scholarly journals Computerized Cognitive Training in Multiple Sclerosis: A Systematic Review and Meta-analysis

2019 ◽  
Vol 33 (9) ◽  
pp. 695-706 ◽  
Author(s):  
Amit Lampit ◽  
Josephine Heine ◽  
Carsten Finke ◽  
Michael H. Barnett ◽  
Michael Valenzuela ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Training ◽  
Psychosocial Functioning ◽  
Prediction Interval ◽  
Meta Analysis ◽  
Cost Effective ◽  
Cognitive Effect ◽  
Computerized Cognitive Training ◽  
Study Heterogeneity ◽  
And Control

Background. Cognitive impairments are common in people with multiple sclerosis (MS). Systematic reviews reported promising evidence for various cognitive interventions in this population. Computerized cognitive training (CCT) has strong evidence for safety and efficacy in several populations, but its effects in MS have yet to be specified. Objective. We aimed to synthesize the evidence from randomized controlled trials (RCTs) investigating the effects of CCT on cognitive, psychosocial, and functional outcomes in adults with MS. Method. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and CENTRAL from inception to March 2019. We calculated standardized mean difference (Hedges’ g) of change from baseline in untrained measures of cognition, individual domains, psychosocial functioning, and daily function between CCT and control groups using a random-effects model. Results. A total of 20 RCTs encompassing 982 participants (78% with relapsing-remitting MS) were included. The overall cognitive effect size was moderate ( g = 0.30; 95% CI = 0.18-0.43), with no evidence of small-study effect or between-study heterogeneity (prediction interval = 0.17-0.44). Small to moderate effect sizes were found for attention/processing speed, executive functions, and verbal and visuospatial memory. Evidence for working memory, fatigue, and psychosocial and daily functioning were inconclusive. Cognitive effects waned without further training. Conclusions. CCT is efficacious for overall and key cognitive domains in adults with MS, but efficacy on other outcomes and in progressive subtypes remains unclear. Long-term and well-powered trials with diverse cohorts are needed to optimize and maintain the efficacy of CCT, investigate transfer to daily living, and determine who can benefit and whether CCT is a cost-effective strategy to attenuate cognitive decline in MS.

scholarly journals Computerized Cognitive Training in People with Depression: A Protocol for a Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Amit Lampit ◽  
Nathalie H Launder ◽  
Ruth Minkov ◽  
Alice Rollini ◽  
Christopher G Davey ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Performance ◽  
Cognitive Training ◽  
Psychosocial Functioning ◽  
Psychiatric Symptoms ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Computerized Cognitive Training ◽  
Design Factors ◽  
Clinical Populations

Abstract Background People with depression often present with concurrent cognitive impairment. Computerized cognitive training (CCT) is safe and efficacious strategy to maintain or enhance cognitive performance in a range of clinical populations. However, its efficacy in people with depression and how it varies across populations and design factors is currently unclear. Methods We searched MEDLINE, EMBASE and PsycINFO from inception to 29 June 2020 for randomised controlled trials examining the efficacy of CCT vs any control condition on cognitive, mood, psychiatric symptoms, psychosocial functioning and daily function in adults with depression. Eligible samples include studies specifically targeting people with major depressive disorder as well as those with other diagnoses where at least 50% of the sample meets clinical criteria for depression, with the exception of major psychiatric disorders or dementia. The primary outcome is change in overall cognitive performance. Multivariate analyses will be used to examine effect sizes on each outcome category as well as possible effect modifiers and correlations between categories. Risk of bias will be assessed using the Cochrane risk of bias tool version 2. Discussion To the best of our knowledge, this will be the first systematic review and meta-analysis of narrowly-defined CCT across clinical populations with depression. We aim to investigate not only whether CCT is efficacious for cognition, but also how such effects vary across design factors, what other clinically relevant outcomes might respond to CCT and the extent to which they differ across populations. Systematic review registration: Submitted and pending evaluation with PROSPERO.

