skip to main content
US FlagAn official website of the United States government
dot gov icon
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
https lock icon
Secure .gov websites use HTTPS
A lock ( lock ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.


Title: Predictors of Effective Working Memory Training in Individuals with Alcohol Use Disorders
BackgroundLow working memory (WM) capacity is associated with alcohol use disorders (AUDs). The importance of WM to adaptive functioning has led to a recent influx of studies attempting to improve individual WM capacity using various cognitive training methods. The present study aimed to examine the efficacy of complex WM training for improving WM capacity among individuals with AUD. MethodsIndividuals were randomized to complete either adaptive WM training or active control training. We applied a methodologically rigorous and structured approach, including a battery of near and moderate transfer measures in those with AUDs and a control group. Additionally, we examined cognitive factors (at baseline) and other predictors of adherence, training task improvement, and transfer. ResultsResults suggest improved WM in individuals with AUDs and controls, as evidenced by improved scores on several transfer measures, after adaptive WM training. However, individuals with AUDs showed poorer adherence and less improvement on the training tasks themselves. Neither IQ, WM, sex, nor condition predicted adherence. Level of training task performance, baseline WM, and IQ predicted transfer task improvement. ConclusionsThis is the first study to rigorously examine both the efficacy of WM training in those with AUDs, and predictors of successful training program adherence and transfer in a large sample. Among study completers, results suggest that AUD status does not predict training improvement and transfer. However, AUD status did predict lower program adherence. WM training was more effective in those with higher cognitive ability at baseline. This study provides direct translation to the development of cognitive interventions for treating AUD.  more » « less
Award ID(s):
1632403
PAR ID:
10077991
Author(s) / Creator(s):
 ;  ;  ;  ;  
Publisher / Repository:
Wiley-Blackwell
Date Published:
Journal Name:
Alcoholism: Clinical and Experimental Research
Volume:
42
Issue:
12
ISSN:
0145-6008
Page Range / eLocation ID:
p. 2432-2441
Format(s):
Medium: X
Sponsoring Org:
National Science Foundation
More Like this
  1. Abstract Working memory (WM) is a fundamental cognitive ability that supports complex thought but is limited in capacity. Thus, WM training interventions have become very popular as a means of potentially improving WM-related skills. Another promising intervention that has gained increasing traction in recent years is transcranial direct current stimulation (tDCS), a noninvasive form of brain stimulation that can modulate cortical excitability and temporarily increase brain plasticity. As such, it has the potential to boost learning and enhance performance on cognitive tasks. This study assessed the efficacy of tDCS to supplement WM training. Sixty-two participants were randomized to receive either right prefrontal, left prefrontal, or sham stimulation with concurrent visuospatial WM training over the course of seven training sessions. Results showed that tDCS enhanced training performance, which was strikingly preserved several months after training completion. Furthermore, we observed stronger effects when tDCS was spaced over a weekend break relative to consecutive daily training, and we also demonstrated selective transfer in the right prefrontal group to nontrained tasks of visual and spatial WM. These findings shed light on how tDCS may be leveraged as a tool to enhance performance on WM-intensive learning tasks. 
    more » « less
  2. Objective:Cognitive training may benefit older adults with mild cognitive impairment (MCI), but the prognostic factors are not well-established. Methods:This study analyzed data from a 78-week trial with 107 participants with MCI, comparing computerized cognitive training (CCT) and computerized crossword puzzle training (CPT). Outcomes were changes in cognitive and functional measures from baseline. Linear mixed-effect models were used to identify prognostic factors for each intervention. Results:Baseline neuropsychological composite z-score was positively associated with cognitive and functional improvements for both interventions in univariable models, retaining significance in the final multivariable model for functional outcome in CPT (P< 0.001). Apolipoprotein E e4 carriers had worse cognitive (P= 0.023) and functional (P= 0.001) outcomes than noncarriers for CPT but not CCT. African Americans showed greater functional improvements than non-African Americans in both CPT (P= 0.001) and CCT (P= 0.010). Better baseline odor identification was correlated with cognitive improvements in CPT (P= 0.006) and functional improvements in CCT (P< 0.001). Conclusion:Baseline cognitive test performance, African American background, and odor identification ability are potential prognostic factors for improved outcomes with cognitive interventions in older adults with MCI. Apolipoprotein E e4 is associated with poor outcomes. Replication of these findings may improve the selection of cognitive interventions for individuals with MCI. 
