Neural correlates of training and transfer effects in working memory in older adults

Randomized controlled trials of non-pharmacological interventions for healthy seniors: Effects on cognitive decline, brain plasticity and activities of daily living-A 23-year scoping review

Little is known about the simultaneous effects of non-pharmacological interventions (NPI) on healthy older adults' behavior and brain plasticity, as measured by psychometric instruments and magnetic resonance imaging (MRI). The purpose of this scoping review was to compile an extensive list of randomized controlled trials published from January 1, 2000, to August 31, 2023, of NPI for mitigating and countervailing age-related physical and cognitive decline and associated cerebral degeneration in healthy elderly populations with a mean age of 55 and over. After inventorying the NPI that met our criteria, we divided them into six classes: single-domain cognitive, multi-domain cognitive, physical aerobic, physical non-aerobic, combined cognitive and physical aerobic, and combined cognitive and physical non-aerobic. The ultimate purpose of these NPI was to enhance individual autonomy and well-being by bolstering functional capacity that might transfer to activities of daily living. The insights from this study can be a starting point for new research and inform social, public health, and economic policies. The PRISMA extension for scoping reviews (PRISMA-ScR) checklist served as the framework for this scoping review, which includes 70 studies. Results indicate that medium- and long-term interventions combining non-aerobic physical exercise and multi-domain cognitive interventions best stimulate neuroplasticity and protect against age-related decline and that outcomes may transfer to activities of daily living.

Trajectories and contributing factors of neural compensation in healthy and pathological aging

Neural degeneration is a hallmark of healthy aging and can be associated with specific cognitive impairments. However, neural degeneration per se is not matched by unremitting declines in cognitive abilities. Instead, middle-aged and older adults typically maintain surprisingly high levels of cognitive functioning, suggesting that the human brain can adapt to structural degeneration by neural compensation. Here, we summarize prevailing theories and recent empirical studies on neural compensation with a focus on often neglected contributing factors, such as lifestyle, metabolism and neural plasticity. We suggest that these factors moderate the relationship between structural integrity and neural compensation, maintaining psychological well-being and behavioral functioning. Finally, we discuss that a breakdown in neural compensation may pose a tipping point that distinguishes the trajectories of healthy vs pathological aging, but conjoint support from psychology and cognitive neuroscience for this alluring view is still scarce. Therefore, future experiments that target the concomitant processes of neural compensation and associated behavior will foster a comprehensive understanding of both healthy and pathological aging.

Effortful and effortless training of executive functions improve brain multiple demand system activities differently: an activation likelihood estimation meta-analysis of functional neuroimaging studies

Both effortful and effortless training have been shown to be effective in enhancing individuals' executive functions. Effortful training improves domain-specific EFs, while effortless training improves domain-general EFs. Furthermore, effortful training has significantly higher training effects on EFs than effortless training. The neural mechanism underlying these different effects remained unclear. The present study conducted meta-analysis on neuroimaging studies to explore the changes of brain activations induced by effortful and effortless training. The results showed that effortful training induced greater activation in superior frontal gyrus, while effortless training induced greater activation in middle frontal gyrus, precuneus and cuneus. The brain regions of MD system enhanced by effortful training were more associated with core cognitive functions underlying EFs, while those enhanced by effortless training were more correlated with language functions. In addition, the significant clusters induced by effortful training had more overlaps with the MD system than effortless training. These results provided us with possibility to discuss the different behavioral results brought by effortful and effortless training.

