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.

2019

Woo, Y. J., Kanellopoulos, A. K., Hemati, P., Kirschen, J., Nebel, R. A., Wang, T., ... & Abrahams, B. S. (2019). Domain-Specific Cognitive Impairments in Humans and Flies With Reduced CYFIP1 Dosage. Biological psychiatry. doi.org/10.1016/j.biopsych.2019.04.008

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Background: Deletions encompassing a four-gene region on chromosome 15 (BP1-BP2 at 15q11.2), seen at a population frequency of 1 in 500, are associated with increased risk for schizophrenia, epilepsy, and other common neurodevelopmental disorders. However, little is known in terms of how these common deletions impact cognition.
Methods: We used a Web-based tool to characterize cognitive function in a novel cohort of adult carriers and their noncarrier family members. Results from 31 carrier and 38 noncarrier parents from 40 families were compared with control data from 6530 individuals who self-registered on the Lumosity platform and opted in to participate in research. We then examined aspects of sensory and cognitive function in flies harboring a mutation in Cyfip, the homologue of one of the genes within the deletion. For the fly studies, 10 or more groups of 50 individuals per genotype were included.
Results: Our human studies revealed profound deficits in grammatical reasoning, arithmetic reasoning, and working memory in BP1-BP2 deletion carriers. No such deficits were observed in noncarrier spouses. Our fly studies revealed deficits in associative and nonassociative learning despite intact sensory perception.
Conclusions: Our results provide new insights into outcomes associated with BP1-BP2 deletions and call for a discussion on how to appropriately communicate these findings to unaffected carriers. Findings also highlight the utility of an online tool in characterizing cognitive function in a geographically distributed population.

2018

Ben-Zion, Z., Fine, N. B., Keynan, J. N., Admon, R., Green, N., Halevi, M., ... & Halpern, P. (2018). Cognitive flexibility predicts PTSD symptoms: observational and interventional studies. Frontiers in psychiatry, 9, 477. doi.org/10.3389/fpsyt.2018.00477

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Introduction: Post-Traumatic Stress Disorder (PTSD) is a prevalent, severe and tenacious psychopathological consequence of traumatic events. Neurobehavioral mechanisms underlying PTSD pathogenesis have been identified, and may serve as risk-resilience factors during the early aftermath of trauma exposure. Longitudinally documenting the neurobehavioral dimensions of early responses to trauma may help characterize survivors at risk and inform mechanism-based interventions. We present two independent longitudinal studies that repeatedly probed clinical symptoms and neurocognitive domains in recent trauma survivors. We hypothesized that better neurocognitive functioning shortly after trauma will be associated with less severe PTSD symptoms a year later, and that an early neurocognitive intervention will improve cognitive functioning and reduce PTSD symptoms.
Methods: Participants in both studies were adult survivors of traumatic events admitted to two general hospitals’ emergency departments (EDs) in Israel. The studies used identical clinical and neurocognitive tools, which included assessment of PTSD symptoms and diagnosis, and a battery of neurocognitive tests. The first study evaluated 181 trauma-exposed individuals one-, six-, and 14 months following trauma exposure. The second study evaluated 97 trauma survivors 1 month after trauma exposure, randomly allocated to 30 days of web-based neurocognitive intervention (n = 50) or control tasks (n = 47), and re-evaluated all subjects three- and 6 months after trauma exposure.
Results: In the first study, individuals with better cognitive flexibility at 1 month post-trauma showed significantly less severe PTSD symptoms after 13 months (p = 0.002). In the second study, the neurocognitive training group showed more improvement in cognitive flexibility post-intervention (p = 0.019), and lower PTSD symptoms 6 months post-trauma (p = 0.017), compared with controls. Intervention- induced improvement in cognitive flexibility positively correlated with clinical improvement (p = 0.002).
Discussion: Cognitive flexibility, shortly after trauma exposure, emerged as a significant predictor of PTSD symptom severity. It was also ameliorated by a neurocognitive intervention and associated with a better treatment outcome. These findings support further research into the implementation of mechanism-driven neurocognitive preventive interventions for PTSD.

