基于严肃游戏的计算机化认知训练对认知衰退的行为和神经学基础：随机对照试验

Behavioural and neuronal substrates of serious game-based computerised cognitive training in cognitive decline: randomised controlled trial.

作者信息

Brill Esther, Holfelder Alexa, Falkner Michael, Krebs Christine, Brem Anna-Katharine, Klöppel Stefan

机构信息

University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Switzerland; and Swiss Institute for Translational and Entrepreneurial Medicine (SITEM), University of Bern, Switzerland.

ARTORG Centre for Biomedical Engineering Research, University of Bern, Switzerland.

出版信息

BJPsych Open. 2024 Nov 6;10(6):e200. doi: 10.1192/bjo.2024.797.

DOI:10.1192/bjo.2024.797

PMID:39501844

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11698156/

Abstract

BACKGROUND

Investigations of computerised cognitive training (CCT) show heterogeneous results in slowing age-related cognitive decline.

AIMS

To comprehensively evaluate the effectiveness of serious games-based CCT, integrating control conditions, neurophysiological and blood-based biomarkers, and subjective measures.

METHOD

In this bi-centric randomised controlled trial with parallel groups, 160 participants (mean age 71.3 years) with cognitive impairment ranging from subjective decline to mild cognitive impairment, were pseudo-randomised to three arms: an intervention group receiving CCT immediately, an active control (watching documentaries) and a waitlist condition, which both started the CCT intervention after the control period. Both active arms entailed a 3-month intervention period comprising a total of 60 at-home sessions (five per week) and weekly on-site group meetings. In the intervention group, this was followed by additional 6 months of CCT, with monthly booster sessions to assess long-term training effects. Behavioural and subjective changes were assessed in 3-month intervals. Biological effects were measured by amyloid blood markers and magnetic resonance imaging obtained before and after training.

RESULTS

Adherence to the training protocol was consistently high across groups and time points (4.87 sessions per week). Domain-specific cognitive scores showed no significant interaction between groups and time points. Significant cognitive and subjective improvements were observed after long-term training. Voxel-based morphometry revealed no significant changes in grey matter volume following CCT, nor did amyloid levels moderate its effectiveness.

CONCLUSIONS

Our study demonstrates no benefits of 3 months of CCT on cognitive or biological outcomes. However, positive effects were observed subjectively and after long-term CCT, warranting the inclusion of CCT in multicomponent interventions.

摘要

背景

计算机化认知训练（CCT）的研究表明，在减缓与年龄相关的认知衰退方面，结果存在异质性。

目的

综合评估基于严肃游戏的CCT的有效性，整合对照条件、神经生理学和血液生物标志物以及主观测量方法。

方法

在这项双中心平行组随机对照试验中，160名认知障碍程度从主观衰退到轻度认知障碍的参与者（平均年龄71.3岁）被伪随机分为三组：立即接受CCT的干预组、积极对照组（观看纪录片）和等待名单组，后者在对照期后开始CCT干预。两个积极组都有一个为期3个月的干预期，包括总共60次在家课程（每周五次）和每周的现场小组会议。在干预组中，随后还有6个月的CCT，每月有强化课程以评估长期训练效果。行为和主观变化每3个月评估一次。通过训练前后获得的淀粉样蛋白血液标志物和磁共振成像测量生物学效应。