Systematic review and meta-analysis of attrition within digital health interventions for people with multiple sclerosis (Preprint)

2021 ◽  
Author(s):  
William Bevens
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
Digital Health ◽  
Meta Analysis ◽  
Health Interventions ◽  
Attrition Rates ◽  
Participant Engagement ◽  
Randomised Controlled ◽  
And Control ◽  
Insight Into

BACKGROUND Digital health interventions (DHI) have revolutionised the management of multiple sclerosis (MS). It is now understood that the technological elements that comprise DHIs can influence participant engagement and that people with MS (PwMS) can experience significant barriers to remaining enrolled in DHIs related to the use of these elements. It is essential to explore the influence of technological elements in mitigating attrition after allocation. OBJECTIVE We examined the study design and technological elements of documented DHIs targeted at PwMS and how these correlated with attrition among participants of randomised-controlled trials (RCTs). METHODS We conducted a systematic review and meta-analysis of RCTs (n=17) describing digital technologies for health interventions for PwMS. We analysed attrition of included studies using a random-effects model and meta-regression to measure the association between potential moderators. RESULTS There were no measured differences in attrition between intervention and control arms; however, some of the heterogeneity observed was explained by the composite technological element score. The pooled attrition rates for the intervention and control arms were 10.6% and 11.2% respectively. CONCLUSIONS Ultimately, this paper provides insight into the technological composition of DHIs and will aid in the design of future studies in this area.

scholarly journals Computerized cognitive training in people with depression: a protocol for a systematic review and meta-analysis

2022 ◽  
Vol 11 (1) ◽  
Author(s):  
Amit Lampit ◽  
Nathalie H. Launder ◽  
Ruth Minkov ◽  
Alice Rollini ◽  
Christopher G. Davey ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cognitive Performance ◽  
Cognitive Training ◽  
Psychiatric Symptoms ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Clinical Criteria ◽  
Computerized Cognitive Training ◽  
Design Factors ◽  
Clinical Populations

Abstract Background People with depression often present with concurrent cognitive impairment. Computerized cognitive training (CCT) is a safe and efficacious strategy to maintain or enhance cognitive performance in a range of clinical populations. However, its efficacy in people with depression and how it varies across populations and design factors are currently unclear. Methods We searched MEDLINE, EMBASE, and PsycINFO from inception to 13 July 2021 for randomised controlled trials examining the efficacy of CCT vs any control condition on cognitive, mood, psychiatric symptoms, psychosocial, and daily functioning in adults with depression. Eligible samples include studies specifically targeting people with major depressive disorder as well as those with other diagnoses where at least 50% of the sample meets the clinical criteria for depression, with the exception of major psychiatric disorders or dementia. The primary outcome is change in the overall cognitive performance. Multivariate analyses will be used to examine the effect sizes on each outcome category as well as possible effect modifiers and correlations between categories. The risk of bias will be assessed using the Cochrane risk of bias tool version 2. Discussion To the best of our knowledge, this will be the first systematic review and meta-analysis of narrowly defined CCT across clinical populations with depression. We aim to investigate not only whether CCT is efficacious for cognition, but also how such effects vary across design factors, what other clinically relevant outcomes might respond to CCT, and the extent to which they differ across populations. Systematic review registration PROSPERO CRD42020204209

scholarly journals Meta-analysis of neural systems underlying placebo analgesia from individual participant fMRI data

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Matthias Zunhammer ◽  
◽  
Tamás Spisák ◽  
Tor D. Wager ◽  
Ulrike Bingel
Keyword(s):  
Functional Neuroimaging ◽  
Meta Analysis ◽  
Neural Systems ◽  
Related Activity ◽  
Placebo Analgesia ◽  
Study Heterogeneity ◽  
Individual Participant ◽  
Decision Making Processes ◽  
Posterior Insula ◽  
And Control

