Working Memory Training in Individuals With Huntington's Disease: A Pilot Project
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 9
- 试验地点
- 2
- 主要终点
- Adherence to training (defined by completing the intervention within the recommended time frame)
研究概览
简要总结
There is a paucity of investigation into effective interventions to enhance cognitive function and/or mitigate cognitive decline in individuals with Huntington disease (HD). This study targeted working memory (WM), which is the ability to actively hold information in the mind in order to perform complex mental tasks, given reports of WM dysfunction in patients with HD. The investigators examined the feasibility of conducting a 5-week WM training program (Cogmed). Patient adherence and treatment tolerance were assessed. In addition, preliminary evidence for the efficacy of this training program on targeted cognitive abilities was examined. Nine patients with pre-manifest or early stage HD underwent training. Patients were assessed before the intervention and one week after completion.
详细描述
Huntington disease (HD) is associated with a variety of cognitive deficits, with prominent difficulties in working memory (WM). WM deficits are notably compromised in early-onset and prodromal HD patients. This study aimed to determine the feasibility of a computer-ized WM training program (Cogmed QM), novel to the HD population. Nine patients, aged 26-62, with early stage HD underwent a 25-session (5 days/week for 5 weeks) WM training program (Cogmed QM). Training exercises involved the manipulation and storage of verbal and visuospatial information, with difficulty adapted as a function of individual performance. Neuropsychological testing was conducted before and after training, and performance on criterion WM measures (Digit Span and Spatial Span) and near-transfer WM measures (Symbol Span and Auditory WM) were evaluated. Post-training inter-views about patient experience were thematically analyzed using NVivo software. Seven of nine patients demonstrated adherence to the training and completed all sessions within the recommended timeframe of 5 weeks. All adherent patients reported that they found training helpful (n=7), and almost all felt that their memory improved (n=6). Compared to baseline scores, patients showed significant improvement on the neuropsychological measures of verbal WM, including Digit Span (p = .047) and Auditory WM (p = .041). This pilot study provides support for feasibility of computerized WM training in early-stage patients with HD. Results suggest that HD patients can improve WM with intensive training, though a full-scale intervention project is needed to understand the reliability of changes over time.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 20 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Laboratory-confirmed gene expansion of at least 36 CAG repeats
- •Reported working memory difficulties on the Patient-Reported Outcomes in Cognitive Impairment (PROCOG) questionnaire
- •Total Functional Capacity (TFC) score of at least 3, taken from the UHDRS
- •Montreal Cognitive Assessment (MOCA) score of 19 or greater
排除标准
- •History of head trauma/neurological event such as stroke
- •Untreated psychiatric symptoms or substance abuse
- •Visual or motor symptoms that would impede ability to complete the program and/or neuropsychological testing
- •Nonfluency in English
结局指标
主要结局
Adherence to training (defined by completing the intervention within the recommended time frame)
时间窗: 40 days
Adherence was defined as completion of at least 80% of the total 25 training sessions within 40 calendar days or less
次要结局
- Symbol Digits Modalities Test (oral administration)(Baseline (time 0) versus Post-intervention test score (up to 45 days post-baseline))
- Symbol span subtest from the Wechsler Memory Scales - fourth edition, reported in raw score units (total correct responses)(Baseline (time 0) versus Post-intervention test score (up to 45 days post-baseline))
- Digit Span subtest from the Wechsler Memory Scales - third edition(Baseline (time 0) versus Post-intervention test score (up to 45 days post-baseline))
- Trail Making Test - Parts A and B(Baseline (time 0) versus Post-intervention test score (up to 45 days post-baseline))
- Spatial Span subtest from the Wechsler Memory Scales - third edition(Baseline (time 0) versus Post-intervention test score (up to 45 days post-baseline))
- Auditory Working Memory from the Woodcock Johnson Tests of Cognitive Ability - third edition(Baseline (time 0) versus Post-intervention test score (up to 45 days post-baseline))
- Verbal Fluency subtest from the Delis-Kaplan Executive Function System(Baseline (time 0) versus Post-intervention test score (up to 45 days post-baseline))
- Word List Learning from the Hopkins Verbal Learning Test -Revised(Baseline (time 0) versus Post-intervention test score (up to 45 days post-baseline))
研究者
Christine Till
Associate Professor, Department of Psychology
York University