Peer-reviewed published papers

Below you'll find abstracts from published papers from our team and HCP collaborators, including observational studies regarding trends in Lumosity data and exploratory research involving subjects suffering from a variety of medical conditions. This content is for informational purposes only. Lumosity is not intended to diagnose, treat, cure, or prevent any disease. You should always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

2015

Morrison, G.E., Simone, C.M., Ng, N.F., Hardy, J.L. (2015). Reliability and validity of the NeuroCognitive Performance Test, a web-based neuropsychological assessment. Frontiers in Psychology, 6:1652. doi:10.3389/fpsyg.2015.01652.

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Abstract

The NeuroCognitive Performance Test (NCPT) is a brief, repeatable, web-based cognitive assessment platform that measures performance across several cognitive domains. The NCPT platform is modular and includes 18 subtests that can be arranged into customized batteries. Here we present normative data from a sample of 130,140 healthy volunteers for an NCPT battery consisting of 8 subtests. Participants took the NCPT remotely and without supervision. Factor structure and effects of age, education, and gender were evaluated with this normative dataset. Test-retest reliability was evaluated in a subset of participants who took the battery again an average of 78.8 days later. The eight NCPT subtests group into 4 putative cognitive domains, have adequate to good test-retest reliability, and are sensitive to expected age- and education-related cognitive effects. Concurrent validity to standard neuropsychological tests was demonstrated in 73 healthy volunteers. In an exploratory analysis the NCPT battery could differentiate those who self-reported Mild Cognitive Impairment or Alzheimer's disease from matched healthy controls. Overall these results demonstrate the reliability and validity of the NCPT battery as a measure of cognitive performance and support the feasibility of web-based, unsupervised testing, with potential utility in clinical and research settings.

Charvet, L.E., Shaw, M.T., Haider, L., Melville, P., Krupp, L.B. (2015). Remotely-delivered cognitive remediation in multiple sclerosis (MS): protocol and results from a pilot study. Multiple Sclerosis Journal - Experimental, Translational and Clinical. 2015 October 5;1:1-10. doi:10.1177/ 2055217315609629.

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Abstract

BACKGROUND: 

Cognitive impairment represents a critical unmet treatment need in multiple sclerosis (MS). Cognitive remediation is promising but traditionally requires multiple clinic visits to access treatment. Computer-based programs provide remote access to intensive and individually-adapted training.

OBJECTIVE: 

Our goal was to develop a protocol for remotely-supervised cognitive remediation that enables individuals with MS to participate from home while maintaining the standards for clinical study.

METHODS:

MS participants (n = 20) were randomized to either an active cognitive remediation program (n = 11) or a control condition of ordinary computer games (n = 9). Participants were provided study laptops to complete training for five days per week over 12 weeks, targeting a total of 30 hours. Treatment effects were measured with composite change via scores of a repeated neuropsychological battery.

RESULTS: 

Compliance was high with an average of 25.0 hours of program use (80% of the target) and did not differ between conditions (25.7 vs. 24.2 mean hours, p = 0.80). The active vs. control participants significantly improved in both the cognitive measures (mean composite z-score change of 0.46 ± 0.59 improvement vs. −0.14 ± 0.48 decline,p = 0.02) and motor tasks (mean composite z-score change of 0.40 ± 0.71improvement vs. −0.64 ± 0.73 decline, p = 0.005).

CONCLUSIONS: 

Remotely-supervised cognitive remediation is feasible for clinical study with potential for meaningful benefit in MS.

Hardy, J.L., Nelson, R.A., Thomason, M.E., Sternberg, D.A., Katovich, K., Farzin, F., Scanlon, M. (2015). Enhancing cognitive abilities with comprehensive training: A large, online, randomized, active-controlled trial. PLoS ONE 10(9): e0134467. doi:10.1371/journal.pone.0134467.

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Abstract

BACKGROUND:

A 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.

METHODS:

The 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.

RESULTS:

Participants 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]).

CONCLUSION:

Taken 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.

Geyer J, Insel P, Farzin F, Sternberg D, Hardy JL, Scanlon M, Mungas D, Kramer J, Mackin RS, Weiner MW. (2015) Evidence for age-associated cognitive decline from internet game scores. Alzheimer’s & Dementia. doi: 10.1016/j.dadm.2015.04.002.

