Computer Training Improves Cognition in Patients With Vascular Cognitive Impairment

A 7-week multi-domain computerized cognitive training program that included processing speed, perception, memory, attention, reasoning, and problem-solving was associated with improvements in global cognitive function in patients with subcortical vascular cognitive impairment, no dementia (VCI-ND), according to study results published in Alzheimer’s & Dementia.

Patients with VCI-ND were enrolled from 3 medical centers in Beijing, China, who presented with multiple (≥3) supratentorial subcortical small infarcts measuring 3 to 20 mm in diameter with/without any degree of white matter lesions or moderate to severe white matter lesions with/without small infarct.

In addition, the researchers enrolled patients who had an absence of cortical or watershed infarcts, hemorrhages, hydrocephalus, or white matter lesions associated with specific causes, as well as no hippocampal or entorhinal cortex atrophy.

The researchers randomly assigned patients to either a 7-week computerized training program (n=30) or a control group (n=30) in a blinded fashion.

The training included processing speed, perception, attention, working memory, long-term memory, calculation, executive control, problem-solving, and reasoning. Individuals in the control group received 4 attention and processing speed tasks, with a total of 30 minutes/d of training. Primary study outcomes included global cognitive function and executive function.

Patients in the intervention group experienced a greater improvement in the Montreal Cognitive Assessment compared with the control group (21.87 to 25.22 vs 21.23 to 21.15, respectively) by the end of treatment (effect size, 0.637; 95% CI, 0.115-1.153; P =.013).

Participants in the intervention arm also had a greater increase in functional connectivity between the left dorsolateral prefrontal cortex and the medial prefrontal cortex based on MRI findings. The improvement in function correlated with a greater change in the Montreal Cognitive assessment by the end of treatment in the intervention group (P =.017).

Study l included the relatively short follow-up period (6 months), as well as the small sample size.

“The significant correlation between the restored connection and improved global cognitive function suggested that biomarkers of functional connectivity as proxy for effects of brain plasticity should be incorporated as outcomes in cognitive training trials,” concluded the researchers.

Reference

Tang Y, Xing Y, Zhu Z, et al. The effects of 7-week cognitive training in patients with vascular cognitive impairment, no dementia (the Cog-VACCINE study): a randomized controlled trial [published online March 17, 2019]. Alzheimers Dement. doi:10.1016/j.jalz.2019.01.009