Department of Neurology, Faculty of Medicine, Maltepe University, İstanbul, Turkey
Department of Neurology, Memorial Şişli Hospital, İstanbul, Turkey
Turk J Med Sci. 2020 Feb 13;50(1):231-238. doi: 10.3906/sag-1905-244.
BACKGROUND/AIM: Clinical trials conducted on the efficacy of computerized cognitive training (CCT) programs have not led to any important breakthroughs. CCT is a safe and inexpensive approach, but its efficacy in patients on rivastigmine therapy has not been evaluated. This study aims to compare effects of CCT and examines rivastigmine to determine whether CCT has any further contributions to make.
Sixty individuals with subjective memory complaint (SCI) and 60 individuals with early stage Alzheimer’s dementia (AD) were subjected to the Montreal Cognitive Assessment (MoCA), Cambridge Cognition (CANTAB tests: MOT, PRM, DMS, SWM, PAL, RTI), and Bayer-ADL. After screening patients who were diagnosed with AD, we started rivastigmine patch treatment (10 cm2 = 9.5 mg). The SCI and AD groups were randomly divided, and one each of the SCI and AD groups were accessed using BEYNEX, a web-based program. After a minimum of at least 1200 min of use, the diagnostic tests were repeated.
The AD groups’ MoCA scores of the BEYNEX-practicing group demonstrated meaningfully increase, whereas they decreased in the control group, and the Bayer-ADL scores indicated improvement in ADL. The CANTAB tests both in SCI and AD and in groups using BEYNEX showed positive improvement in MOT, DMS, and PAL data.
This study is a rare example that focuses on both groups with SCI and AD. The efficacy of CCT varies across cognitive domains and shows significant efficacy for AD but small improvements in cognitively healthy older adults. In future studies, integration with a smart learning algorithm may lead to interesting observations on which parameters are more sensitive to change under long-term use of CCT in a large number of subjects.
背景/目的:针对计算机认知训练(CCT)程序疗效的临床试验并未取得任何重大突破。CCT 是一种安全且廉价的方法,但尚未评估其在接受利斯的明治疗的患者中的疗效。本研究旨在比较 CCT 的效果,并检验利斯的明,以确定 CCT 是否有进一步的贡献。
对 60 名有主观记忆投诉(SCI)的个体和 60 名早期阿尔茨海默病(AD)患者进行蒙特利尔认知评估(MoCA)、剑桥认知(CANTAB 测试:MOT、PRM、DMS、SWM、PAL、RTI)和 Bayer-ADL 评估。在筛选出被诊断为 AD 的患者后,我们开始使用利斯的明贴片治疗(10 cm2 = 9.5 mg)。将 SCI 和 AD 组随机分组,每组各有一名 SCI 和 AD 患者使用基于网络的 BEYNEX 进行评估。使用至少 1200 分钟后,重复进行诊断测试。
BEYNEX 练习组的 AD 组的 MoCA 评分显著提高,而对照组则下降,Bayer-ADL 评分表明日常生活活动能力有所改善。CANTAB 测试在 SCI 和 AD 以及使用 BEYNEX 的组中,MOT、DMS 和 PAL 数据均有积极改善。
本研究是一个罕见的同时关注 SCI 和 AD 两组患者的例子。CCT 的疗效因认知领域而异,对 AD 有显著疗效,但对认知健康的老年人的改善较小。在未来的研究中,与智能学习算法的整合可能会对长期使用 CCT 对大量受试者的哪些参数更敏感变化产生有趣的观察。