Working memory training (WMT) is one of the most widely studied areas in cognitive training. A central concern in WMT research is the transferability of training effects, which remains a topic of ongoing debate. Recently, an executive n-back paradigm, which increases the manipulation of working memory load, has been proposed as a more suitable approach to assess working memory. In the present study, we examined whether executive n-back training, compared to traditional n-back training, led to broader transfer effects across cognitive tasks. Over six daily sessions, participants completed either the executive n-back task or the traditional n-back task. The findings demonstrated that executive n-back training transferred to the Operation Span task, which also measures working memory but differs structurally from the n-back task, and to the task switching, which assesses cognitive flexibility. Furthermore, these transfer effects persisted even after a 3-month interval. These findings suggest that the executive n-back task is more effective than the traditional n-back task. Moreover, this research sheds light on the potential applications of executive n-back training in enhancing cognitive functions more generally, highlighting its utility in both clinical and educational settings where cognitive flexibility and working memory improvements are critical.

Impact of emotional working memory training on threat-related attentional bias in social anxiety: Evidence from eye movements.

Purpose: Memory impairments after traumatic brain injury (TBI) can disrupt daily functioning, highlighting the need for effective interventions. Although transcranial direct current stimulation (tDCS) and computer-assisted cognitive rehabilitation (RehaCom) each show promise, evidence on their combined effects is limited. This randomized controlled trial investigated the efficacy of concurrent tDCS and RehaCom training on working memory and cortical activity post-TBI. Method: Thirty adults with memory impairments 2–12 weeks after TBI were recruited from a trauma hospital in Shiraz, Iran. Participants were randomly assigned to an intervention group (n = 15) receiving ten 30-minute sessions of combined anodal tDCS (1–2 mA to bilateral prefrontal cortex) and RehaCom working memory training, or a control group (n = 15) receiving no intervention. Working memory (RehaCom module) and cortical activity (quantitative electroencephalography; QEEG) were assessed pre- and post-intervention. Findings: The intervention group showed significant improvements in working memory span (F = 5.52, p=.022, η2p=.17) and reduced position errors (F = 10.37, p=.003, η2p=.27). QEEG revealed increased theta power at Fp2 and F7, and alpha power at F7 and F3 (F = 4.59–5.97, p<.05). Reliable Change Index analysis indicated clinically meaningful gains in 33–53% of participants. Conclusion: Combined tDCS and RehaCom training enhanced working memory and cortical activity following TBI.

Depression and anxiety disorders are associated with deficits in several cognitive domains. This meta-analytic review assessed the effects of emotional working memory training (eWMT) on depression and anxiety and their related emotional and cognitive domains. Eligible studies were assessed for changes in depression, anxiety, emotion and cognition after eWMT. Methodological quality was assessed using Cochrane Collaboration's guidelines, and random-effects models aggregated the results of individual studies. Of 1314 studies identified, 16 were included (883 participants; mean age range, 14.35-68.79 years; 70.44% female). Nine studies were high quality, seven were moderate quality, and none were low quality. There was relatively high heterogeneity across studies and study populations. The eWMT significantly reduced depression (standardized mean difference [SMD], -2.04; 95% confidence interval [CI], -3.68 to -0.39; p = 0.02) and anxiety (SMD, -0.44; 95% CI = -0.23 to -0.17; p < 0.001) and significantly enhanced reappraisal (SMD, 0.38; 95% CI, 0.11 to 0.66; p = 0.03) and working memory capacity (SMD, 0.31; 95% CI, 0.10 to 0.53; p < 0.001), with no significant effect on rumination. Training frequency, training environment, and type of control group differentially affected working memory capacity. Our results demonstrated that eWMT alleviated depression and anxiety, but not rumination, and improved the related factors of reappraisal and working memory. Given the limited number of studies and substantial heterogeneity in the data, further research is needed to support these results.

