Immediate and Sustained Effects of Neurofeedback and Working Memory Training on Cognitive Functions in Children and Adolescents with ADHD: A Multi-Arm Pragmatic Randomized Controlled Trial

Objective: To evaluate the effects of neurocognitive training methods on targeted cognitive functions in children and adolescent with ADHD. Method: A pragmatic four-arm randomized controlled trial compared two types of neurofeedback (Slow Cortical Potential and Live Z-score) and Working-memory training (WMT) with treatment as usual. N = 202 participants with ADHD aged 9 to 17 years were included. A battery of cognitive function tests was completed pretreatment, posttreatment, and after 6-months. Results: The effects of WMT on spatial and verbal working-memory were superior to neurofeedback and treatment as usual at posttreatment, but only partially sustained at follow-up. No other consistent effects were observed. We found no clear indications that effects were moderated by ADHD presentation, ongoing medication, age, or sex. Conclusion: The sustained effects of neurocognitive training on cognitive functioning in children and adolescents with ADHD may be limited. Future research should focus on more personalized forms of neurocognitive training.

Which Factor Is More Relevant to the Effectiveness of the Cognitive Intervention? A Meta-Analysis of Randomized Controlled Trials of Cognitive Training on Symptoms and Executive Function Behaviors of Children With Attention Deficit Hyperactivity Disorder

Objective: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by developmentally inappropriate inattention, hyperactivity, and impulsivity. Multiple cognitive training appeared to be more effective than working memory training, but the evidence remains insufficient, particularly for the subgroup symptoms and executive function behaviors at home. Further analysis of the impact of factors on the effectiveness would facilitate the development of cognitive training.Methods: We searched PubMed, Cochrane Library, Psyche, Embase, Chinese Biomedical Literature Database, CNKI, and Weifang Database, and included randomized controlled trials (RCTs) of children with ADHD undergoing cognitive intervention. Metaanalysis and univariate metaregression were performed by STATE. The risk of bias was assessed with the Cochrane risk of bias tool 2.0 by the two investigators separately. This study was registered with INPLASY, number INPLASY202140065.Results: We included 17 RCTs in the systematic review, with a combined 1,075 participants. For metaanalyses of both subgroups of ADHD symptoms and the executive function behaviors, the test of published bias failed to reach the p < 0.05 level. When all of the training are considered together, cognitive training can improve the presentation of inattention symptoms [SMD = −0.390, 95%CI (−0.675, −0.104)] and executive function behaviors (SMD = −0.319, 95%CI (−0.527, −0.111)]. In the subgroup analysis, the effects of working memory training on both presentations were not statistically significant. In contrast, the multiple cognitive training had significant effects on the presentation of inattention symptoms [SMD = −0.507, 95% CI (−0.722, −0.292)], hyperactivity/impulsivity [SMD = −0.305, 95% CI (−0.518, −0.09)], and the executive function behaviors [SMD = −0.499, 95%CI (−0.707, −0.290)]. In addition, metaregression analysis showed that only training frequency did significantly impact the symptoms of ADHD and the executive function behaviors.Conclusion: This study showed that improvements in symptoms and executive function behaviors were related to the domains of cognitive intervention. The findings suggest that multiple domains of cognitive training and moderate training frequency may have wider clinical benefits. All the above results highlight further research in refining the executive functions of children with ADHD and developing individually tailored cognitive intervention on homes based for children with vulnerable executive functions.Systematic Review Registration: [http://inplasy.com/], [INPLASY202140065].

Teaching Interpreting for Tourism Purposes

This article proposes a model for teaching interpreting for tourism purposes. It shows the aims of the model, interpreting materials, training strategies, training environment and assessment techniques. The model aims to train students to interpret in English with or without prior preparation or knowledge of the topic and without taking or reading form notes. The training model consists of the following exercises: (i) breathing exercises; (ii) memory training exercises; (iii) shadowing exercises; (iv) sentence paraphrasing; (v) summarizing sentences, then whole paragraphs about tourism; (vi) listening to single words, sentences, and a short paragraph about tourism and interpreting them; (vii) listening to familiar and easy tourism topics, then more difficult ones with a variety of tourism sub-topics. In a multimedia language lab, the students may listen to tourism podcasts, watch tourism documentaries or TED Talks and interpret the content from English to Arabic and vice versa. Simulations (role playing) of tourists and interpreters in teams of three or more may be conducted. Students may also visit a local tourist attraction, interpret, or give a commentary on-site. The training program objectives, types of interpreting, interpreting exercises, training materials, teaching and learning strategies and assessment techniques are described in detail.