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Abstract

INTRODUCTION:

Lumosity's Memory Match (LMM) is an online game requiring visual working memory. Change in LMM scores may be associated with individual differences in age-related changes in working memory.

METHODS:

Effects of age and time on LMM learning and forgetting rates were estimated using data from 1890 game sessions for users aged 40 to 79 years.

RESULTS:

There were significant effects of age on baseline LMM scores (β = −.31, standard error or SE = .02, P < .0001) and lower learning rates (β = −.0066, SE = .0008, P < .0001). A sample size of 202 subjects/arm was estimated for a 1-year study for subjects in the lower quartile of game performance.

DISCUSSION:

Online memory games have the potential to identify age-related decline in cognition and to identify subjects at risk for cognitive decline with smaller sample sizes and lower cost than traditional recruitment methods.

Donner Y, Hardy JL. (2015) Piecewise power laws in individual learning curves. Psychonomic Bulletin & Review. ISSN:1531-5320. doi: 10.3758/s13423-015-0811-x.

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Abstract

The notion that human learning follows a smooth power law (PL) of diminishing gains is well-established in psychology. This characteristic is observed when multiple curves are averaged, potentially masking more complex dynamics underpinning the curves of individual learners. Here, we analyzed 25,280 individual learning curves, each comprising 500 measurements of cognitive performance taken from four cognitive tasks. A piecewise PL (PPL) model explained the individual learning curves significantly better than a single PL, controlling for model complexity. The PPL model allows for multiple PLs connected at different points in the learning process. We also explored the transition dynamics between PL curve component pieces. Performance in later pieces typically surpassed that in earlier pieces, after a brief drop in performance at the transition point. The transition rate was negatively associated with age, even after controlling for overall performance. Our results suggest at least two processes at work in individual learning curves: locally, a gradual, smooth improvement, with diminishing gains within a specific strategy, which is modeled well as a PL; and globally, a discrete sequence of strategy shifts, in which each strategy is better in the long term than the ones preceding it. The piecewise extension of the classic PL of practice has implications for both individual skill acquisition and theories of learning.

2014

Ballesteros S, Prieto A, Mayas J, Toril P, Pita C, Ponce de León L, Reales JM and Waterworth J (2014) Brain training with non-action video games enhances aspects of cognition in older adults: a randomized controlled trial. Front. Aging Neurosci. 6:277. doi: 10.3389/fnagi.2014.00277.

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Abstract

Age-related cognitive and brain declines can result in functional deterioration in many cognitive domains, dependency, and dementia. A major goal of aging research is to investigate methods that help to maintain brain health, cognition, independent living and wellbeing in older adults. This randomized controlled study investigated the effects of 20 1-h non-action video game training sessions with games selected from a commercially available package (Lumosity) on a series of age-declined cognitive functions and subjective wellbeing. Two groups of healthy older adults participated in the study, the experimental group who received the training and the control group who attended three meetings with the research team along the study. Groups were similar at baseline on demographics, vocabulary, global cognition, and depression status. All participants were assessed individually before and after the intervention, or a similar period of time, using neuropsychological tests and laboratory tasks to investigate possible transfer effects. The results showed significant improvements in the trained group, and no variation in the control group, in processing speed (choice reaction time), attention (reduction of distraction and increase of alertness), immediate and delayed visual recognition memory, as well as a trend to improve in Affection and Assertivity, two dimensions of the Wellbeing Scale. Visuospatial working memory (WM) and executive control (shifting strategy) did not improve. Overall, the current results support the idea that training healthy older adults with non-action video games will enhance some cognitive abilities but not others.

Tartaglione EV, Derleth M, Yu L, & Ioannou GN (2014). Can computerized brain training games be used to identify early cognitive impairment in cirrhosis? American Journal of Gastroenterology, 109(3), 316-323. doi: 10.1038/ajg.2013.306.

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Abstract

OBJECTIVES:

We evaluated whether commercially available, computerized “brain-training” games can be used to identify subtle cognitive impairments in patients with cirrhosis.