Working memory training embedded in metacognitive intervention: EFL listening comprehension

Major depressive disorder (MDD) is associated with reduced quality of life and relapse risk. However, few studies have investigated how quality of life is associated with cognitive deficits following MDD and is affected by cognitive training. This study investigated the long-term effects of computer-based working memory training (CWMT) on health-related quality of life (HRQL) in remitted MDD, and the association between executive functions (EF) and HRQL. Twenty-nine remitted participants (M age 36.21, SD = 10.8) were included in a pre-post pilot study of CWMT with 1- and 2-year follow-up. Twenty participants completed 5 weeks of CWMT, 12 participants were included at the 1-year follow-up, and 10 participants returned for the 2-year follow-up. The 36-item Short-Form Health Survey was used to assess HRQL. Associations between subjective and objective cognitive EF and HRQL were measured by the Behavior Rating Inventory of Executive Function for Adults (BRIEF-A) and a neuropsychological test battery of EF. Significant moderate improvements were found in aspects of HRQL after 2 years (d = 0.66). There were negative correlations between HRQL and BRIEF-A pre-intervention (r = 0.47-0.65). However, the study did not find significant associations between improved EF and improved HRQL. Preliminary results indicate long-term improvements in HRQL following CWMT. Subjective EF deficits were associated with poorer HRQL. However, due to limitations including small sample size and multiple statistical comparisons, larger controlled studies are needed to investigate and replicate the potential effects of CWMT on HRQL.

Background and ObjectivesWorking memory training (WMT) has been shown to improve WM in healthy older adults, patients with mild cognitive impairment, and individuals with HIV, including improvements in WM network efficiency. This randomized study explored near-transfer and far-transfer effects of WMT and examined whether LMX1A or APOE ɛ4 genotype variations influenced these effects in individuals with HIV and HIV-seronegative (SN) controls.MethodsParticipants were recruited from local communities. After screening and baseline evaluation, participants were randomized to either 25 sessions of adaptive or nonadaptive WMT (as an active control) over 5–8 weeks. Nontrained near-transfer WM tests, far-transfer tests, and self-reported executive functioning were performed at baseline, 1-month, and 6-month follow-ups. Genotyping included LMX1A-rs4657412 and APOEɛ-rs429358/rs7412. Primary outcomes included near-transfer and far-transfer training gains and genotype associations at 1 and 6 months. Secondary outcomes were genotypic effects on self-reported functioning. Linear mixed-effect models were used to compare the training gains across training types, HIV serostatus, and genotype variations.ResultsA total of 107 participants (60 with HIV, 47 SN) completed adaptive WMT, and 70 active controls (36 with HIV, 34 SN) completed nonadaptive WMT. Overall, 96 adaptive WMT participants and 68 active controls completed the 1-month follow-up while 77 adaptive WMT participants and 37 active controls completed the 6-month follow-up. Adaptive WMT led to higher improvement indices in SN participants than in the HIV group (training*HIV serostatus: p = 0.038, β = −0.22 [−0.33, −0.12]) and similar near-transfer and far-transfer effects (training type*visit: p < 0.001–0.028, β = 0.25–0.64 at 1 month, β = 0.29–0.77 at 6 months) in both groups, but greater improvements in far-transfer tasks in the HIV group at 6 months (training type*HIV serostatus*visit: p = 0.001–0.039, β = 0.60–1.11 at 6 months). Compared with LMX1A-G carriers, LMX1A-AA carriers showed higher improvement indices (training*LMX1A genotype: p < 0.001, β = 0.39 [0.29, 0.49]). While both genotype groups showed near-transfer and far-transfer gains, LMX1A-G carriers gained more after adaptive WMT than nonadaptive WMT in WM (training type*LMX1A genotype*visit: p = 0.015, β = 0.90 [0.31,1.48] at 6 months) and visuoperceptual (training type*LMX1A genotype*visit: p < 0.001, β = 1.18 [0.66, 1.69]) domains. Compared with non–ɛ4 carriers, APOE ɛ4 carriers showed greater improvement on processing speed (APOE ɛ4 genotype*training type*visit: p = 0.008, β = 0.68 [0.14, 1.22] at 1 month, and β = 0.90 [0.25, 1.55] at 6 months).DiscussionAdaptive WMT improved near-transfer WM, far-transfer performance, and self-reported executive functioning in all participants, but more sustained effects among participants with HIV. These findings suggest that adaptive WMT can be an effective adjunctive therapy for cognitive deficits in PWH, especially in those with LMX1A-G/GA and/or APOE ɛ4 carriers.Classification of EvidenceThis study provides Class IV evidence that adaptive WMT improves near-transfer WM, far-transfer performance, and self-reported executive functioning in patients with or without HIV, regardless of LMX1A or APOE ɛ4 genotype status. NCT02602418 (registered at ClinicalTrials.gov, Registered: May 11, 2015. First patient enrolled: September 15, 2012.

