Virtual reality‐based cognitive‐motor training for middle‐aged adults at high Alzheimer's disease risk: A randomized controlled trial

Alzheimer's and Dementia: Translational Research and Clinical Interventions - Tập 4 - Trang 118-129 - 2018
Glen M. Doniger1,2,3, Michal Schnaider Beeri2,3,4, Alex Bahar-Fuchs2,5,6, Amihai Gottlieb1, Anastasia Tkachov2, Hagar Kenan2, Abigail Livny2,7,8, Yotam Bahat1, Hadar Sharon1, Oran Ben-Gal1, Maya Cohen1,2, Gabi Zeilig7,9, Meir Plotnik1,10,11
1Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Ramat Gan, Israel
2Joseph Sagol Neuroscience Center, Sheba Medical Center, Ramat Gan, Israel
3Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC) Herzliya, Herzliya, Israel
4Department of Psychiatry, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
5Center for Research on Aging, Health, and Wellbeing, Research School of Population Health, The Australian National University, Canberra, ACT, Australia
6The Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Victoria, Australia
7Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
8Department of Diagnostic Imaging, Sheba Medical Center, Ramat Gan, Israel
9Department of Neurological Rehabilitation, Sheba Medical Center, Ramat Gan, Israel
10Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
11Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel

Tóm tắt

AbstractIntroductionUbiquity of Alzheimer's disease (AD) coupled with relatively ineffectual pharmacologic treatments has spurred interest in nonpharmacologic lifestyle interventions for prevention or risk reduction. However, evidence of neuroplasticity notwithstanding, there are few scientifically rigorous, ecologically relevant brain training studies focused on building cognitive reserve in middle age to protect against cognitive decline. This pilot study will examine the ability of virtual reality (VR) cognitive training to improve cognition and cerebral blood flow (CBF) in middle‐aged individuals at high AD risk due to parental history.MethodsThe design is an assessor‐blind, parallel group, randomized controlled trial of VR cognitive‐motor training in middle‐aged adults with AD family history. The experimental group will be trained with adaptive “real‐world” VR tasks targeting sustained and selective attention, working memory, covert rule deduction, and planning, while walking on a treadmill. One active control group will perform the VR tasks without treadmill walking; another will walk on a treadmill while watching scientific documentaries (nonspecific cognitive stimulation). A passive (waitlist) control group will not receive training. Training sessions will be 45 minutes, twice/week for 12 weeks. Primary outcomes are global cognition and CBF (from arterial spin labeling [ASL]) at baseline, immediately after training (training gain), and 3 months post‐training (maintenance gain). We aim to recruit 125 participants, including 20 passive controls and 35 in the other groups.DiscussionCurrent pharmacologic therapies are for symptomatic AD patients, whereas nonpharmacologic training is administrable before symptom onset. Emerging evidence suggests that cognitive training improves cognitive function. However, a more ecologically valid cognitive‐motor VR setting that better mimics complex daily activities may augment transfer of trained skills. VR training has benefited clinical cohorts, but benefit in asymptomatic high‐risk individuals is unknown. If effective, this trial may help define a prophylactic regimen for AD, adaptable for home‐based application in high‐risk individuals.

Tài liệu tham khảo

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Alzheimer's and Dementia: Translational Research and Clinical Interventions

Tập 4

118-129

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