METHODS:

We compared patients with cirrhosis who did not have overt encephalopathy (n=31), patients with pre-cirrhotic chronic liver disease (n=28), and normal controls without liver disease (n=16) with respect to their scores on the number connection test-A (NCT-A), the Inhibitory Control Test (ICT), and five, short (~2.5 min), brain-training games that were administered on an Apple iPad and tested different cognitive domains.

RESULTS:

Patients with cirrhosis had similar scores to patients with pre-cirrhotic liver disease and slightly worse scores than normal controls in the NCT-A and the ICT, although these differences were not statistically significant. In contrast, patients with cirrhosis had significantly worse scores than patients with pre-cirrhotic liver disease and even more so than normal controls in all five of the brain-training games. After adjustment for age and educational attainment, these differences remained significant for two of the tests, “Color Match” which is a version of the Stroop test and measures selective attention, and “Memory Matrix”, which measures visuospatial memory. The area under the receiver operating characteristic curve discriminating cirrhosis from pre-cirrhotic liver disease was 0.56 (95% confidence interval (CI) 0.41–0.72) for the ICT and 0.58 (95% CI 0.43–0.73) for the NCT-A, indicating no discrimination, while it was 0.75 (95% CI 0.63–0.87) for “Color Match” and 0.77 (95% CI 0.64–0.90) for “Memory Matrix”, indicating good discrimination.

CONCLUSIONS:

Short, brain-training games administered on an iPad can be used as psychometric tests to detect subtle cognitive impairments in patients with cirrhosis without overt encephalopathy that could not be detected by the NCT-A or the ICT.

Dannhauser TM, Cleverley M, Whitfield TJ, Fletcher BC, Stevens T, Walker Z. A complex multimodal activity intervention to reduce the risk of dementia in mild cognitive impairment-ThinkingFit: pilot and feasibility study for a randomized controlled trial. BMC Psychiatry. 2014 May 5;14(1):129. doi: 10.1186/1471-244X-14-129.

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Abstract

BACKGROUND:

Dementia affects 35 million people worldwide and is currently incurable. Many cases may be preventable because regular participation in physical, mental and social leisure activities during middle age is associated with up to 47% dementia risk reduction. However, the majority of middle-aged adults are not active enough. MCI is therefore a clear target for activity interventions aimed at reducing dementia risk. An active lifestyle during middle age reduces dementia risk but it remains to be determined if increased activity reduces dementia risk when MCI is already evident. Before this can be investigated conclusively, complex multimodal activity programmes are required that (1) combine multiple health promoting activities, (2) engage people with MCI, and (3) result in sufficient adherence rates.

METHODS:

We designed the ThinkingFit programme to engage people with MCI in a complex intervention comprised of three activity components: physical activity, group-based cognitive stimulation (GCST) and individual cognitive stimulation (ICST). Engagement and adherence was promoted by applying specific psychological techniques to enhance behavioural flexibility in an early pre-phase and during the course of the intervention. To pilot the intervention, participants served as their own controls during a 6- to 12-week run-in period, which was followed by 12 weeks of activity intervention.

RESULTS:

Out of 212 MCI patients screened, 163 were eligible, 70 consented and 67 completed the intervention (mean age 74 years). Activity adherence rates were high: physical activity = 71%; GCST = 83%; ICST = 67%. Significant treatment effects (p < .05) were evident on physical health outcomes (decreased BMI and systolic blood pressure, [pre/post values of 26.3/25.9 kg/m2 and 145/136 mmHg respectively]), fitness (decreased resting and recovery heart rate [68/65 bpm and 75/69 bpm]), and cognition (improved working memory [5.3/6.3 items]).

CONCLUSIONS:

We found satisfactory recruitment, retention and engagement rates, coupled with significant treatment effects in elderly MCI patients. It appears feasible to conduct randomized controlled trials of the dementia prevention potential of complex multimodal activity programmes like ThinkingFit.

TRIAL REGISTRATION:

ClinicalTrials.gov registration nr: NCT01603862; date: 17/5/2012.

Mayas J, Parmentier FBR, Andres P, Ballesteros S. (2014). Plasticity of attentional functions in older adults after non-action video game training: a randomized, controlled trial. PLoS One, 9(3):e92269. doi: 10.1371/journal.pone.0092269.