Charvet, L., Shaw, M., Dobbs, B., Frontario, A., Sherman, K., Bikson, M., … Kasschau, M. (2018). Remotely Supervised Transcranial Direct Current Stimulation Increases the Benefit of At-Home Cognitive Training in Multiple Sclerosis. Neuromodulation : journal of the International Neuromodulation Society, 21(4), 383–389. doi:10.1111/ner.12583

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Objective: To explore the efficacy of remotely-supervised transcranial direct current stimulation (RS-tDCS) paired with cognitive training (CT) exercise in participants with multiple sclerosis (MS).
Methods: In a feasibility study of RS-tDCS in MS, participants completed ten sessions of tDCS paired with CT (1.5 mA × 20 min, dorsolateral prefrontal cortex montage). RS-tDCS participants were compared to a control group of adults with MS who underwent ten 20-min CT sessions through the same remotely supervised procedures. Cognitive outcomes were tested by composite scores measuring change in performance on standard tests (Brief International Cognitive Assessment in MS or BICAMS), basic attention (ANT-I Orienting and Attention Networks, Cogstate Detection), complex attention (ANT-I Executive Network, Cogstate Identification and One-Back), and intra-individual response variability (ANT-I and Cogstate identification; sensitive markers of disease status).
Results: After ten sessions, the tDCS group (n = 25) compared to the CT only group (n = 20) had significantly greater improvement in complex attention (p = 0.01) and response variability (p = 0.01) composites. The groups did not differ in measures of basic attention (p =0.95) or standard cognitive measures (p = 0.99).
Conclusions: These initial findings indicate benefit for RS-tDCS paired with CT in MS. Exploratory analyses indicate that the earliest tDCS cognitive benefit is seen in complex attention and response variability. Telerehabilitation using RS-tDCS combined with CT may lead to improved outcomes in MS.

Corti, C., Poggi, G., Romaniello, R., Strazzer, S., Urgesi, C., Borgatti, R., & Bardoni, A. (2018). Feasibility of a home-based computerized cognitive training for pediatric patients with congenital or acquired brain damage: An explorative study. PloS one, 13(6), e0199001.

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Objectives: Pediatric brain damage is associated with various cognitive deficits. Cognitive rehabilitation may prevent and reduce cognitive impairment. In recent years, home-based computerized cognitive training (CCT) has been introduced in clinical practice to increase treatment opportunities for patients (telerehabilitation). However, limited research has been conducted thus far on investigating the effects of remote CCT for the juvenile population in contexts other than English-speaking countries. The aim of the present study was to investigate the feasibility of a home-based CCT in a group of Italian adolescents with brain damage. A commercially available CCT (Lumosity) developed in the English language was used due to the lack of telerehabilitation programs in the Italian language that allow stimulation of multiple cognitive domains and, at the same time, remote automatic collection of data. Thus, this investigation provides information on the possibility of introducing CCT programs available in foreign languages in countries with limited investment in the telerehabilitation field.
Methods: 32 adolescents aged 11–16 with a diagnosis of congenital or acquired (either traumatic or non-traumatic) brain damage participated in the study. They received 40 training sessions (5 days/week for 8 weeks). Before starting the training program, they received face-to-face demonstration of training exercises and written instructions in their mother tongue. The feasibility of both training and study design and procedures was assessed through 9 criteria taken from extant literature.
Results: All 9 feasibility criteria were met. 31 out of the 32 participants demonstrated adherence to the training program. 94.2% of training sessions were completed in the recommended timeframe. No significant technical issue was found.
Conclusions: Telerehabilitation seems to be a feasible practice for adolescents with brain damage. A training program developed in a foreign language can be used to counter the unavailability of programs in patients’ mother tongue.

Bell, C. F., Warrick, M. M., Gallagher, K. C., & Baregamian, N. (2018). Neurocognitive performance profile postparathyroidectomy: a pilot study of computerized assessment. Surgery, 163(2), 457-462. doi.org/10.1016/j.surg.2017.09.001

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Background: Neurocognitive symptoms attributable to primary hyperparathyroidism are important diagnostic criteria, yet the basic characterization and assessment of neurocognitive deficits in primary hyperparathyroidism are not defined fully.
Methods: In this prospective pilot study, patients with unequivocal biochemical diagnosis of primary hyperparathyroidism were evaluated for neurocognitive performance preoperatively and postparathyroidectomy (2 weeks, 6 months) using a battery of computerized modular tests designed by LUMOSITY. The individual test scores and aggregate scores representing a subject's total neurocognitive performance profile were calculated. Statistical comparisons between groups were performed using univariate analysis and repeated measures of analysis of variance.
Results: In the study, 34 participants were assessed preoperatively; 18 completed all 3 assessments, 2 completed pretest and 6-month assessments, and 30 completed preoperative and 2-week postparathyroidectomy assessments. Primary hyperparathyroidism patients demonstrated significant deficits in memory, attention, mental flexibility, and speed of processing when compared with controls. Total neurocognitive performance profile score was significantly lower at the preoperative (P = .0001) and 2-week postparathyroidectomy (P = .0004) time points when compared with controls; this difference was bridged by 6 months postparathyroidectomy.
Conclusion: Computerized neurocognitive performance profile assessment validated the neurocognitive benefits of parathyroidectomy. Additional study is needed to determine if this novel method provides long-term, objective, quantifiable, and accessible neurocognitive performance profile assessment in primary hyperparathyroidism patients and can serve as a valuable diagnostic and prognostic tool.

