Department of Speech and Language Therapy, Higher Educational Institute of Epirus, Ioannina, Greece.
Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece.
Neural Plast. 2018 Jul 11;2018:2845176. doi: 10.1155/2018/2845176. eCollection 2018.
There is an increasing interest in the effect of nonpharmacological interventions on the course of patients with Alzheimer's disease (AD). The objective of the present study is to determine the benefits of a structured, multidomain, mostly computer-based, cognitive training (MCT) οn the cognitive performance of patients with early-stage AD.
Fifty patients with early-stage AD participated in the study. Patients were randomly allocated either to the training program group ( = 25) or to a wait list control group ( = 25). The training program group received computer-assisted MCT and linguistic exercises utilizing pen and paper supplemented by cognitive-linguistic exercises for homework. The duration of the MCT intervention program was 15 weeks, and it was administered twice a week. Each session lasted for approximately one hour. Objective measures of episodic memory, delayed memory, word recognition, attention, executive function, processing speed, semantic fluency, and naming were assessed at baseline and after the completion of the program in both groups.
Analysis showed that in controls, delayed memory and executive function had deteriorated over the observation period of 15 weeks, while the training group improved their performance in word recognition, Boston Naming Test (BNT), semantic fluency (SF), clock-drawing test (CDT), digit span forward (DSF), digit span backward (DSB), trail-making test A (TMT A), and trail-making test B (TMT B). Comparison between the training group and the controls showed that MCT had a significant beneficial effect in delayed memory, naming, semantic fluency, visuospatial ability, executive functions, attention, and processing speed.
The study provides evidence of a beneficial effect of MCT with an emphasis on cognitive-language performance of patients with early-stage AD. Considering the limited efficacy of current pharmacological therapies in AD, concurrent computer-based MCT may represent an additional enhancing treatment option in early-stage AD patients.
人们对非药物干预对阿尔茨海默病(AD)患者病程的影响越来越感兴趣。本研究的目的是确定结构化、多领域、主要基于计算机的认知训练(MCT)对早期 AD 患者认知表现的益处。
50 名早期 AD 患者参加了这项研究。患者被随机分配到训练计划组(n=25)或等待名单对照组(n=25)。训练计划组接受计算机辅助 MCT 和纸笔语言练习,并辅以认知语言练习作为家庭作业。MCT 干预计划的持续时间为 15 周,每周两次。每次课程持续约一小时。在两组中,在基线和计划完成后评估情景记忆、延迟记忆、单词识别、注意力、执行功能、处理速度、语义流畅性和命名的客观测量。
分析表明,在对照组中,延迟记忆和执行功能在 15 周的观察期内恶化,而训练组在单词识别、波士顿命名测试(BNT)、语义流畅性(SF)、画钟测试(CDT)、数字跨度正向(DSF)、数字跨度反向(DSB)、连线测试 A(TMT A)和连线测试 B(TMT B)方面的表现有所提高。训练组与对照组的比较表明,MCT 对延迟记忆、命名、语义流畅性、视空间能力、执行功能、注意力和处理速度有显著的有益影响。
该研究提供了 MCT 有益效果的证据,重点是早期 AD 患者的认知语言表现。考虑到目前 AD 药物治疗的疗效有限,基于计算机的 MCT 可能是早期 AD 患者的另一种增强治疗选择。