The Influence of Probiotic Supplementation on the Obesity Indexes, Neuroinflammatory and Oxidative Stress Markers, Gut Microbial Diversity, and Working Memory in Obese Thai Children

Obesity is a worldwide health problem with a complex interaction between gut microbiota and cognition. Several studies have demonstrated that probiotic treatments improve characteristics linked to obesity. The present study aimed to evaluate the effects of probiotic supplementation on the obesity indexes, inflammatory and oxidative stress markers, gut microbiota, and working memory in obese children. Ten obese children were assigned to receive the probiotics (8 × 109 CFU of Lactobacillus paracasei HII01 and Bifidobacterium animalis subsp. lactis) for 12 weeks. Demographic data were recorded. Urine and fecal samples were collected to evaluate biomarkers related to obesity and cognition. Behavioral working memory was assessed using the visual n-back test. Electroencephalography was employed to measure electrical activity during the visual n-back test. All parameters were evaluated at the baseline and after 12 weeks. The results revealed that probiotic supplementation significantly altered some gut microbial metabolites, gut microbiota, total antioxidant capacity, and neuroinflammatory markers. However, no significant changes were observed in the visual n-back test or electroencephalographic recordings after 12 weeks. In conclusion, the use of probiotics might be an alternative treatment that could improve the gut microbial ecosystem and microbial metabolites, as well as host antioxidant and neuroinflammation levels. The preliminary results indicated that further detailed prolonged studies are needed in order to determine the beneficial effects of the studied probiotics.

Impact of Computerized Cognitive Training on Default Mode Network Connectivity in Subjects at Risk for Alzheimer's Disease: A 78-week Randomized Controlled Trial

BACKGROUND

Mild cognitive impairment (MCI) represents a high risk group for Alzheimer's disease (AD). Computerized Cognitive Games Training (CCT) is an investigational strategy to improve targeted functions in MCI through the modulation of cognitive networks.

OBJECTIVE

The goal of this study was to examine the effect of CCT versus a non-targeted active brain exercise on functional cognitive networks.

METHODS

107 patients with MCI were randomized to CCT or web-based crossword puzzles. Resting-state functional MRI (fMRI) was obtained at baseline and 18 months to evaluate differences in fMRI measured within- and between-network functional connectivity (FC) of the default mode network (DMN) and other large-scale brain networks: the executive control, salience, and sensorimotor networks.

RESULTS

There were no differences between crosswords and games in the primary outcome, within-network DMN FC across all subjects. However, secondary analyses suggest differential effects on between-network connectivity involving the DMN and SLN, and within-network connectivity of the DMN in subjects with late MCI. Paradoxically, in both cases, there was a decrease in FC for games and an increase for the crosswords control (p < 0.05), accompanied by lesser cognitive decline in the crosswords group.

CONCLUSION

Results do not support a differential impact on within-network DMN FC between games and crossword puzzle interventions. However, crossword puzzles might result in cognitively beneficial remodeling between the DMN and other networks in more severely impaired MCI subjects, parallel to the observed clinical benefits.

Computerized Games versus Crosswords Training in Mild Cognitive Impairment

BACKGROUND

Mild cognitive impairment (MCI) increases the risk of dementia. The efficacy of cognitive training in patients with MCI is unclear.

METHODS

In a two-site, single-blinded, 78-week trial, participants with MCI - stratified by age, severity (early/late MCI), and site - were randomly assigned to 12 weeks of intensive, home-based, computerized training with Web-based cognitive games or Web-based crossword puzzles, followed by six booster sessions. In mixed-model analyses, the primary outcome was change from baseline in the 11-item Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog) score, a 70 point scale in which higher scores indicate greater cognitive impairment at 78 weeks, adjusted for baseline. Secondary outcomes included change from baseline in neuropsychological composite score, University of California San Diego Performance-Based Skills Assessment (functional outcome) score, and Functional Activities Questionnaire (functional outcome) score at 78 weeks, adjusted for baseline. Changes in hippocampal volume and cortical thickness on magnetic resonance imaging were assessed.

RESULTS

Among 107 participants (n=51 [games]; n=56 [crosswords]), ADAS-Cog score worsened slightly for games and improved for crosswords at week 78 (least squares [LS] means difference, -1.44; 95% confidence interval [CI], -2.83 to -0.06; P=0.04). From baseline to week 78, mean ADAS-Cog score worsened for games (9.53 to 9.93) and improved for crosswords (9.59 to 8.61). The late MCI subgroup showed similar results (LS means difference, -2.45; SE, 0.89; 95% CI, -4.21 to -0.70). Among secondary outcomes, the Functional Activities Questionnaire score worsened more with games than with crosswords at week 78 (LS means difference, -1.08; 95% CI, -1.97 to -0.18). Other secondary outcomes showed no differences. Decreases in hippocampal volume and cortical thickness were greater for games than for crosswords (LS means difference, 34.07; SE, 17.12; 95% CI, 0.51 to 67.63 [hippocampal volume]; LS means difference, 0.02; SE, 0.01; 95% CI, 0.00 to 0.04 [cortical thickness]).

