognitive flexibility training after stroke. We also compared its results with the effectiveness of the same training in healthy elderly.Trial registrationThe Netherlands National Trial Register NTR5174. Registered 22 May 2015.Electronic supplementary materialThe online version of this article (doi:10.1186/s12883-015-0397-y) contains supplementary material, which is available to authorized users.

Evaluating an Online Cognitive Training Platform for Older Adults: User Experience and Implementation Requirements.

Decline of cognitive function is a part of aging. However, intensive cognitive training can improve important cognitive functions, such as attention and working memory. Because existing systems are not older adult-friendly and are usually not based on scientific evidence, an online platform was developed for cognitive training with information and communication features and evaluated in an 8-week field test. In a randomized clinical trial with 80 older adults, findings from log data analysis and questionnaires revealed a good use of the online platform. Communication or assistive features were not used often. Good usability ratings were given to the cognitive exercises. Subjective improvements of cognitive functions due to the training were reported. The current article presents concrete requirements and recommendations for deploying cognitive training software in older adult residential homes.

The Effect of Online Cognitive Training on Sustained Attention Measures for Electric Power Line Installers

This research builds on previous studies that identify inattentiveness as a causal factor of accidents. Cognitive training exercises were used to determine if attentiveness of electric power line installers could be increased. Participants, selected from two electric utilities and two electric power contractors, were randomly placed in either a control or a treatment group. Only the treatment group completed cognitive training, with both groups participating in pre- and posttests of sustained attention using the Sustained Attention to Response Task (SART). A significant trade-off between response accuracy and reaction time on SART was obtained for both groups. A multivariate analysis of covariance revealed a significant effect of cognitive training on performance, with the effect dominated by the change in reaction time rather than response accuracy. The results of this experiment followed the trend of previous research demonstrating that cognitive training can increase sustained attention ability.

Preliminary evidence for the feasibility of at-home online cognitive training with older adults.

Increased levels of cognitive activity may improve general cognitive function in older adults and potentially increase cognitive reserve, protecting against the onset of dementia associated with syndromes like Alzheimer's disease. To test the efficacy of cognitive training administered online, 18 participants (11 cognitively healthy; 7 mild cognitive impairment) were recruited from a clinical population of older adults to complete an online training intervention (CogniFit™). Before and after training, participants completed a separate battery of assessment measures, including measures of quality of life and competency at everyday activities, as well as a series of tests assessing cognitive function. Participants generally adhered to the online training protocol and completed a computerized assessment battery pre- and post-training. However, participants with mild cognitive impairment (MCI) were somewhat less likely to adhere to the protocol, suggesting that more direct contact is needed with this population in intervention research. Furthermore, participants demonstrated significant improvement on a measure of working memory and also in processing speed across several assessments, though these data are tentative, as no control data exist. These results, along with the generally good adherence observed, suggest that online cognitive training is feasible for this population and a potentially valuable tool for the wider dissemination of cognitive training.

Cognitive Training Enhances Working Memory Capacity in Healthy Adults. A Pilot Study

Working Memory (WM) was previously conceptualized as a heritable trait resistant to extraneous influences. Recently, emerging evidence suggests that WM capacity can be improved by repeatedly using it as part of a cognitive training. In this pilot study, a new online cognitive training program is proposed. Twenty-five young healthy adults completed the training on their home computers. Before and after the training participants’ WM and attention capacity were measured. Results demonstrated that a short cognitive training produce significant improvements in participants’ WM (d=0.91) and attention capacity (d=0.66). It appears that healthy adult participants benefit from such a cognitive training.

Improved Processing Speed: Online Computer-based Cognitive Training in Older Adults

In an increasingly aging population, a number of adults are concerned about declines in their cognitive abilities. Online computer-based cognitive training programs have been proposed as an accessible means by which the elderly may improve their cognitive abilities; yet, more research is needed in order to assess the efficacy of these programs. In the current study, a commercially available 21-day online computer-based cognitive training intervention was administered to 34 individuals aged between 53 and 75 years. The intervention consisted of computerized training in reaction time, inspection time, short-term memory for words, executive function, visual spatial acuity, arithmetic, visual spatial memory, visual scanning/discrimination, and n-back working memory. An active solitaire control group was also included. Participants were tested at baseline, posttraining and at three-weeks follow-up using a battery of neuropsychological outcome measures. These consisted of simple reaction time, complex reaction time, digit forwards and backwards, spatial working memory, digit symbol substitution, RAVLT, and trail making. Significant improvement in simple reaction time and choice reaction time task was found in the cognitive training group both posttraining and at three-weeks follow-up. However, no significant improvements on the other cognitive tasks were found. The training program was found to be successful in achieving transfer of trained cognitive abilities in speed of processing to similar untrained tasks.

Online games training aging brains: limited transfer to cognitive control functions

The prevalence of age-related cognitive decline will increase due to graying of the global population. The goal of the present study was to test whether playing online cognitive training games can improve cognitive control (CC) in healthy older adults. Fifty-four older adults (age 60–77) played five different cognitive training games online for 30 min a day over a period of seven weeks (game group). Another group of 20 older adults (age 61–73) instead answered quiz questions about documentaries online (documentary group). Transfer was assessed by means of a cognitive test battery administered before and after the intervention. The test battery included measures of working memory updating, set shifting, response inhibition, attention, and inductive reasoning. Compared with the documentary group, the game group showed larger improvement of inhibition (Stop-Signal task) and inductive reasoning (Raven-SPM), whereas the documentary group showed more improvement in selective attention (UFoV-3). These effects qualify as transfer effects, because response inhibition, inductive reasoning and selective attention were not targeted by the interventions. However, because seven other indicators of CC did not show benefits of game training and some of those that did suffered from potential baseline differences, the study as a whole provides only modest support for the potential of videogame training to improve CC in healthy older adults.

The Promise of Online Cognitive Behavioural Therapy Training for Rural and Remote Mental Health Professionals

The aim of this paper is to indicate how online cognitive behavioural therapy (CBT) training for rural and remote health professionals can enhance access to evidence-based treatments in rural communities and address psychotherapy training shortfalls for rural practitioners treating Australians with high prevalence psychological disorders. Issues of cost, distance and disruption to services have meant that, until now, it has been very difficult to provide really effective training in evidence-based therapies (in the main, CBT) for Australian rural and remote health professionals. The recent development of online CBT training provides new opportunities. Online training, supplemented by regular supervision, can fulfil many of the functions of face-to-face training at significantly reduced cost. While face-to-face residential workshops will still be necessary to embed new skills, we estimate that online training can reduce the face-to-face time required by at least 50%.