Fine, N. B., Achituv, M., Etkin, A., Merin, O., & Shalev, A. Y. (2018). Evaluating web-based cognitive-affective remediation in recent trauma survivors: study rationale and protocol. European journal of psychotraumatology, 9(1), 1442602. doi.org/10.1080/20008198.2018.1442602

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Background: The immediate aftermath of traumatic events is a period of enhanced neural plasticity, following which some survivors remain with post-traumatic stress disorder (PTSD) whereas others recover. Evidence points to impairments in emotional reactivity, emotion regulation, and broader executive functions as critically contributing to PTSD. Emerging evidence further suggests that the neural mechanisms underlying these functions remain plastic in adulthood and that targeted retraining of these systems may enhance their efficiency and could reduce the likelihood of developing PTSD. Administering targeted neurocognitive training shortly after trauma exposure is a daunting challenge. This work describes a study design addressing that challenge. The study evaluated the direct effects of cognitive remediation training on neurocognitive mechanisms that hypothetically underlay PTSD, and the indirect effect of this intervention on emerging PTSD symptoms.
Method: We describe a study rationale, design, and methodological choices involving: (a) participants’ enrollment; (b) implementation and management of a daily self-administered, web-based intervention; (c) reliable, timely screening and assessment of treatment of eligible survivors; and (d) defining control conditions and outcome measures. We outline the rationale of choices made regarding study sample, timing of intervention, measurements, monitoring participants’ adherence, and ways to harmonize and retain interviewers’ fidelity and mitigate eventual burnout by repeated contacts with recently traumatized survivors.
Conclusion: Early web-based interventions targeting causative mechanisms of PTSD can be informed by the model presented in this paper.

McAdams-DeMarco, M. A., Konel, J., Warsame, F., Ying, H., Fernández, M. G., Carlson, M. C., ... & Segev, D. L. (2018). Intradialytic cognitive and exercise training may preserve cognitive function. Kidney international reports, 3(1), 81-88. doi.org/10.1016/j.ekir.2017.08.006

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Introduction: Cognitive decline is common and increases mortality risk in hemodialysis patients. Intradialytic interventions like cognitive training (CT) and exercise training (ET) may preserve cognitive function.
Methods: We conducted a pilot randomized controlled trial of 20 hemodialysis patients to study the impact of 3 months of intradialytic CT (tablet-based brain games) (n = 7), ET (foot peddlers) (n = 6), or standard of care (SC) (n = 7) on cognitive function. Global cognitive function was measured by the Modified Mini Mental Status Exam (3MS), psychomotor speed was measured by Trail Making Tests A and B (TMTA and TMTB), and executive function was assessed by subtracting (TMTB − TMTA). Lower 3MS scores and slower TMTA and TMTB times reflected worse cognitive function. P values for differences were generated using analysis of variance, and 95% confidence intervals (CIs) and P values were generated from linear regression.
Results: Patients with SC experienced a decrease in psychomotor speed and executive function by 3 months (TMTA: 15 seconds; P = 0.055; TMTB: 47.4 seconds; P = 0.006; TMTB − TMTA; 31.7 seconds; P = 0.052); this decline was not seen among those with CT or ET (all P > 0.05). Compared with SC, the difference in the mean change in 3MS score was −3.29 points (95% CI: −11.70 to 5.12; P = 0.42) for CT and 4.48 points (95% CI: −4.27 to 13.22; P = 0.30) for ET. Compared with SC, the difference in mean change for TMTA was −15.13 seconds (95% CI: −37.64 to 7.39; P = 0.17) for CT and −17.48 seconds (95% CI: −41.18 to 6.22; P = 0.14) for ET, for TMTB, the difference was −46.72 seconds (95% CI: −91.12 to −2.31; P = 0.04) for CT and −56.21 seconds (95% CI: −105.86 to −6.56; P = 0.03) for ET, and for TMTB – TMTA, the difference was −30.88 seconds (95% CI: −76.05 to 14.28; P = 0.16) for CT and −34.93 seconds (95% CI: −85.43 to 15.56; P = 0.16) for ET.
Conclusion: Preliminary findings of our pilot study suggested that cognitive decline in psychomotor speed and executive function is possibly prevented by intradialytic CT and ET. These preliminary pilot findings should be replicated.