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Abstract

A major goal of recent research in aging has been to examine cognitive plasticity in older adults and its capacity to counteract cognitive decline. The aim of the present study was to investigate whether older adults could benefit from brain training with video games in a cross-modal oddball task designed to assess distraction and alertness. Twenty-seven healthy older adults participated in the study (15 in the experimental group, 12 in the control group. The experimental group received 20 1-hr video game training sessions using a commercially available brain-training package (Lumosity) involving problem solving, mental calculation, working memory and attention tasks. The control group did not practice this package and, instead, attended meetings with the other members of the study several times along the course of the study. Both groups were evaluated before and after the intervention using a cross-modal oddball task measuring alertness and distraction. The results showed a significant reduction of distraction and an increase of alertness in the experimental group and no variation in the control group. These results suggest neurocognitive plasticity in the old human brain as training enhanced cognitive performance on attentional functions.

Hooker CI, Carol EE, Eisenstein TJ, Yin H, Lincoln SH, Tully LM, et al. (2014) A pilot study of cognitive training in clinical high risk for psychosis: Initial evidence of cognitive benefit. Schizophrenia Research, Volume 157 , Issue 1 , 314 - 316.

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Abstract

Individuals at clinical high risk (CHR) for psychosis have cognitive deficits that are associated with functional impairment and psychosis conversion (Giuliano et al., 2012). Targeted cognitive training (TCT) (i.e., intense, progressively difficult practice of a cognitive skill) improves cognition and daily functioning in schizophrenia (Wykes et al., 2011). TCT has been proposed as a preventive intervention for CHR, but research is minimal and optimal training parameters, including dose, intensity, and setting, are unknown. Because prolonged duration of untreated CHR symptoms can compromise outcome, rapid treatment response is essential (Fusar-Poli et al., 2009). However, ambiguous risk status, psychosis-related stigma, and practical scheduling problems can reduce treatment motivation and compliance. Without pilot data to guide intervention development, the randomized-controlled trials necessary to show efficacy of cognitive training in CHR may be unsuccessful.

This study investigated the feasibility and potential behavioral benefits of 40hours/8weeks of computer-based TCT in a single group of CHR participants. Cognitive and functional outcome were assessed with measures recommended for clinical trials, including the MATRICS Consensus Cognitive Battery (MCCB) and Global Functioning (GF): Role and Social scales(Cornblatt et al., 2007). Training performance was analyzed to: verify the relationship between training engagement and treatment outcome; identify an early predictor of treatment response; and evaluate intervention length.

2013

Kesler S, Hadi Hosseini SM, Heckler C, Janelsins M, Palesh O, Mustian K, & Morrow G. (2013). Cognitive training for improving executive function in chemotherapy-treated breast cancer survivors. Clinical Breast Cancer, 13(4), 299-306. doi: 10.1016/j.clbc.2013.02.004.

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Abstract

BACKGROUND:

A majority of breast cancer (BC) survivors, particularly those treated with chemotherapy, experience long-term cognitive deficits that significantly reduce quality of life. Among the cognitive domains most commonly affected include executive functions (EF), such as working memory, cognitive flexibility, multitasking, planning, and attention. Previous studies in other populations have shown that cognitive training, a behavioral method for treating cognitive deficits, can result in significant improvements in a number of cognitive skills, including EF.

MATERIALS AND METHODS:

In this study, we conducted a randomized controlled trial to investigate the feasibility and preliminary effectiveness of a novel, online EF training program in long-term BC survivors. A total of 41 BC survivors (21 active, 20 wait list) completed the 48 session training program over 12 weeks. The participants were, on average, 6 years after therapy.

RESULTS:

Cognitive training led to significant improvements in cognitive flexibility, verbal fluency and processing speed, with marginally significant downstream improvements in verbal memory as assessed via standardized measures. Self-ratings of EF skills, including planning, organizing, and task monitoring, also were improved in the active group compared with the wait list group.

CONCLUSIONS:

Our findings suggest that EF skills may be improved even in long-term survivors by using a computerized, home-based intervention program. These improvements may potentially include subjective EF skills, which suggest a transfer of the training program to real-world behaviors.

Sternberg DA, Ballard K, Hardy JL, Katz B, Doraiswamy PM, & Scanlon M. (2013). The largest human cognitive performance dataset reveals insights into the effects of lifestyle factors and aging. Frontiers in Human Neuroscience, 7:292. doi: 10.3389/fnhum.2013.00292.

