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Computerized cognitive training effective for childhood cancer survivors
Computerized cognitive training appeared viable and effective for improving working memory, attention and processing speed among survivors of childhood cancer, according to findings from a randomized, single blind study.
“Children receiving [central nervous system]-directed therapy for cancer are at risk for cognitive problems, with few available empirically supported interventions,” Heather M. Conklin, PhD, of the department of psychology at St. Jude Children’s Research Hospital, and colleagues wrote. “Cognitive problems indicate neurodevelopmental disruption that may be modifiable with intervention.”
To analyze the short-term efficacy of a computerized cognitive training program as well as neural correlates of cognitive change, the researchers evaluated 68 survivors of childhood acute lymphoblastic leukemia or brain tumor with known cognitive deficits treated at St. Jude Children’s Research Hospital between December 2010 and December 2013.
Researchers randomly assigned 34 patients (mean age, 12.21 years; 53% boys; 68% ALL survivors) to a computerized cognitive intervention group. They assigned the other 34 patients (mean age, 11.82 years; 53% boys, 71% ALL survivors) to a control group.
Members of the cognitive intervention group were instructed to complete 25 home training sessions during a 5- to 9-week period. Each session entailed 30- to 45-minute visual–spatial and verbal working memory exercises in the form of games, with exercise difficulty adapted based on performance.
Telephone coaching sessions also were provided weekly to bolster motivation and provide feedback. After about 10 weeks from baseline, participants were seen for follow-up cognitive evaluations and neuroimaging examinations.
Six months later, participants were seen for a final cognitive assessment, at which time the intervention was offered to the control participants.
Results showed participants initially assigned to the cognitive intervention demonstrated greater improvement in working memory (3.13 ± 0.58 vs. 0.75 ± 0.43; P = .002; effect size, 0.84), and attention (3.3 ± 0.71 vs. 1.25 ± 0.39; P = .01; effect size, 0.65) as measured by the Wechsler Intelligence Scale for Children
Participants in the intervention group also demonstrated greater improvement in processing speed as measured by Conners’ Continuous Performance Test hit reaction time (– 2.1 ± 1.47 vs. 2.54 ± 1.25; P = .02; effect size ,0.61).
Parents of children in the intervention group reported more substantial decreases in inattention and executive dysfunction. Researchers observed significant pre- to post-training reduction in activation of left lateral prefrontal and bilateral medial frontal areas as determined by functional MRI.
“Study findings show computerized cognitive training is feasible and efficacious for childhood cancer survivors experiencing cognitive late effects,” Conklin and colleagues wrote. “High acceptability and training compliance have been reported and are consistent with other computerized cognitive intervention studies, suggesting better participation than therapist-delivered cognitive intervention.” – by Jennifer Byrne
Disclosure: Please see the full study for a list of all researchers’ relevant financial disclosures.