Hayashi Hiroshi, Sone Toshimasa, Iokawa Kazuaki, Sumigawa Koshi, Fujita Takaaki, Kawamata Hironori, Asao Akihiko, Kawasaki Iori, Ogasawara Maki, Kawakatsu Shinobu
Department of Occupational Therapy Fukushima Medical University School of Health Sciences Fukushima Japan.
Department of Neuropsychiatry, Aizu Medical Center Fukushima Medical University Aizuwakamatsu Japan.
Health Sci Rep. 2024 Jun 17;7(6):e2175. doi: 10.1002/hsr2.2175. eCollection 2024 Jun.
Mild cognitive impairment (MCI) is a widespread condition in older individuals, posing significant risk of dementia. However, limited research has been conducted to explore effective interventions and clarify their impact at the neural level. Therefore, this study aimed to investigate the effects of computerized cognitive training (CCT) and explore the associated neural mechanisms in preventing dementia in older individuals with MCI, with a view to inform future intervention efforts.
We reviewed the effects of CCT on biomarker outcomes in older adults with MCI. The search was conducted for studies published between 2010 and May 10, 2023, using three search engines: PubMed, Scopus, and Cumulative Index to Nursing and Allied Health Literature. The inclusion criteria were as follows: studies that involved participants diagnosed with MCI, included CCT, included quantitative assessment of biomarker results, and conducted randomized controlled trials.
Sixteen studies that used biomarkers, including magnetic resonance imaging, electroencephalography (EEG), functional near-infrared spectroscopy (fNIRS), and blood or salivary biomarkers, were extracted. The results showed that CCT caused changes in structure and function within the main brain network, including the default mode network, and decreased both theta rhythm activity on EEG and prefrontal activity on fNIRS, with improvement in cognitive function. Furthermore, CCT combined with physical exercise showed more significant structural and functional changes in extensive brain regions compared with CCT alone. Virtual reality-based cognitive training improved not only executive function but also instrumental activities of daily living.
CCT causes functional and structural changes in extensive brain regions and improves cognitive function in older adults with MCI. Our findings highlight the potential of individualized intervention methods and biomarker assessment according to the specific causes of MCI. Future research should aim to optimize these personalized therapeutic strategies to maximize the benefits of CCT in older adults with MCI.
轻度认知障碍（MCI）在老年人中普遍存在，是痴呆症的重大风险因素。然而，针对有效干预措施及其在神经层面的影响的研究有限。因此，本研究旨在探讨计算机化认知训练（CCT）对患有MCI的老年人预防痴呆症的效果，并探索相关的神经机制，以为未来的干预措施提供参考。
我们回顾了CCT对患有MCI的老年人生物标志物结果的影响。使用三个搜索引擎：PubMed、Scopus和护理及联合健康文献累积索引，检索2010年至2023年5月10日发表的研究。纳入标准如下：涉及被诊断为MCI的参与者的研究、包括CCT的研究、包括生物标志物结果定量评估的研究以及进行随机对照试验的研究。
提取了16项使用生物标志物的研究，包括磁共振成像、脑电图（EEG）、功能性近红外光谱（fNIRS）以及血液或唾液生物标志物。结果表明，CCT导致主要脑网络（包括默认模式网络）内的结构和功能发生变化，降低了EEG上的θ节律活动和fNIRS上的前额叶活动，同时认知功能得到改善。此外，与单独的CCT相比，CCT与体育锻炼相结合在广泛的脑区显示出更显著的结构和功能变化。基于虚拟现实的认知训练不仅改善了执行功能，还改善了日常生活中的工具性活动。
CCT可导致患有MCI的老年人广泛脑区的功能和结构变化，并改善认知功能。我们的研究结果突出了根据MCI的具体病因采用个性化干预方法和生物标志物评估的潜力。未来的研究应旨在优化这些个性化治疗策略，以最大限度地提高CCT对患有MCI的老年人益处。