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Abstract

Making new breakthroughs in understanding the processes underlying human cognition may depend on the availability of very large datasets that have not historically existed in psychology and neuroscience. Lumosity is a web-based cognitive training platform that has grown to include over 600 million cognitive training task results from over 35 million individuals, comprising the largest existing dataset of human cognitive performance. As part of the Human Cognition Project, Lumosity's collaborative research program to understand the human mind, Lumos Labs researchers and external research collaborators have begun to explore this dataset in order uncover novel insights about the correlates of cognitive performance. This paper presents two preliminary demonstrations of some of the kinds of questions that can be examined with the dataset. The first example focuses on replicating known findings relating lifestyle factors to baseline cognitive performance in a demographically diverse, healthy population at a much larger scale than has previously been available. The second example examines a question that would likely be very difficult to study in laboratory-based and existing online experimental research approaches at a large scale: specifically, how learning ability for different types of cognitive tasks changes with age. We hope that these examples will provoke the imagination of researchers who are interested in collaborating to answer fundamental questions about human cognitive performance.

Rattray B, & Smee D. (2013). Exercise improves reaction time without compromising accuracy in a novel easy-to-administer tablet-based cognitive task. Journal of Science and Medicine in Sport, 16(6), 567–570. doi: 10.1016/j.jsams.2012.12.007.

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Abstract

OBJECTIVES:

Moderate intensity aerobic exercise is known to facilitate cognitive performance but new technologies enable increasing opportunities to investigate this phenomenon under different circumstances. This study aimed to describe the effect of exercise on executive function assessed though a novel tablet-based test.

DESIGN:

Twenty healthy, active participants volunteered to take part in the randomised fully controlled trial.

METHODS:

Participants undertook an initial test of maximal aerobic capacity as well as ventilatory threshold during an incremental cycle test. A touch screen tablet computer was placed in the middle of the handlebars at an angle of approximately 45°, and participants were asked to complete the response-inhibition cognitive task (Speed Match, Lumos Labs Inc.) at set time points. A full familiarisation trial was performed prior to subsequent visits, in which participants completed either the control (no exercise) and exercise (90% ventilatory threshold (VT)) trials in a randomised order. During the 1 h trials, the cognitive task was performed prior to, during and post the intervention. Reaction time and accuracy of participant responses were recorded.

RESULTS:

Performing the cognitive task resulted in elevated heart rates and ventilation rates during control and exercise. Exercise facilitated performance in the executive function task such that reaction time was enhanced with no change in accuracy. A range of reliability measures are also reported.

CONCLUSIONS:

This method of assessing executive function during exercise displays face validity and provides promise for further investigation of cognitive function using a simple, short duration, easily administered and widely available test.

Schneider S, Abeln V, Popova J, Fomina E, Jacubowski A, Meeusen R, Struder HK. (2013). The influence of exercise on prefrontal cortex activity and cognitive performance during a simulated space flight to Mars (MARS500). Behavioural Brain Research, 236(1):1-7. doi: 10.1016/j.bbr.2012.08.022.

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Abstract

With respect to the plans of national and internationals space agencies to send people to Mars or Moon, long-term isolation studies are performed to learn about the psycho-physiological and psycho-social limitations of such missions. From June 3rd 2010 to November 4th 2011 six participants lived under totally isolated and confined conditions in the MARS500 habitat located in Moscow. Despite the possibility to mimic the condition of space travel, this study allowed for experimental conditions under very reliable and traceable conditions. As exercise is widely discussed to have a positive impact on neuro-cognitive performance, this study aimed to test the effect of different exercise protocol (endurance/strength orientated) on brain cortical activity and cognitive performance. Brain cortical activity was recorded using a 16 channel EEG before and after exercise across the 520 days of confinement. Cognitive performance was assessed using three commercially available brain games. Following the theory of transient hypofrontality, results show a significant decrease of frontal brain cortical activity after exercise (p<.05) which was most expressed after endurance orientated protocols. Cognitive performance was improved following running sessions on an active treadmill (p<.05). Results let us assume that not exercise per se acts as a neuro-enhancer. It is more likely that a general defocusing caused by an immersion into exercise is necessary to improve cognitive performance.

