Investigating the Beneficial Effects of Mindfulness-based Training on Neuropsychological Outcomes in Mild Cognitive Impairment
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Mild Cognitive Impairment
- Sponsor
- Singapore General Hospital
- Enrollment
- 81
- Locations
- 1
- Primary Endpoint
- Change in Immediate Memory
- Status
- Completed
- Last Updated
- 6 years ago
Overview
Brief Summary
This study evaluates the effects of Mindfulness-based Interventions (MBI) on the neuropsychological profile of individuals with mild cognitive impairment (MCI). It will also investigate changes in fMRI activity, such as resting-state functional connectivity networks and changes in activity in attention networks in task-related fMRI using graph theory analysis after Mindfulness-based Interventions. Participants will be randomly assigned to receive either the Mindfulness-Based Intervention, Cognitive Rehabilitation Training or Treatment as Usual as the passive control group comparison.
Detailed Description
As the population of Singapore ages rapidly, cognitive decline associated with both normal aging and disease is becoming a frequently encountered health challenge. In our proposed study, we will investigate the effects of mindfulness-based interventions (MBI), which have shown significant promise in halting and even reversing age-related cognitive impairment. MBI enhances the quality and frequency of mindfulness, defined as a mental state achieved by focusing one's attention and awareness on the present moment, while calmly acknowledging and accepting one's feelings, thoughts, and bodily sensations. In this study, we will administer a standardized MBI program or Cognitive Rehabilitation Therapy to a group of 60 patients diagnosed with mild cognitive impairment (MCI), a condition marked by deficits in language, memory and attention that often leads to dementia; an additional 30 patients will be assigned to the control group. There will be 3 runs with 30 persons per run; each group will have 10 randomly assigned participants. By comparing the 3 groups across the 3 runs, we seek to test the following hypotheses: 1) MBI will result in significantly greater improvements in neuropsychological testing outcomes across multiple cognitive domains, including attention, memory, language and processing speed, 2) MBI will strengthen cortical connectivity as measured by functional magnetic resonance imaging (fMRI), and 3) MBI will lead to changes in fMRI activation on a test of facets of attention. Neuropsychological testing will take place in SGH, while fMRI and EEG scanning will take place in the Center for Cognitive Neuroscience at Duke-NUS. Both the MBI and CRT will be facilitated by trained personnel. Our proposed experiment comprises one of the most comprehensive interrogations of the effects of MBT on patients to date, and if successful, could rapidly translate into a program with both clinical and economic impact.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Fluent in English
- •Mild Cognitive Impairment: Fulfill Diagnostic and Statistical Manual of Mental Disorders version five (DSM-V) diagnostic criteria for Minor Neurocognitive Disorder
- •MMSE score = 20-30
- •Clinical Dementia Rating Score (CDR) = 0.5
- •Age: ≤75 years
Exclusion Criteria
- •Presence of major neurological conditions such as epilepsy, stroke, Parkinson's Disease and or brain injury
- •Presence of major psychiatric conditions such as major depression or schizophrenia
- •Unsuitability for fMRI scanning (e.g. pacemakers, metallic implants, claustrophobia)
- •Unable to give or no consent available
- •Left-handed participants may take part in the study but will not undergo fMRI scanning
Outcomes
Primary Outcomes
Change in Immediate Memory
Time Frame: 10 minutes
The RBANS Immediate Memory Index is composite of the learning (immediate) trials of the Story Memory and List Learning subtests. This index is a measure of initial encoding and learning complex and simple verbal information. Low scores on this index indicate difficulties with verbal learning.
Chang in Mindfulness Awareness and Attention Scores
Time Frame: An average of 3 months
Dispositional Mindfulness and present-centered attention-awareness in everyday experience is measured with this scale. This instrument focused on the absence of attention to and awareness of present experience, and operationalized mindfulness as a single construct.
Change in Processing Speed: Colour Trails 1 and 2
Time Frame: 10 minutes
Speed of cognitive processing and executive functioning is measured by the total time taken to complete each task.
Change in Attention
Time Frame: 10 minutes
The RBANS Attention Index is a composite of the Digit Span and Coding subtests. This index is a measure of simple auditory registration and visual scanning and processing speed. Low scores on this index indicate difficulties with basic attention processes and speed of information processing.
Change in Delayed Memory
Time Frame: 30 minutes
The RBANS Delayed Memory Index is a composite of the Story Memory Recall, List Learning Recall, List Learning Recognition, and Figure Recall subtests. This index is a measure of delayed recall and recognition for verbal and visual information. Low scores on this index indicate difficulties with recognition and retrieval of information from long-term memory stores.
Secondary Outcomes
- Change in functional imaging measures: Resting state(10 minutes)
- Change in Subjective Quality of Life: Short-Form 36(An average of 3 months)
- Imaging measures (structural): change in orbitofrontal cortex volume(6 minutes)
- Change in Subjective measures of Sleep quality: Insomnia Severity Index(Two weeks)
- Change in Subjective measures of Sleep quality: Pittsburgh Sleep Quality Index Score(One month)