Background and objectivesMild traumatic brain injury (mTBI) frequently results in persistent cognitive deficits with limited evidence-based rehabilitation options. Visual timing deficits, potentially linked to dorsal visual pathway dysfunction, represent a promising therapeutic target. This study examined whether a novel intervention targeting dorsal visual pathways (PATH) demonstrates superior efficacy compared to conventional cognitive therapies targeting ventral pathway deficits or working memory impairments.MethodsTwenty-four participants (aged 23–62 years) with mTBI were randomized to receive one of three interventions over 12 weeks: (1) PATH training targeting dorsal visual pathway function, (2) Orientation Discrimination (OD) targeting ventral pathway pattern discrimination, both of these 20-min interventions followed by 10-min of digit memory exercises, or (3) ReCollect, working memory training. Each intervention consisted of 36 sessions (30 min each, three times weekly). Primary outcome was visual working memory (VWM) performance; secondary outcomes included processing speed, reading speed, auditory working memory, selective attention, and cognitive flexibility assessed via standardized neuropsychological measures. Magnetoencephalography (MEG) recordings during resting state and an N-Back task provided neurophysiological validation.ResultsPATH training yielded significantly greater VWM improvements (49%) compared to ReCollect (13%) and OD (8%) interventions. Repeated-measures ANOVA confirmed superior efficacy of dorsal pathway training (significant at p = 0.011). Similar gains for PATH training were also found for processing speed, reading speed, and cognitive flexibility, especially when compared to the OD group, revealing importance of strengthening the dorsal stream before digit memory exercises. MEG analysis revealed PATH-specific activation in not only bilateral dorsolateral prefrontal cortex, anterior cingulate cortex, posterior parietal cortex, superior occipital gyri, but also the left anterior temporal lobe and hippocampus, primary motor cortex, and the cerebellum, as well as lower gamma-band noise, suggesting enhanced neural timing, attention, working memory, memory consolidation and retrieval mechanisms beyond the targeted dorsal pathways.ConclusionDorsal visual pathway retraining followed by targeted working memory exercises demonstrates superior therapeutic efficacy for cognitive rehabilitation following mTBI compared to conventional approaches. The intervention promotes beneficial neuroplasticity extending to memory-related brain regions, supporting its potential as a targeted, mechanistically-informed therapy for post-concussive cognitive deficits.

The working memory modifiability: Effects of mediation on working memory and analogical thinking.

Working memory training may enhance cognitive function in Mild Cognitive Impairment (MCI). Given that one-third of individuals with MCI progress to dementia within five years, interventions that delay progression are critical. This study investigates the effect of home-based computerized working memory training on cognitive function in MCI. In this multi-center randomized controlled trial, participants with MCI were assigned to either a five-week home-based computerized working memory training program (n=94) or an active control group playing web-based solitaire (n=53). All participants received weekly coaching by telephone. We analyzed the change in working memory, measured by the Spatial Span Backwards subtest (higher score indicates better working memory), from baseline to 3 months post-intervention. A mixed-effects model with robust standard errors was employed to account for both fixed and random effects. Fixed effects included treatment group, age, sex, and General Ability Index (GAI), while the random effect accounted for variability between centers. Among 147 participants (mean age 68 years; standard deviation 7.5; 43% women), the Spatial Span Backwards score improved significantly in the working memory training group compared to the active control group at 3 months (least squares mean difference, 0.60; 95% confidence interval, 0.44 to 0.75 p<0.001). In individuals with MCI, home-based computerized working memory training significantly improved working memory after 3 months compared to active controls.

Enhancing brain plasticity: Functional near-infrared spectroscopy evidence for computerized working memory training in healthy adults.