AbstractThe brain systems underlying placebo analgesia are insufficiently understood. Here we performed a systematic, participant-level meta-analysis of experimental functional neuroimaging studies of evoked pain under stimulus-intensity-matched placebo and control conditions, encompassing 603 healthy participants from 20 (out of 28 eligible) studies. We find that placebo vs. control treatments induce small, widespread reductions in pain-related activity, particularly in regions belonging to ventral attention (including mid-insula) and somatomotor networks (including posterior insula). Behavioral placebo analgesia correlates with reduced pain-related activity in these networks and the thalamus, habenula, mid-cingulate, and supplementary motor area. Placebo-associated activity increases occur mainly in frontoparietal regions, with high between-study heterogeneity. We conclude that placebo treatments affect pain-related activity in multiple brain areas, which may reflect changes in nociception and/or other affective and decision-making processes surrounding pain. Between-study heterogeneity suggests that placebo analgesia is a multi-faceted phenomenon involving multiple cerebral mechanisms that differ across studies.

scholarly journals The Effects of Gamification on Computerized Cognitive Training: Systematic Review and Meta-Analysis

10.2196/18644 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e18644 ◽  
Author(s):  
Julie F Vermeir ◽  
Melanie J White ◽  
Daniel Johnson ◽  
Geert Crombez ◽  
Dimitri M L Van Ryckeghem
Keyword(s):  
Systematic Review ◽  
Cognitive Training ◽  
Meta Analysis ◽  
Empirical Studies ◽  
Age Groups ◽  
Future Research ◽  
Computerized Cognitive Training ◽  
Meta Analyses ◽  
Game Elements ◽  
The Impact

Background There has been a growing interest in the application of gamification (ie, the use of game elements) to computerized cognitive training. The introduction of targeted gamification features to such tasks may increase motivation and engagement as well as improve intervention effects. However, it is possible that game elements can also have adverse effects on cognitive training (eg, be a distraction), which can outweigh their potential motivational benefits. So far, little is known about the effectiveness of such applications. Objective This study aims to conduct a systematic review and meta-analysis to investigate the effect of gamification on process outcomes (eg, motivation) and on changes in the training domain (eg, cognition), as well as to explore the role of potential moderators. Methods We searched PsycINFO, Cumulative Index to Nursing and Allied Health Literature, ProQuest Psychology, Web of Science, Scopus, PubMed, Science Direct, Excerpta Medica dataBASE, Institute of Electrical and Electronics Engineers Xplore, Association for Computing Machinery, and a range of gray-area literature databases. The searches included papers published between 2008 and 2018. Meta-analyses were performed using a random-effects model. Results The systematic review identified 49 studies, of which 9 randomized controlled trials were included in the meta-analysis. The results of the review indicated that research in this context is still developing and lacks well-controlled empirical studies. Gamification in cognitive training is applied to a large range of age groups and audiences and is mostly delivered at a research site through computers. Rewards and feedback continue to dominate the gamification landscape, whereas social-oriented features (eg, competition) are underused. The meta-analyses showed that gamified training tasks were more motivating/engaging (Hedges g=0.72) and more demanding/difficult (Hedges g=–0.52) than non- or less-gamified tasks, whereas no effects on the training domain were found. Furthermore, no variables moderated the impact of gamified training tasks. However, meta-analytic findings were limited due to a small number of studies. Conclusions Overall, this review provides an overview of the existing research in the domain and provides evidence for the effectiveness of gamification in improving motivation/engagement in the context of cognitive training. We discuss the shortcomings in the current literature and provide recommendations for future research.