CONCLUSIONS

Home-based computerized training with crosswords demonstrated superior efficacy to games for the primary outcome of baseline-adjusted change in ADAS-Cog score over 78 weeks. (Supported by the National Institutes of Health, National Institute on Aging; ClinicalTrials.gov number, NCT03205709.).

Effects of working memory training on cognition in healthy older adults: A systematic review

ABSTRACT. The working memory (WM) training in older adults can benefit their cognition. However, there is a dearth of literature reviews on the subject. Objective: This study aimed to investigate and evaluate the effects of WM training on the cognition of healthy older adults, in individual and group interventions reported in the literature. Methods: This is a systematic review involving a qualitative analysis of publications on the SciELO, LILACS, and MEDLINE databases carried out between March and June 2021. Results: A total of 47 studies were identified and analyzed, comprising 40 in older adults only and 7 comparing older and younger adults, investigating individual or group WM training or other types of intervention focused on WM effects. Conclusions: Both individual and group intervention contributed to the maintenance and/or improvement of cognition in older adults exploiting brain plasticity to promote mental health and prevent cognitive problems that can negatively impact quality of life of this group.

Effects of a three-week executive control training on adaptation to task difficulty and emotional interference

Intact executive functions are characterized by flexible adaptation to task requirements, while these effects are reduced in internalizing disorders. Furthermore, as executive functions play an important role in emotion regulation, deficits in executive functions may contribute to symptom generation in psychological disorders through increased emotional interference. Thus, the present study investigated transfer effects of a three-week executive control training on adaptation to task difficulty and emotional interference in healthy participants (n = 24) to further explore the training's suitability for clinical application. To assess the adaptation to task difficulty, the proportion congruency effect on behavioral data (response times, error rates) and ERP measures (N2, CRN) was assessed in a flanker task with varying frequency of incompatible trials (25%, 75%). To quantify emotional interference, flanker stimuli were superimposed on neutral or negative pictures. Replicating previous results, the training increased interference control as indexed by decreased response times and errors rates, increased N2 amplitude and decreased CRN amplitude in incompatible trials after training. Proportion congruency effects were weaker than expected and not affected by the training intervention. The training lead to a shift in the time-point of emotional interference: before training negative pictures lead to a reduction in CRN amplitude, while after training this reduction was observed for the N2. This pattern illustrates that the training leads to a change in task processing mode from predominant response-related cognitive control to predominant stimulus-related cognitive control (N2), indicating a proactive processing mode.

Training Willpower: Reducing Costs and Valuing Effort

The integrative model of effortful control presented in a previous article aimed to specify the neurophysiological bases of mental effort. This model assumes that effort reflects three different inter-related aspects of the same adaptive function. First, a mechanism anchored in the salience network that makes decisions about the effort that should be engaged in the current task in view of costs and benefits associated with the achievement of the task goal. Second, a top-down control signal generated by the mechanism of effort that modulates neuronal activity in brain regions involved in the current task to filter pertinent information. Third, a feeling that emerges in awareness during effortful tasks and reflects the costs associated with goal-directed behavior. The aim of the present article is to complete this model by proposing that the capacity to exert effortful control can be improved through training programs. Two main questions relative to this possible strengthening of willpower are addressed in this paper. The first question concerns the existence of empirical evidence that supports gains in effortful control capacity through training. We conducted a review of 63 meta-analyses that shows training programs are effective in improving performance in effortful tasks tapping executive functions and/or self-control with a small to large effect size. Moreover, physical and mindfulness exercises could be two promising training methods that would deserve to be included in training programs aiming to strengthen willpower. The second question concerns the neural mechanisms that could explain these gains in effortful control capacity. Two plausible brain mechanisms are proposed: (1) a decrease in effort costs combined with a greater efficiency of brain regions involved in the task and (2) an increase in the value of effort through operant conditioning in the context of high effort and high reward. The first mechanism supports the hypothesis of a strengthening of the capacity to exert effortful control whereas the second mechanism supports the hypothesis of an increase in the motivation to exert this control. In the last part of the article, we made several recommendations to improve the effectiveness of interventional studies aiming to train this adaptive function."Keep the faculty of effort alive in you by a little gratuitous exercise every day."James (1918, p. 127).