2017

Guerra-Carrillo, B., Katovich, K., & Bunge, S. A. (2017). Does higher education hone cognitive functioning and learning efficacy? Findings from a large and diverse sample. PloS one, 12(8), e0182276. doi.org/10.1371/journal.pone.0182276

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Attending school is a multifaceted experience. Students are not only exposed to new knowledge but are also immersed in a structured environment in which they need to respond flexibly in accordance with changing task goals, keep relevant information in mind, and constantly tackle novel problems. To quantify the cumulative effect of this experience, we examined retrospectively and prospectively, the relationships between educational attainment and both cognitive performance and learning. We analyzed data from 196,388 subscribers to an online cognitive training program. These subscribers, ages 15–60, had completed eight behavioral assessments of executive functioning and reasoning at least once. Controlling for multiple demographic and engagement variables, we found that higher levels of education predicted better performance across the full age range, and modulated performance in some cognitive domains more than others (e.g., reasoning vs. processing speed). Differences were moderate for Bachelor’s degree vs. High School (d = 0.51), and large between Ph.D. vs. Some High School (d = 0.80). Further, the ages of peak cognitive performance for each educational category closely followed the typical range of ages at graduation. This result is consistent with a cumulative effect of recent educational experiences, as well as a decrement in performance as completion of schooling becomes more distant. To begin to characterize the directionality of the relationship between educational attainment and cognitive performance, we conducted a prospective longitudinal analysis. For a subset of 69,202 subscribers who had completed 100 days of cognitive training, we tested whether the degree of novel learning was associated with their level of education. Higher educational attainment predicted bigger gains, but the differences were small (d = 0.04–0.37). Altogether, these results point to the long-lasting trace of an effect of prior cognitive challenges but suggest that new learning opportunities can reduce performance gaps related to one’s educational history.

Clark, C. M., Lawlor-Savage, L., & Goghari, V. M. (2017). Working memory training in healthy young adults: Support for the null from a randomized comparison to active and passive control groups. PloS one, 12(5), e0177707. doi.org/10.1371/journal.pone.0177707

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Training of working memory as a method of increasing working memory capacity and fluid intelligence has received much attention in recent years. This burgeoning field remains highly controversial with empirically-backed disagreements at all levels of evidence, including individual studies, systematic reviews, and even meta-analyses. The current study investigated the effect of a randomized six week online working memory intervention on untrained cognitive abilities in a community-recruited sample of healthy young adults, in relation to both a processing speed training active control condition, as well as a no-contact control condition. Results of traditional null hypothesis significance testing, as well as Bayesian factor analyses, revealed support for the null hypothesis across all cognitive tests administered before and after training. Importantly, all three groups were similar at pre-training for a variety of individual variables purported to moderate transfer of training to fluid intelligence, including personality traits, motivation to train, and expectations of cognitive improvement from training. Because these results are consistent with experimental trials of equal or greater methodological rigor, we suggest that future research re-focus on: 1) other promising interventions known to increase memory performance in healthy young adults, and; 2) examining sub-populations or alternative populations in which working memory training may be efficacious.

Richards, A., Inslicht, S. S., Metzler, T. J., Mohlenhoff, B. S., Rao, M. N., O’Donovan, A., & Neylan, T. C. (2017). Sleep and cognitive performance from teens to old age: more is not better. Sleep, 40(1), zsw029.

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Objectives: To determine the interaction of age and habitual sleep duration in predicting cognitive performance in a large sample of participants aged 15 to 89 years.
Methods: This study is a cross-sectional analysis of performance data gathered between January 2012 and September 2013. First-time players (N = 512823) of three internet cognitive training games measuring processing speed, working memory, visuospatial memory, and arithmetic participated in the study.
Results: Performance was based on a measure of speed and accuracy for each game. The relationship between performance and self-reported habitual sleep duration was examined in the sample as a whole and across 10-year age groups starting at age 15 and ending at 75 and older. Performance peaked at 7 h of sleep duration for all three games in the sample as a whole, and the decrements in performance for sleep durations greater than 7 h were either comparable or greater in the youngest as compared to the oldest age groups.
Conclusions: These findings challenge the hypothesis that deteriorating cognitive performance with long sleep duration is driven by medical comorbidities associated with aging. Further, these data are consistent with an optimal dose model of sleep and suggest that the model for the homeostatic recovery of cognitive function as a function of sleep duration should incorporate a curvilinear decline with longer duration sleep, indicating that there may be a cost to increased sleep. Replication and further research is essential for clarifying the sleep duration–cognition relationship in youth and adults of all ages.