ABSTRACTBackgroundWhile multi‐site noninvasive brain stimulation demonstrates enhanced cognitive benefits in mild cognitive impairment (MCI), the efficacy of transcranial alternating current stimulation (tACS) in this paradigm remains unestablished. The study aims were to investigate the therapeutic effects of multi‐site tACS on MCI patients and its underlying neural mechanism.MethodsA parallel, sham‐controlled trial was conducted with 60 MCI participants assigned to multi‐site tACS (prefrontal gyrus and precuneus), single‐site tACS (precuneus), or sham groups. All participants underwent 20 days of 7 Hz tACS concurrent with working memory training. Cognitive assessments and fMRI examinations were performed pre‐ and post‐ intervention. Local and remote functional connectivity changes were evaluated using regional homogeneity (Reho) and resting‐state network (RSN) analyses, respectively.ResultsMulti‐site tACS demonstrated superior cognitive improvements, particularly in verbal fluency (p = 0.006) and recognition memory (p = 0.025), compared to sham stimulation. Significant ReHo changes were observed in the superior frontal gyrus (SFG) and superior temporal gyrus (STG) exclusively in the multi‐site group (p < 0.05). Additionally, multi‐site tACS induced broader functional connectivity alterations in the default mode network (DMN), executive control network (ECN), and left frontoparietal network (FPN). Correlations were found between the Reho changes in SFG and STG and the score changes of immediate memory (r = 0.367, p = 0.039) and language naming (r = 0.371, p = 0.037), respectively. Functional connectivity changes in the right inferior parietal lobe were also significantly correlated with the score changes of language naming (r = −0.374, p = 0.035). Moreover, more functional connectivity changes between the prefrontal gyrus stimulation site and the salience network and DMN were also detected in the multi‐site group relative to the single‐site group.ConclusionsMulti‐site tACS is more effective than single‐site tACS in enhancing cognitive functions and modulating cognition‐related brain networks in MCI patients. These superior neuromodulatory effects of multi‐site tACS may be attributed to its capacity to modulate functional networks across the prefrontal gyrus more extensively.

Top-Down Modulation of Auditory-Motor Integration in Individuals with Primary Muscle Tension Dysphonia: The Role of Auditory Working Memory.

Effects of virtual reality-based cognitive training on working memory and frontotemporal lobe in patients with major depressive disorder: A randomized controlled study.

BackgroundAgeing often leads to a decline in working memory, negatively impacting daily functioning and life satisfaction. Gamified mobile applications have emerged as promising instruments for cognitive enhancement, offering the potential to enhance motivation and engagement among the elderly population. This investigation examines the acceptability and practicality of a gamified memory enhancement application involving 20 older people.MethodUsing qualitative methods, the study gathered insights into the preferences and needs of older adults regarding mobile application use. Semi‐structured interviews assessed subjective experiences, perceived usability, and practical utility, while a focus group examined collective perceptions of user satisfaction, barriers to engagement, and reactions to gamified elements. The analyses were assessed through the viewpoint of the Technology Acceptance Model (TAM), underlining perceived benefits and usability, as well as attitudes about and the desire to utilize the application.ResultsResults showed high acceptability, with participants highlighting the application's engaging features and cognitive benefits. However, concerns regarding practicality surfaced, particularly concerning navigation difficulties and the need for clearer instructions. Insights derived from TAM indicated that perceived ease of use and utility had a substantial impact on participants' attitudes.Discussion and ConclusionGamified applications have significant potential for enhancing cognitive function in older adults, but usability improvements are crucial. Consistent with the findings of TAM, ease of use and perceived benefits were pivotal for acceptance, suggesting that improvements focused on user experience could promote wider adoption and sustained engagement.

ABSTRACT Purpose While functional near-infrared spectroscopy (fNIRS) has been used to examine working memory (WM) and prefrontal cortex (PFC) activation in clinical populations such as traumatic brain injury, mild cognitive impairment, and Alzheimer’s disease, its application in persons with aphasia (PWA) remains limited. This study aims to investigate differences in PFC activation patterns among PWA and healthy controls (HC) across varying levels of working memory (WM) load utilizing fNIRS. Methods A 16-channel fNIRS system was used to measure PFC hemodynamic activation associated with WM processing. This study employed a cross-sectional group comparison design, enabling direct evaluation of differences between PWA and HC across varying WM loads. The participant sample included 10 PWA and 10 age-matched neurotypical healthy controls. All participants completed an n-back task with two WM load conditions: low load (1-back) and high load (2-back). Performance accuracy and response time were analyzed within and between groups. Oxygenation changes in the PFC were measured across 16 PFC channels grouped into four separate quadrants lateral left, central left, central right, and lateral right regions. Results Behavioral analyses revealed significant decreases in performance accuracy (p = .005) and increased response times (p < .025) under higher WM load (2-back) in both groups. However, between-group differences in performance were not statistically significant (p > .05). Hemodynamically, both groups showed increased PFC oxygenation during the high load task. Notably, PWA exhibited greater right lateral PFC activation compared to HC, who showed predominant left lateral PFC activation. Quadrant-level analyses revealed significant differences in oxygenation patterns across PFC regions, particularly during the high load condition for PWA (p ≤ .025). Conclusions The findings suggest that increased cognitive demands elicit distinct PFC activation patterns in PWA compared to HC, likely reflecting compensatory recruitment of right hemisphere resources following left hemisphere injury. Future studies should investigate how PFC activation patterns relate to lesion characteristics and aphasia severity. Thus, fNIRS proves to be a valuable tool for characterizing WM-related brain activity in clinical populations. Similarly, fNIRS has the potential to identify compensatory activation patterns that directly inform rehabilitation, enabling targeted WM training and the use of non-invasive brain stimulation to enhance neural plasticity and maximize translational impact.