2011

Finn M, & McDonald S. (2011). Computerised cognitive training for older persons with mild cognitive impairment: A pilot study using a randomised controlled trial design. Brain Impairment, 12(3), 187–199. doi: 10.1375/brim.12.3.187.

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Abstract

The results of a pilot randomised controlled trial of computerised cognitive training in older adults with mild cognitive impairment (MCI) are reported. Participants (N = 25) were randomised into either the treatment or waitlist training groups. Sixteen participants completed the 30-session computerised cognitive training program using exercises that target a range of cognitive functions including attention, processing speed, visual memory and executive functions. It was hypothesised that participants would improve with practice on the trained tasks, that the benefits of training would generalise to nontrained neuropsychological measures, and that training would result in improved perceptions of memory and memory functioning when compared with waitlist controls. Results indicated that participants were able to improve their performance across a range of tasks with training. There was some evidence of generalisation of training to a measure of visual sustained attention. There were no significant effects of training on self-reported everyday memory functioning or mood. The results are discussed along with suggestions for future research.

Hardy JL, Drescher D, Sarkar K, Kellett G, & Scanlon M. (2011). Enhancing visual attention and working memory with a web-based cognitive training program. Mensa Research Journal, 42(2), 13–20.

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Abstract

A 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. To address these considerations, the present study evaluated an online cognitive training program comprised of 49 distinct 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. Participants 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. 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. Taken 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.

Kesler SR, Sheau K, Koovakkattu D, & Reiss AL. (2011). Changes in frontal-parietal activation and math skills performance following adaptive number sense training: preliminary results from a pilot study. Neuropsychological Rehabilitation, 21(4), 433-454. doi: 10.1080/09602011.2011.578446.

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Abstract

Number sense is believed to be critical for math development. It is putatively an implicitly learned skill and may therefore have limitations in terms of being explicitly trained, particularly in individuals with altered neurodevelopment. A case series study was conducted using an adaptive, computerised programme that focused on number sense and general problem-solving skills. The study was designed to investigate training effects on performance as well as brain function in a group of children with Turner syndrome who are at risk for math difficulties and altered development of math-related brain networks. Standardised measurements of math and math-related cognitive skills as well as functional magnetic resonance imaging (fMRI) were used to assess behavioural and neurobiological outcomes following training. Participants demonstrated significantly increased basic math skills, including number sense, and calculation as well as processing speed, cognitive flexibility and visual-spatial processing skills. With the exception of calculation, increased scores also were clinically significant (i.e., recovered) based on reliable change analysis. Participants additionally demonstrated significantly increased bilateral parietal lobe activation and decreased frontal-striatal and mesial temporal activation following the training programme. These findings show proof of concept for an accessible training approach that may be potentially associated with improved number sense, math and related skills, as well as functional changes in math-related neural systems, even among individuals at risk for altered brain development.

Kesler S, Lacayo N, & Booil J. (2011). A pilot study of an online cognitive rehabilitation program for executive function skills in children with cancer-related brain injury. Brain Injury, 24(1), 101–112. doi: 10.3109/02699052.2010.536194.

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Abstract

PRIMARY OBJECTIVES:

Children with a history of cancer are at increased risk for cognitive impairments, particularly in executive and memory domains. Traditional, in-person cognitive rehabilitation strategies may be unavailable and/or impractical for many of these children given difficulties related to resources and health status. The feasibility and efficacy of implementing a computerized, home-based cognitive rehabilitation curriculum designed to improve executive function skills was examined in these children.

METHODS:

A one-arm open trial pilot study of an original executive function cognitive rehabilitation curriculum was conducted with 23 paediatric cancer survivors aged 7-19.

RESULTS:

Compliance with the cognitive rehabilitation program was 83%, similar to that of many traditional programs. Following the cognitive intervention, participants showed significantly increased processing speed, cognitive flexibility, verbal and visual declarative memory scores as well as significantly increased pre-frontal cortex activation compared to baseline.

CONCLUSIONS:

These results suggest that a program of computerized cognitive exercises can be successfully implemented at home in young children with cancer. These exercises may be effective for improving executive and memory skills in this group, with concurrent changes in neurobiologic status.