Ballesteros, S., Mayas, J., Ruiz-Marquez, E., Preito, A., Toril, P., Ponce de Leon, L., de Ceballos, M.L., Reales Avilés, J.M. (2017) Effects of Video Game Training on Behavioral and Electrophysiological Measures of Attention and Memory: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. 2017 Jan 24;6(1):e8. doi: 10.2196/resprot.6570

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Background: Neuroplasticity-based approaches seem to offer promising ways of maintaining cognitive health in older adults and postponing the onset of cognitive decline symptoms. Although previous research suggests that training can produce transfer effects, this study was designed to overcome some limitations of previous studies by incorporating an active control group and the assessment of training expectations.
Objective: The main objectives of this study are (1) to evaluate the effects of a randomized computer-based intervention consisting of training older adults with nonaction video games on brain and cognitive functions that decline with age, including attention and spatial working memory, using behavioral measures and electrophysiological recordings (event-related potentials [ERPs]) just after training and after a 6-month no-contact period; (2) to explore whether motivation, engagement, or expectations might account for possible training-related improvements; and (3) to examine whether inflammatory mechanisms assessed with noninvasive measurement of C-reactive protein in saliva impair cognitive training-induced effects. A better understanding of these mechanisms could elucidate pathways that could be targeted in the future by either behavioral or neuropsychological interventions.
Methods: A single-blinded randomized controlled trial with an experimental group and an active control group, pretest, posttest, and 6-month follow-up repeated measures design is used in this study. A total of 75 cognitively healthy older adults were randomly distributed into experimental and active control groups. Participants in the experimental group received 16 1-hour training sessions with cognitive nonaction video games selected from Lumosity, a commercial brain training package. The active control group received the same number of training sessions with The Sims and SimCity, a simulation strategy game.
Results: We have recruited participants, have conducted the training protocol and pretest assessments, and are currently conducting posttest evaluations. The study will conclude in the first semester of 2017. Data analysis will take place during 2017. The primary outcome is transfer of benefit from training to attention and working memory functions and the neural mechanisms underlying possible cognitive improvements.
Conclusions: We expect that mental stimulation with video games will improve attention and memory both at the behavioral level and in ERP components promoting brain and mental health and ext

2016

Torous, J., Staples, P., Fenstermacher, E., Dean, J., & Keshavan, M. (2016). Barriers, Benefits, and Beliefs of Brain Training Smartphone Apps: An Internet Survey of Younger US Consumers. Frontiers in human neuroscience, 10. doi: 10.3389/fnhum.2016.00180

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Background: While clinical evidence for the efficacy of brain training remains in question, numerous smartphone applications (apps) already offer brain training directly to consumers. Little is known about why consumers choose to download these apps, how they use them, and what benefits they perceive. Given the high rates of smartphone ownership in those with internet access and the younger demographics, we chose to approach this question first with a general population survey that would capture primarily this demographic.
Method: We conducted an online internet-based survey of the US population via mTurk regarding their use, experience, and perceptions of brain training apps. There were no exclusion criteria to partake although internet access was required. Respondents were paid 20 cents for completing each survey. The survey was offered for a 2-week period in September 2015.
Results: 3125 individuals completed the survey and over half of these were under age 30. Responses did not significantly vary by gender. The brain training app most frequently used was Lumosity. Belief that a brain-training app could help with thinking was strongly correlated with belief it could also help with attention, memory, and even mood. Beliefs of those who had never used brain-training apps were similar to those who had used them. Respondents felt that data security and lack of endorsement from a clinician were the two least important barriers to use.
Discussion: Results suggest a high level of interest in brain training apps among the US public, especially those in younger demographics. The stability of positive perception of these apps among app-naïve and app-exposed participants suggests an important role of user expectations in influencing use and experience of these apps. The low concern about data security and lack of clinician endorsement suggest apps are not being utilized in clinical settings. However, the public’s interest in the effectiveness of apps suggests a common theme with the scientific community’s concerns about direct to consumer brain training programs.

Wentink, M.M., Berger, M.A.M., de Kloet, A.J., Meesters, H., Band, G.P.H., Wolterbeek, R., Goossens, P.H., Vliet Vlieland, T.P.M. (2016). The effects of an 8-week computer-based brain training programme on cognitive functioning, QoL and self-efficacy after stroke. Neurospychological Rehabilitation: An International Journal, volume 26, Issue 5-6. doi:10.1080/09602011.2016.1162175

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Cognitive impairment after stroke has a direct impact on daily functioning and quality of life (QoL) of patients and is associated with higher mortality and healthcare costs. The aim of this study was to determine the effect of a computer-based brain training programme on cognitive functioning, QoL and self-efficacy compared to a control condition in stroke patients. Stroke patients with self-perceived cognitive impairment were randomly allocated to the intervention or control group. The intervention consisted of an 8-week brain training programme (Lumosity Inc.®). The control group received general information about the brain weekly. Assessments consisted of a set of neuropsychological tests and questionnaires. In addition, adherence with trained computer tasks was recorded. No effect of the training was found on cognitive functioning, QoL or self-efficacy when compared to the control condition, except for very limited effects on working memory and speed. This study found very limited effects on neuropsychological tests that were closely related to trained computer tasks, but no transfers to other tests or self-perceived cognitive failures, QoL or self-efficacy. These findings warrant the need for further research into the value of computer-based brain training to improve cognitive functioning in the chronic phase after stroke.