    more » « less
  3. Abstract BACKGROUNDLimited research has explored the effect of cardiovascular risk and amyloid interplay on cognitive decline in East Asians. METHODSVascular burden was quantified using Framingham's General Cardiovascular Risk Score (FRS) in 526 Korean Brain Aging Study (KBASE) participants. Cognitive differences in groups stratified by FRS and amyloid positivity were assessed at baseline and longitudinally. RESULTSBaseline analyses revealed that amyloid‐negative (Aβ–) cognitively normal (CN) individuals with high FRS had lower cognition compared to Aβ– CN individuals with low FRS (p < 0.0001). Longitudinally, amyloid pathology predominantly drove cognitive decline, while FRS alone had negligible effects on cognition in CN and mild cognitive impairment (MCI) groups. CONCLUSIONOur findings indicate that managing vascular risk may be crucial in preserving cognition in Aβ– individuals early on and before the clinical manifestation of dementia. Within the CN and MCI groups, irrespective of FRS status, amyloid‐positive individuals had worse cognitive performance than Aβ– individuals. HighlightsVascular risk significantly affects cognition in amyloid‐negative older Koreans.Amyloid‐negative CN older adults with high vascular risk had lower baseline cognition.Amyloid pathology drives cognitive decline in CN and MCI, regardless of vascular risk.The study underscores the impact of vascular health on the AD disease spectrum. 
    more » « less
  4. BackgroundSemantic intrusion errors (SIEs) are associated with mild cognitive impairment (MCI) due to Alzheimer's disease (AD). It is unknown whether accounting for maximum learning capacity still leads to an increase in SIEs when elevated plasma p-tau217, a biological indicator of underlying AD, is present. MethodsOne hundred fifty-eight older adult participants completed the Loewenstein-Acevedo Scales for Semantic Interference and Learning (LASSI-L), a sensitive cognitive challenge test designed to elicit SIEs. Of these, 108 were clinically diagnosed with amnestic MCI (aMCI). Fifty-eight individuals met or exceeded a plasma p-tau217positivity of >0.55 pg/ml, while 50 individuals scored below this threshold. ResultsAfter adjusting for demographic covariates and maximum learning capacity, the aMCI p-tau217+ group evidenced more SIEs compared to aMCI p-tau217- on the first (list B1;p= 0.035) and second trials of the competing list (list B2;p= 0.006). Biological predictors such asApoEε4 status, higher p-tau217, and older age were predictors of an elevated number of SIEs [list B2:F(3,104) = 10.92;p= 0.001;R= 0.489)]. ConclusionsUnlike previous studies that used amyloid PET or other plasma biomarkers, individuals with aMCI p-tau217+ evidenced more SIEs, even after adjusting for their initial learning capacity, a covariate that has not been studied previously. These findings support that SIEs are more prevalent in the presence of underlying AD pathology and occur independent of learning deficits. 
    more » « less
  5. BackgroundCognitive training may partially reverse cognitive deficits in people with HIV (PWH). Previous functional MRI (fMRI) studies demonstrate that working memory training (WMT) alters brain activity during working memory tasks, but its effects on resting brain network organization remain unknown. PurposeTo test whether WMT affects PWH brain functional connectivity in resting‐state fMRI (rsfMRI). Study TypeProspective. PopulationA total of 53 PWH (ages 50.7 ± 1.5 years, two women) and 53HIV‐seronegative controls (SN, ages 49.5 ± 1.6 years, six women). Field Strength/SequenceAxial single‐shot gradient‐echo echo‐planar imaging at 3.0 T was performed at baseline (TL1), at 1‐month (TL2), and at 6‐months (TL3), after WMT. AssessmentAll participants had rsfMRI and clinical assessments (including neuropsychological tests) at TL1 before randomization to Cogmed WMT (adaptive training,n = 58: 28 PWH, 30 SN; nonadaptive training,n = 48: 25 PWH, 23 SN), 25 sessions over 5–8 weeks. All assessments were repeated at TL2 and at TL3. The functional connectivity estimated by independent component analysis (ICA) or graph theory (GT) metrics (eigenvector centrality, etc.) for different link densities (LDs) were compared between PWH and SN groups at TL1 and TL2. Statistical TestsTwo‐way analyses of variance (ANOVA) on GT metrics and two‐samplet‐tests on FC or GT metrics were performed. Cognitive (eg memory) measures were correlated with eigenvector centrality (eCent) using Pearson's correlations. The significance level was set atP < 0.05 after false discovery rate correction. ResultsThe ventral default mode network (vDMN) eCent differed between PWH and SN groups at TL1 but not at TL2 (P = 0.28). In PWH, vDMN eCent changes significantly correlated with changes in the memory ability in PWH (r = −0.62 at LD = 50%) and vDMN eCent before training significantly correlated with memory performance changes (r = 0.53 at LD = 50%). Data ConclusionICA and GT analyses showed that adaptive WMT normalized graph properties of the vDMN in PWH. Evidence Level1 Technical Efficacy1 
    more » « less