Computer-based, personalized cognitive training versus classical computer games: a randomized double-blind prospective trial of cognitive stimulation.

BACKGROUND: Many studies have suggested that cognitive training can result in cognitive gains in healthy older adults. We investigated whether personalized computerized cognitive training provides greater benefits than those obtained by playing conventional computer games. METHODS: This was a randomized double-blind interventional study. Self-referred healthy older adults (n = 155, 68 ± 7 years old) were assigned to either a personalized, computerized cognitive training or to a computer games group. Cognitive performance was assessed at baseline and after 3 months by a neuropsychological assessment battery. Differences in cognitive performance scores between and within groups were evaluated using mixed effects models in 2 approaches: adherence only (AO; n = 121) and intention to treat (ITT; n = 155). RESULTS: Both groups improved in cognitive performance. The improvement in the personalized cognitive training group was significant (p < 0.03, AO and ITT approaches) in all 8 cognitive domains. However, in the computer games group it was significant (p < 0.05) in only 4 (AO) or 6 domains (ITT). In the AO analysis, personalized cognitive training was significantly more effective than playing games in improving visuospatial working memory (p = 0.0001), visuospatial learning (p = 0.0012) and focused attention (p = 0.0019). CONCLUSIONS: Personalized, computerized cognitive training appears to be more effective than computer games in improving cognitive performance in healthy older adults. Further studies are needed to evaluate the ecological validity of these findings.

Strategy application test: discriminate validity studies.

PURPOSE: Having a method of testing strategy application abilities provides important information for occupational performance. The goal of the present study was to investigate the discriminate validity of a strategy application test. This test measures the ability to apply and maintain a working strategy for efficient execution of tasks. The advantages of this test are that it is standardized, short, simple to administer, and applicable to various clinical populations. METHOD: Five different groups of participants were studied: senior healthy people, children affected by attention-deficit hyperactivity disorder, people with multiple sclerosis or with depression and schizophrenia. All of these individuals had some frontal lobe involvement, thus suggesting possible executive dysfunction. RESULTS: As hypothesized, the results demonstrated strategy application skill impairment in all the clinical groups, as well as a gradual decline in strategy application abilities with advanced aging. PRACTICE IMPLICATIONS: These results exhibit the discriminate validity of the strategy application test and add to the accumulating evidence of executive dysfunction in these populations.

Cognitive strategies application of multiple sclerosis patients.

When performing a novel task, people need to generate and apply a working strategy. The application of an appropriate working strategy enables patients with cognitive impairment (CI) to perform tasks efficiently, which in turn makes it easier to meet the challenges of daily life tasks. We investigated the strategy application abilities (SAA) of multiple sclerosis (MS) patients and compared these results with data based on healthy subjects' performance. Seventy-six patients performed a Strategy Application Test (SAT) along with other cognitive tests, and completed depression, fatigue, and activity of daily living (ADL) questionnaires. Our results indicated that 76% of the MS patients included had impaired SAA, and that this impairment was not correlated with their depression, fatigue, Expanded Disability Severity Scale (EDSS), or ADL. These findings may have important implications for the understanding of the capability of MS patients to cope with nonroutine tasks, as well as for the potential of future implementation of cognitive rehabilitation in improving the SAA of patients with MS or other cognitive disorders.

The automatic and controlled information-processing dissociation: is it still relevant?

The purpose of this paper is to examine the "dual-process" information-processing model of Schneider and Shiffrin (Schneider, W., and Shiffrin, R. M., Psychol. Rev. 84: 1-66, 1977; see also Shiffrin, R. M., and Schneider, W., Psychol. Rev. 84: 127-190, 1977) in light of the research data that have accumulated since the model was introduced more than 20 years ago. First, a brief introduction of the basic model of automatic and controlled information processing will be given. Second, some alternatives to the basic model that were developed over the last two decades will be reviewed. Third, data from neuropsychology and cognitive neuroscience that have a bearing upon this framework will be considered. Finally, some comments on the current usefulness of the dual-process framework for neuropsychological research will be offered.

Automatic and controlled verbal-information processing in patients with frontal lobe lesions.

The selectivity of frontal lobe lesion effects in the domains of verbal-information processing has not been well established. The authors hypothesized that capacity-limited controlled processing would be more impaired than automatic processing in frontal lobe patients (FLPs). Fifteen FLPs were compared with 2 matched control groups: 14 posterior-lesion patients and 15 normal controls. Both behavioral and event-related brain potential (ERP) measures were collected. Results suggest that both automatic and controlled processing were affected by frontal lobe lesions. ERP results indicated that the main dificulty for the FLPs was in the perceptual stage of information processing. This rather unexpected result may be explained by a basic difficulty of FLPs in attending to a new stimulus in order to process it.

Distractibility after frontal lobe lesions: behavioral and event-related brain potential evidence.

The authors used a semantic priming paradigm to investigate the distractibility phenomenon of patients with frontal lobe lesions (FLPs). They tested two distractibility categories: an inhibition category requiring inhibition of an automatic response and a distraction category caused by irrelevant, unexpected stimuli. Fifteen FLPs were compared with 2 matched control groups: 14 posterior-lesion patients and 15 normal controls. Both behavioral and event-related brain potential (ERP) measures were used. The results suggest that, although there were differences in performance between the FLP group and the control groups, there was no evidence that the FLPs had difficulty specifically with the inhibition category. The most consistent ERP result was that the FLP group had longer N100 latencies than either control group. On the basis of these results, the authors hypothesize that FLPs have difficulty focusing on and starting to process a new stimulus. The authors also discuss the unique contribution ERP evidence has made to cognitive studies.