The Efficacy of Computerized Cognitive Training in Adults With ADHD

2016 ◽  
Vol 20 (12) ◽  
pp. 991-1003 ◽  
Author(s):  
Adi Stern ◽  
Elad Malik ◽  
Yehuda Pollak ◽  
Omer Bonne ◽  
Adina Maeir
Keyword(s):  
Cognitive Training ◽  
Interaction Effects ◽  
Control Group ◽  
Occupational Performance ◽  
Neurocognitive Performance ◽  
Cognitive Demands ◽  
Computerized Cognitive Training ◽  
Randomized Control ◽  
And Control

Objective: This is a randomized control trial examining the efficiency of computerized cognitive training (CCT) for adults with ADHD, comparing two training conditions with graded levels of executive cognitive demands. Method: Adults with ADHD ( n = 60) were randomized into study ( n = 34) and control ( n = 26) groups. Training was conducted with the computerized AttenFocus program. Control group received a simple, non-hierarchical version with less executive demands. Results: Significant positive changes in symptoms ratings, ecological measures of executive functions, and occupational performance were found in both groups. No significant changes were found in variables of neurocognitive performance battery and quality of life. No significant time by group interaction effects were found. Conclusion: No benefits of the intervention were found relative to the control. Lack of interaction effects may be due to insufficient power, non-specific cognitive training or placebo effects. Results demonstrate some positive findings for general CCT, yet do not support the inclusion of specific higher level executive training.

Computerized cognitive training and functional recovery in major depressive disorder: A meta-analysis

2016 ◽  
Vol 189 ◽  
pp. 184-191 ◽  
Author(s):  
Jeffrey N. Motter ◽  
Monique A. Pimontel ◽  
David Rindskopf ◽  
Davangere P. Devanand ◽  
P. Murali Doraiswamy ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Cognitive Training ◽  
Functional Recovery ◽  
Meta Analysis ◽  
Major Depressive ◽  
Computerized Cognitive Training

scholarly journals The Effects of Gamification on Computerized Cognitive Training: Systematic Review and Meta-Analysis (Preprint)

2020 ◽  
Author(s):  
Julie F Vermeir ◽  
Melanie J White ◽  
Daniel Johnson ◽  
Geert Crombez ◽  
Dimitri M L Van Ryckeghem
Keyword(s):  
Systematic Review ◽  
Cognitive Training ◽  
Meta Analysis ◽  
Empirical Studies ◽  
Age Groups ◽  
Future Research ◽  
Computerized Cognitive Training ◽  
Meta Analyses ◽  
Game Elements ◽  
The Impact

BACKGROUND There has been a growing interest in the application of gamification (ie, the use of game elements) to computerized cognitive training. The introduction of targeted gamification features to such tasks may increase motivation and engagement as well as improve intervention effects. However, it is possible that game elements can also have adverse effects on cognitive training (eg, be a distraction), which can outweigh their potential motivational benefits. So far, little is known about the effectiveness of such applications. OBJECTIVE This study aims to conduct a systematic review and meta-analysis to investigate the effect of gamification on process outcomes (eg, motivation) and on changes in the training domain (eg, cognition), as well as to explore the role of potential moderators. METHODS We searched PsycINFO, Cumulative Index to Nursing and Allied Health Literature, ProQuest Psychology, Web of Science, Scopus, PubMed, Science Direct, Excerpta Medica dataBASE, Institute of Electrical and Electronics Engineers Xplore, Association for Computing Machinery, and a range of gray-area literature databases. The searches included papers published between 2008 and 2018. Meta-analyses were performed using a random-effects model. RESULTS The systematic review identified 49 studies, of which 9 randomized controlled trials were included in the meta-analysis. The results of the review indicated that research in this context is still developing and lacks well-controlled empirical studies. Gamification in cognitive training is applied to a large range of age groups and audiences and is mostly delivered at a research site through computers. Rewards and feedback continue to dominate the gamification landscape, whereas social-oriented features (eg, competition) are underused. The meta-analyses showed that gamified training tasks were more motivating/engaging (Hedges g=0.72) and more demanding/difficult (Hedges g=–0.52) than non- or less-gamified tasks, whereas no effects on the training domain were found. Furthermore, no variables moderated the impact of gamified training tasks. However, meta-analytic findings were limited due to a small number of studies. CONCLUSIONS Overall, this review provides an overview of the existing research in the domain and provides evidence for the effectiveness of gamification in improving motivation/engagement in the context of cognitive training. We discuss the shortcomings in the current literature and provide recommendations for future research.

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