Global trends on studies with cognitive training: Mapping and bibliometric analysis using CiteSpace

The widespread utility of cognitive training has gained its value in maintaining cognitive performance, reducing neuropsychiatric illnesses, restoring their abilities, and preventing cognitive decline. The objective of this article is to explore the global trends in cognitive training studies. Publication records were obtained from the Web of Science (WoS) core collection for the period of 25 years from 1996 to 2020. CiteSpace 5.7.R5 (64-bit) W version software was used for mapping and bibliometric analysis. Overall, 4,575 records were retrieved and analyzed using bibliometric approaches such as dual-overlay analysis, author co-citation analysis (ACA), document co-citation analysis (DCA), and keyword analysis. It was found that the publication records were increased steadily in the recent five years (2016-2020). The US academic institutions and journals played the dominant role in the field of cognitive training. However, University College London (UCL) had contributed for the highest publication records (128) with a centrality value of 0.12. Few studies were contributed by the developing countries/territories. Author Spector, A had the highest number of publications (47). However, Author Simons, DT as the top-author based on citation burst value (35.15) focused on brain-training interventions. Through the DCA, it was found that working memory training has to be the predominant trend in this domain. The most recent burst keywords such as ‘cognitive intervention,’ ‘plasticity,’ ‘group cognitive intervention,’ ‘virtual reality,’ and ‘prevention’ were considered to be the indicators of emerging trends.

Hospital-Based Modified Cogmed Working Memory Training for Youth With ADHD

Objective: This study evaluated a modified working memory training program, Cogmed, for ADHD youth. Method: Forty youth were randomized to modified Cogmed training (MCT) or treatment as usual (CON). MCT was delivered in an outpatient mental health clinic in 3 weekly 35-minute sessions with a dedicated coach for 10 weeks. Participants completed assessments at baseline, after the intervention, and again 3 months later. Results: After controlling for baseline, groups were comparable on working memory, academics, and ADHD symptoms. The MCT group was rated by parents and teachers as having fewer executive function challenges and youth endorsed better self-concept compared with the CON group. Conclusions: MCT was associated with some improvement, which could not be attributed to increased working memory capacity and may reflect other facets of the program. Results question the usefulness of Cogmed but highlight considerations for optimizing adherence, engagement, and the therapeutic alliance in interventions for ADHD youth.

The Pursuit of Effective Working Memory Training: a Pre-registered Randomised Controlled Trial with a Novel Varied Training Protocol

Working memory (WM) training, typically entailing repetitive practice with one or two tasks, has mostly yielded only limited task-specific transfer effects. We developed and tested a new WM training approach where the task paradigm, stimulus type, and predictability of the stimulus sequence were constantly altered during the 4-week training period. We expected that this varied training protocol would generate more extensive transfer by facilitating the use of more general strategies that could be applied to a range of WM tasks. Pre-post transfer effects following varied training (VT group, n = 60) were compared against traditional training (TT group, training a single adaptive WM task, n = 63), and active controls (AC, n = 65). As expected, TT evidenced strong task-specific near transfer as compared to AC. In turn, VT exhibited task-specific near transfer only on one of the measures, and only as compared to the TT group. Critically, no evidence for task-general near transfer or far transfer effects was observed. In sum, the present form of VT failed to demonstrate broader transfer. Nevertheless, as VT has met with success in other cognitive domains, future studies should probe if and how it would be possible to design WM training protocols that promote structural learning where common features of specific tasks would be identified and utilised when selecting strategies for novel memory tasks.

Acupuncture and Related Therapies for the Cognitive Function of Alzheimer’s Disease: A Network Meta-Analysis

Background: Acupuncture and acupuncture-related therapies are effective for Alzheimer's disease (AD), therefore, we aimed to compare and rank the interventions that mainly focus on acupuncture-related therapies in the treatment of patients with mild to moderate AD. Methods: We used network meta-analysis to evaluate the direct and indirect evidence shown in randomized controlled trials of AD. The data were analyzed using RavMan manager, Stata, and WinBUGS software after two researchers independently screened the literature, extracted the data, and assessed the risk of bias in the included studies. Results: We analyzed a total of 36 eligible studies, including 2712 patients, involving 14 types of acupuncture-related therapies and comprehensive therapies. For Mini-Mental State Examination (MMSE), acupuncture (ACU) combined with cognitive and memory training (Training) was more effective than ACU, ACU+Chinese herb (CH), ACU+Donepezil (DON), CH, DON, DON+Nimodipine (NIM), Music therapy (Music), NIM, Placebo, and Training (P<0.05), while ACU+CH was batter than CH (P<0.05), and ACU+DON+NIM was better than DON+NIM (P<0.05). For Alzheimer's Disease Assessment Scale-Cognitive section (ADAS-cog), ACU was more effective than DON and placebo (P<0.05). For Activities of Daily Living (ADL), ACU+DON was better than CH, DON, NIM, and Placebo (P<0.05). For the clinical effectiveness rate, ACU, ACU+CH, ACU+CH+DON, ACU+CH+DON+NIM, ACU+DON, CH, NIM were all more effective than DON+NIM (P<0.05), while ACU and ACU+CH were better than DON (P<0.05). The comprehensive ranking results show that ACU+training and ACU have the highest ranking probability. Conclusion: ACU+Training and ACU may be the best therapies to improve the cognitive function of patients with mild to moderate AD, while the combination of acupuncture-related therapies and other therapies has a higher overall benefit.