Toril P, Reales JM, Mayas J and Ballesteros S (2016) Video Game Training Enhances Visuospatial Working Memory and Episodic Memory in Older Adults. Front. Hum. Neurosci. 10:206. doi: 10.3389/fnhum.2016.00206

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In this longitudinal intervention study with experimental and control groups, we investigated the effects of video game training on the visuospatial working memory (WM) and episodic memory of healthy older adults. Participants were 19 volunteer older adults, who received 15 1-h video game training sessions with a series of video games selected from a commercial package (Lumosity), and a control group of 20 healthy older adults. The results showed that the performance of the trainees improved significantly in all the practiced video games. Most importantly, we found significant enhancements after training in the trained group and no change in the control group in two computerized tasks designed to assess visuospatial WM, namely the Corsi blocks task and the Jigsaw puzzle task. The episodic memory and short-term memory of the trainees also improved. Gains in some WM and episodic memory tasks were maintained during a 3-month follow-up period. These results suggest that the aging brain still retains some degree of plasticity, and that video game training might be an effective intervention tool to improve WM and other cognitive functions in older adults.

Thompson, P.J., Conn, H., Baxendale, S.A., Connachie, E., McGrath, K., Geralid, C., Duncan, J.S. (2016) Optimizing memory function in temporal lobe epilepsy. Seizure. Vol 38, 68-74. doi 10.1016/j.seizure.2016.04.008

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PURPOSE: The 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).
METHODS: Seventy-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.
RESULTS: Group 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.
CONCLUSIONS: The 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.

Newport, B. (2016) Cognitive and Non-Cogntivie Variables Affecting Academic Performance in College Students. Presented at the National Congerence on Undergraduate Research (NCUR) 2016 in Asheville, North Carolina.

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Recent research indicates an important role for non-cognitive variables in learning by college students. The present study was conducted to explore the relationships among growth mindset, self-efficacy, grit, Lumosity cognitive training, and academic performance, particularly in underprepared college students. Results could suggest how to improve academic performance of these students. Out of 117 possible participants, 83 (47 males and 36 females) who were enrolled in either a general psychology (GP), a freshman seminar (FS), or a remedial study skills (RSS) course completed two surveys. One survey was sent within the first 4 weeks of the semester and a second during the last 3 weeks of the semester to measure growth mindset, self-efficacy, and grit. Between those surveys, Group RSS participated in Lumosity, a collection of web-based games, and underwent intensive growth mindset, grit, and selfefficacy interventions. Group GP had basic exposure to growth mindset concepts. Group FS was the control group with no interventions. When comparing beginning and end survey results, we found significant improvement in selfefficacy across Groups FS (paired samples Wilcoxon test, p < 0.001) and RSS (p=0.048). Group FS significantly improved in grit (p < 0.001), and Group RSS showed almost significant improvement (p = 0.087). Group GP, which included more than 50% non-freshman, showed almost significant increases in grit (p = 0.052) but not in self-efficacy. In linear regression analyses, growth mindset and grit were significant predictors of self-efficacy. Lumosity cumulative performance, attention, and flexibility scores increased significantly (paired t-tests, p < 0.025) but were not predicted by our non-cognitive measures. In spite of improvements in non-cognitive variables, it is uncertain why the improvements occurred or whether they are predictive of cognitive performance. We hope to clarify these questions by analyses of the relationship between non-cognitive variables and grade point averages.

Lathan, C., Wallace, A.S., Shewbridge, R., Ng, N., Morrison, G., Resnick, H.E. (2016). Cognitive health assessment and establishment of a virtual cohort of dementia caregivers. Dementia and Geriatric Cognitive Disorders. 2016;6:98-107. doi: 10.1159/000444390

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Background: Many factors impact caregivers' cognitive health and, by extension, their ability to provide care. This study examined the relationship between psychosocial factors and cognitive performance among dementia caregivers and established a virtual cohort of caregivers for future research.
Methods: Data on 527 caregivers were collected via a Web-based survey that assessed cognitive performance. Caregiver data were compared to corresponding data from 527 age-, race-, gender-, and education-matched controls from a normative database. Caregiver self-reported sleep, stress, health, and social support were also assessed.
Results: Caregivers performed significantly worse than controls on 3 of 5 cognitive subtests. Stress, sleep, perceived support, self-rated health, years of caregiving, race, and gender were significant predictors of cognitive performance.
Conclusion: In this sample of dementia caregivers, psychosocial factors interacted in complex ways to impact cognitive performance. Further investigation is needed to better understand how these factors affect cognitive performance among caregivers. This could be accomplished by the establishment of a virtual cohort that facilitates the development of digital tools to support the evaluation and management of caregiver needs in a manner that helps them remain effective in their caregiving roles.

