The Effect of Attention Process Training (APT-II) On Cognitive and Daily Life Functioning in Patients With a Mild Cognitive Impairment: A Randomized Controlled Trial

Introduction. Older adults with mild cognitive impairment (MCI) are at increased risk of developing dementia even if they do not meet the criteria for dementia. Executive control of working memory, which is implicated in divided attention, is often impaired in this population, and such impairment is a strong predictor of dementia. Slowing the development of dementia by enhancing cognitive and brain plasticity represents a current and future challenge for clinicians and researchers. Cognitive rehabilitation allows patients to compensate for cognitive deficits with the ultimate goal of reducing the impact of such deficits on everyday life. We aim to examine the effectiveness and generalization of an attention and working memory training program (Attention Process Training or APT-II) in improving cognitive and everyday functioning in patients with MCI by means of a single-blind, randomized controlled trial.Methods. Twenty-two MCI patients will be randomly assigned to either a "Cognitive Training with APT-II" group or a "Standard Care" group. Initially, patients will be administered a battery of standardized neuropsychological tests to ensure that they meet MCI criteria. The intervention will consist of a cognitive training program (APT-II) and will last 8 weeks (two sessions per week). One of the strengths of APT-II training is that it emphasizes the transfer of cognitive gains from training sessions to everyday life. To evaluate the treatment's effectiveness in improving cognitive and daily life functioning, cognitive and functional outcomes will be assessed just before, immediately after, 3 months after, and 6 months after the intervention program. A divided attention memory task performed in virtual reality will also be administered to evaluate the effects of APT-II training on the management of attentional resources in a relatively ecological situation. Perspective. If our results indicate an improvement in the cognitive and daily life performance of older adults with MCI, this non-invasive, low-cost technique may deserve increased consideration as a therapeutic intervention to delay or reverse cognitive decline an diminish the risk of developing dementia in this population.Trial registration. ClinicalTrials.gov, ID: NCT04606953, Registered on 28 October 2020.

Investigating music-based cognitive rehabilitation for individuals with moderate to severe chronic acquired brain injury: A feasibility experiment

BACKGROUND: Acquired brain injuries often cause cognitive impairment, significantly impacting participation in rehabilitation and activities of daily living. Music can influence brain function, and thus may serve as a uniquely powerful cognitive rehabilitation intervention. OBJECTIVE: This feasibility study investigated the potential effectiveness of music-based cognitive rehabilitation for adults with chronic acquired brain injury. METHODS: The control group participated in three Attention Process Training (APT) sessions, while the experimental group participated in three Music Attention Control Training (MACT) sessions. Pre-and post- testing used the Trail Making A & B, Digit Symbol, and Brown-Peterson Task as neuropsychological tests. RESULTS: ANOVA analyses showed no significant difference between groups for Trail A Test, Digit Symbol, and Brown-Peterson Task. Trail B showed significant differences at post-test favouring MACT over APT. The mean difference time between pre-and post-tests for the Trail B Test was also significantly different between APT and MACT in favour of MACT using a two-sample t-test as well as a follow-up nonparametric Mann Whitney U-test. CONCLUSIONS: The group differences found in the Trail B tests provided preliminary evidence for the efficacy of MACT to arouse and engage attention in adults with acquired brain injury.

Improving Discourse following Traumatic Brain Injury: A Tale of Two Treatments

Persons with traumatic brain injury (TBI) often present with discourse-level deficits that affect functional communication. These deficits are not thought to be primarily linguistic in nature but instead are thought to arise from the interaction of linguistic and cognitive processes. Discourse processing treatment (DPT) is a discourse-based treatment protocol which targets discourse deficits frequently seen in TBI. Attention Process Training-2 (APT-2) is a published treatment protocol which targets four levels of attention. The purpose of this article is to investigate the effectiveness of DPT and APT-2 in improving discourse production and cognition in adults with TBI. Our results suggest that DPT results in greater improvement in discourse informativeness and coherence, but the combination of DPT and APT-2 resulted in greater generalization to untrained stimuli. Both DPT and APT-2 appear to have some potential to improve cognition, but there was intersubject variability with regard to which treatment is more effective.