长期认知训练可增强 MCI 患者的流体认知能力和大脑连通性。

IF 5.8 1区 医学 Q1 PSYCHIATRY
Elveda Gozdas, Bárbara Avelar-Pereira, Hannah Fingerhut, Lauren Dacorro, Booil Jo, Leanne Williams, Ruth O'Hara, S M Hadi Hosseini
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引用次数: 0

摘要

失忆性轻度认知障碍(aMCI)是阿尔茨海默病(AD)的一个风险因素。多领域认知训练(CT)可减缓认知能力下降,延缓阿尔茨海默病的发病。然而,大多数研究都是针对单一认知领域的短期干预,或者缺乏积极的对照。我们进行了一项单盲随机对照试验,研究为期 6 个月的多领域 CT 对 aMCI 患者的流体认知、记忆和执行功能网络的功能连接(主要结果)以及白质微结构特性(次要结果)的影响。60名参与者被随机分配到多领域CT或填字游戏训练(CW)组,34名参与者完成了干预。我们发现,在流体认知(P = 0.007,F (1,28) = 8.26,Cohen's d = 0.38,95% 置信区间 [CI]:2.45-14.4)方面,组与组之间存在明显的交互作用,90% 的 CT 患者在干预后表现出改善(P = 0.007,F (1,28) = 8.26,Cohen's d = 0.38,95% 置信区间 [CI]:2.45-14.4)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Long-term cognitive training enhances fluid cognition and brain connectivity in individuals with MCI.

Amnestic mild cognitive impairment (aMCI) is a risk factor for Alzheimer's disease (AD). Multi-domain cognitive training (CT) may slow cognitive decline and delay AD onset. However, most work involves short interventions, targeting single cognitive domains or lacking active controls. We conducted a single-blind randomized controlled trial to investigate the effect of a 6-month, multi-domain CT on Fluid Cognition, functional connectivity in memory and executive functioning networks (primary outcomes), and white matter microstructural properties (secondary outcome) in aMCI. Sixty participants were randomly assigned to either a multi-domain CT or crossword training (CW) group, and thirty-four participants completed the intervention. We found a significant group-by-time interaction in Fluid Cognition (p = 0.007, F (1,28) = 8.26, Cohen's d = 0.38, 95% confidence interval [CI]: 2.45-14.4), with 90% of CT patients showing post-intervention improvements (p < 0.01, Cohen's d = 0.7). The CT group also showed better post-intervention Fluid Cognition than healthy controls (HCs, N = 45, p = 0.045). Functional connectivity analyses showed a significant group-by-time interaction (Cohen's d ≥ 0.8) in the dorsolateral prefrontal cortex (DLPFC) and inferior parietal cortex (IPC) networks. Specifically, CT displayed post-intervention increases whereas CW displayed decreases in functional connectivity. Moreover, increased connectivity strength between the left DLPFC and medial PFC was associated with improved Fluid Cognition. At a microstructural level, we observed a decline in fiber density (FD) for both groups, but the CT group declined less steeply (1.3 vs. 2%). The slower decline in FD for the CT group in several tracts, including the cingulum-hippocampus tract, was associated with better working memory. Finally, we identified regions in cognitive control and memory networks for which baseline functional connectivity and microstructural properties were associated with changes in Fluid Cognition. Long-term, multi-domain CT improves cognitive functioning and functional connectivity and delays structural brain decline in aMCI (ClinicalTrials.gov number: NCT03883308).

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来源期刊
CiteScore
11.50
自引率
2.90%
发文量
484
审稿时长
23 weeks
期刊介绍: Psychiatry has suffered tremendously by the limited translational pipeline. Nobel laureate Julius Axelrod''s discovery in 1961 of monoamine reuptake by pre-synaptic neurons still forms the basis of contemporary antidepressant treatment. There is a grievous gap between the explosion of knowledge in neuroscience and conceptually novel treatments for our patients. Translational Psychiatry bridges this gap by fostering and highlighting the pathway from discovery to clinical applications, healthcare and global health. We view translation broadly as the full spectrum of work that marks the pathway from discovery to global health, inclusive. The steps of translation that are within the scope of Translational Psychiatry include (i) fundamental discovery, (ii) bench to bedside, (iii) bedside to clinical applications (clinical trials), (iv) translation to policy and health care guidelines, (v) assessment of health policy and usage, and (vi) global health. All areas of medical research, including — but not restricted to — molecular biology, genetics, pharmacology, imaging and epidemiology are welcome as they contribute to enhance the field of translational psychiatry.
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