2015

Humeidan, M.L., Otey, A. Culeta-Alarcon, A., Mavarex-Martinez, A., Stoicea, N., Bergese, S. (2015) Perioperative cognitive protection - cognitive exercise and cognitive reserve (The Neurobics Trial): A single blind randomized trial. Clinical Therapuetics vol 37. doi: 10.1016/j.clinthera.2015.10.013

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PURPOSE: The Neurobics Trial is a single-blind, parallel-group, randomized, controlled trial. The main study objective is to compare effectiveness of preoperative cognitive exercise versus no intervention for lowering the incidence of postoperative delirium. Enrollment began March 2015 and is ongoing.
METHODS: Eligible participants include patients older than 60 years of age scheduled for nonemergent, noncardiac, nonneurological surgery at our institution. Patients provide consent and are screened at our Outpatient Preoperative Assessment Clinic to rule out preexisting cognitive dysfunction, significant mental health disorders, and history of surgery requiring general anesthesia in the preceding 6 months. Participants meeting criteria are randomized to complete 1 hour daily of electronic tablet-based cognitive exercise for 10 days before surgery or no preoperative intervention. Compliance with the effective dose of 10 total hours of preoperative exercise is verified on return of the patient for surgery with time logs created by the software application and by patient self-reporting. After surgery, patients are evaluated for delirium in the postanesthesia recovery area, and then twice daily for the remainder of their hospitalization. Additionally, postoperative quality of recovery is assessed daily, along with pain scores and opiate use. More comprehensive cognitive assessments are completed just before discharge for baseline comparison, and quality of recovery is assessed via telephone interview 7, 30, and 90 days post-surgery. The primary outcome is the incidence of delirium during the postoperative hospitalization period. Randomization is computer generated, with allocation concealment in opaque envelopes. All postoperative assessments are completed by blinded study personnel.
FINDINGS: The study is actively recruiting with 19 patients having provided consent to date, and a total of 264 patients is required for study completion; therefore, no data analysis is currently under way (www.clinicaltrials.gov; NCT02230605).
IMPLICATIONS: To our knowledge, the Neurobics Trial is the first randomized, controlled study to investigate the effectiveness of a significant preoperative cognitive exercise regimen for the prevention of delirium after noncardiac, nonneurological surgery in elderly patients.

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.

Schofield, H., Loewenstein, G., Kopsic, J., Volpp, K.G. (2015) Comparing the effectiveness of individualistic, altruistic, and competitive incentives in motivating completion of mental exercises. Journal of Health Economics. Vol 44, 286-299. doi: 10.1016/j.jhealeco.2015.09.007

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Abstract

This study examines the impact of individually oriented, purely altruistic, and a hybrid of competitive and cooperative monetary reward incentives on older adults' completion of cognitive exercises and cognitive function. We find that all three incentive structures approximately double the number of exercises completed during the six-week active experimental period relative to a no incentive control condition. However, the altruistic and cooperative/competitive incentives led to different patterns of participation, with significantly higher inter-partner correlations in utilization of the software, as well as greater persistence once incentives were removed. Provision of all incentives significantly improved performance on the incentivized exercises. However, results of an independent cognitive testing battery suggest no generalizable gains in cognitive function resulted from the training.

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.

Rattray, B., Smee, D.J. (2015) The effect of high and low exercise intensity periods on a simple memory recognition test. Journal of Sport and Health Science. In Press, Corrected Proof. doi.org/10.1016/j.jshs.2015.01.005

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Abstract

Purpose: The purpose of this study was to investigate the effect of variable intensities on a simple memory recognition task during exercise.
Methods: Twenty active participants took part in initial testing, a familiarization trial and then four 60 min cycling interventions in a randomized order. Interventions consisted of no exercise (control), constant exercise at 90% ventilatory threshold (constant) and 2 trials that initially mimicked the constant trial, but then included periods of high (∼90% VO2peak) and low intensities (∼50%VO2peak). Cardiorespiratory measures and capillary blood samples were taken throughout. A short tablet-based cognitive task was completed prior to and during (50 and 55 min into exercise) each intervention.
Results: The exercise conditions facilitated response time (p = 0.009), although the extent of this effect was not as strong in the variable exercise conditions (p = 0.011–0.089). High intensity exercise periods resulted in some cognitive regression back towards control trial performance. Elevations in cardiorespiratory measures and periods of hypocapnia could not explain changes in cognitive performance.
Conclusion: Changes in cognitive performance with variations in exercise intensity are likely to have implications for sport and occupational settings. The timing of cognitive tests to exercise intensity changes as well as use of short cognitive assessments will be important for future work.