Short- and long-term cognitive and electrophysiological effects of a brief working memory training in older adults: a pilot study.

Abstract Computerized cognitive training has reasonable evidence for ameliorating cognitive deficits in childhood cancer survivors; however, availability, affordability, and nonadaptation are impending factors. Despite therapist-delivered cognitive training has similar effects, there is no indigenous and replicable structured manualized cognitive training for childhood cancer survivors in India. The feasibility and indicative impact assessment of a manualized cognitive training toolkit (MCTT) (similar effect size as CogMed working memory training and PSSCogRehb software for children with attention deficit hyperactivity disorder) was examined to fabricate to meet the needs of the target group. With a pre–post design, 10 survivors (M = 8, F = 2) between 6 and 11 years (mean age = 8.6 ± 2.7 years) with Social Quotient (SQ) ≥ 85 (mean SQ = 99.8 ± 11.75), and having significant cognitive deficits were recruited. Far-transfer effects were assessed through parents' rated Child Behavior Rating Scale, and near-transfer effects through Cognitive Assessment System-2. Note that 58.33% had cognitive deficits across planning, attention, and successive and simultaneous processing. MCTT with 18 cognitive tasks (16 difficulty levels) delivered in 8 days (over 2 weeks:16 hours) was feasible. Except attention domain, MCTT had significant near-transfer effects on planning (Z = 2.88, p &lt; 0.01, r = 0.86), simultaneous (Z = 2.55, p &lt; 0.01, r = 0.81), and successive processing (Z = 2.45, p &lt; 0.01, r = 0.77) with large effect size. MCTT was a feasible toolkit; however, refabrication with increased number of attention-focused tasks and difficulty levels was indicated. Expectedly, MCTT did not have positive/negative impacts on behaviors. MCTT has potentiality for a randomized controlled trial and can be compared to any computerized training for this target group.

Can working memory training improve working memory capacity in typically developing children?: Training methods reveal specific effects.

It is vital that working memory capacity can be assessed and trained with motivating resources, in a personalized way in children with neurodevelopmental disorders. This paper illustrates the possibility of a serious game, such as WorM, to assess and train children’s working memory capacity. WorM was designed, developed and evaluated through three studies (Study 1: informative, Study 2: validation and Study 3: user studies). The first two qualitative studies employ in-depth interviews and focus group discussions, to identify, argue and validate suitable design aspects guided by interviews from teachers and psychologists. The third study presents the usefulness of WorM based on the Item Response Theory analysis and answers from 23 end-user, typical children. Examples of important design aspects identified in Study 1 revealed the role of captivating interests, customization, short duration, rewards, feedback and clear instructions for designing tasks with right images and sound effects. From these, Study 2 enhanced the role of interactive visual feedback for correct and incorrect sorting, using images, keyboard keys, multiple colors, or the phase of the trial. Study 3 illustrates how Correct Pepper Classification tasks show some variability in difficulty, where the range of difficulties was higher in the game tasks than in the standardized Childhood Executive Functioning Inventory (CHEXI) task, usually applied for identifying the NDD characteristics in the examined users. While both instruments showed good reliability with high Person and Item Separation Reliability and Cronbach’s alpha values, the findings of this paper suggest that serious games can offer promising prospects to provide meaningful contexts to assess and train working memory by the WorM game.Supplementary InformationThe online version contains supplementary material available at 10.1186/s40359-025-02912-9.