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.

Hooker, C. 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. doi: http://dx.doi.org/10.1016/j.schres.2014.05.034

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Abstract

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.

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.

Abstract plus Abstract minus

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.

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.

Zickefoose, S., Hux, K., Brown, J., & Wulf, K. (2013). Let the games begin: a preliminary study using attention process training-3 and Lumosity brain games to remediate attention deficits following traumatic brain injury. Brain Inj, 27(6), 707-716. doi: 10.3109/02699052.2013.775484

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Abstract

PRIMARY OBJECTIVE: Computer-based treatments for attention problems have become increasingly popular and available. The researchers sought to determine whether improved performance by survivors of severe traumatic brain injury (TBI) on two computer-based treatments generalized to improvements on comparable, untrained tasks and ecologically-plausible attention tasks comprising a standardized assessment. RESEARCH DESIGN: The researchers used an -A-B-A-C-A treatment design repeated across four adult survivors of severe TBI. METHODS AND PROCEDURES: Participants engaged in 8 weeks of intervention using both Attention Process Training-3 (APT-3) and Lumosity™ (2010) Brain Games. Two participants received APT-3 treatment first, while the other two received Lumosity™ treatment first. All participants received both treatments throughout the course of two, 1-month intervention phases. MAIN OUTCOMES AND RESULTS: Individual growth curve analyses showed participants made significant improvements in progressing through both interventions. However, limited generalization occurred: one participant demonstrated significantly improved performance on one of five probe measures and one other participant showed improved performance on some sub-tests of the Test of Everyday Attention; no other significant generalization results emerged. These findings call into question the assumption that intervention using either APT-3 or Lumosity™ will prompt generalization beyond the actual tasks performed during treatment.

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.

2012

Kpolovie, P.J. (2012) Lumosity training and brain-boosting food effects on learning. Education Research Journal Vol. 2(6): 186 – 198.

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Abstract

This randomized six-group experimental study investigated the effects of lumosity training, and brain-boosting food on students' learning, in order to proffer optimum functional or workable solution to the ever fresh question of how learning could best be improved. Seventy-two randomly drawn subjects and four treatments cum two control conditions were randomized into six groups of 4 treatments and 2 controls of 12 each. For six weeks that the experiment lasted, while one of the experimental brain-boosting food groups received brain-boosting food (salmon, mackerel and sardines, that are rich in omega-3 essential fatty acids as well as blueberries, mangoes plus watermelon that are antioxidant), the other received suitable dose of brain-boosting food supplements (ginkgo biloba and folic acid), while eating normal food. While one of the two lumosity training groups exercised the brain with it for 15 minutes twice a day, the other did for 30 minutes twice daily; each preceding a two-hour prep time. The control groups' members of course, were accorded no treatment. Results showed positive significant effects of lumosity training and brain-boosting food on learning as subjects in each of the treatment groups learned significantly better than their counterparts in the control groups. Consequently, brain-enhancement exercise with lumosity training, and eating of brain-boosting food were recommended.

Koorenhof, L., Baxendale, S., Smith, N., & Thompson, P. (2012). Memory rehabilitation and brain training for surgical temporal lobe epilepsy patients: a preliminary report. Seizure, 21(3), 178-182. doi.org/10.1016/j.seizure.2011.12.001

Abstract plus Abstract minus

Abstract

The short term impact of a memory rehabilitation programme on verbal memory test performance and subjective ratings of memory in everyday life was assessed in healthy controls and left temporal lobe epilepsy (LTLE) surgical patients. The intervention involved training in the use of external and internal memory support strategies. Half of the sample in addition undertook computerised brain training exercises as homework. LTLE patients were seen either before surgery or 3–6 months after their operation. Improvements in verbal memory were observed in both groups. An effect of brain training was recorded but this did not occur in a consistent direction. Subjective ratings of memory indicated improvements that were significant for the LTLE group but not the controls. Positive changes in the memory outcome measures were associated with improvements in mood. Pre-operative memory rehabilitation was not associated with better outcomes than post-operative intervention. Further research is needed to explore the persistence of the changes observed and to explore if pre-operative rehabilitation offsets post-operative memory decline.

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.

Abstract plus Abstract minus

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.