What Is Targeted When We Train Working Memory? Evidence From a Meta-Analysis of the Neural Correlates of Working Memory Training Using Activation Likelihood Estimation

Working memory (WM) is the system responsible for maintaining and manipulating information, in the face of ongoing distraction. In turn, WM span is perceived to be an individual-differences construct reflecting the limited capacity of this system. Recently, however, there has been some evidence to suggest that WM capacity can increase through training, raising the possibility that training can functionally alter the neural structures supporting WM. To address the hypothesis that the neural substrates underlying WM are targeted by training, we conducted a meta-analysis of functional magnetic resonance imaging (fMRI) studies of WM training using Activation Likelihood Estimation (ALE). Our results demonstrate that WM training is associated exclusively with decreases in blood oxygenation level-dependent (BOLD) responses in clusters within the fronto-parietal system that underlie WM, including the bilateral inferior parietal lobule (BA 39/40), middle (BA 9) and superior (BA 6) frontal gyri, and medial frontal gyrus bordering on the cingulate gyrus (BA 8/32). We discuss the various psychological and physiological mechanisms that could be responsible for the observed reductions in the BOLD signal in relation to WM training, and consider their implications for the construct of WM span as a limited resource.

Neuronal efficiency following n-back training task is accompanied by a higher cerebral glucose metabolism

Recent functional magnetic resonance imaging (fMRI) studies revealed lower neural activation during processing of an n-back task following working memory training, indicating a training-related increase in neural efficiency. In the present study, we asked if the training induced regional neural activation is accompanied by changes in glucose consumption. An active control and an experimental group of healthy middle-aged volunteers conducted 32 sessions of visual and verbal n-back trainings over 8 weeks. We analyzed data of 52 subjects (25 experimental and 27 control group) for practice effects underlying verbal working memory task and 50 subjects (24 experimental and 26 control group) for practice effects underlying visual WM task. The samples of these two tasks were nearly identical (data of 47 subjects were available for both verbal and visual tasks). Both groups completed neuroimaging sessions at a hybrid PET/MR system before and after training. Each session included criterion task fMRI and resting state positron emission tomography with FDG (FDG-PET). As reported previously, lower neural activation following n-back training was found in regions of the fronto-parieto-cerebellar circuitry during a verbal n-back task. Notably, these changes co-occurred spatially with a higher relative FDG-uptake. Decreased neural activation within regions of the fronto-parietal network during visual n-back task did not show co-occurring changes in relative FDG-uptake. There was no direct association between neuroimaging and behavioral measures, which could be due to the inter-subjects' variability in reaching capacity limits. Our findings provide new details for working memory training induced neural efficiency on a molecular level by integrating FDG-PET and fMRI measures.

Latent brain state dynamics and cognitive flexibility in older adults

Cognitive impairment in older adults is a rapidly growing public health concern as the elderly population dramatically grows worldwide. While it is generally assumed that cognitive deficits in older adults are associated with reduced brain flexibility, quantitative evidence has been lacking. Here, we investigate brain flexibility in healthy older adults (ages 60-85) using a novel Bayesian switching dynamical system algorithm and ultrafast temporal resolution (TR = 490 ms) whole-brain fMRI data during performance of a Sternberg working memory task. We identify latent brain states and characterize their dynamic temporal properties, including state transitions, associated with encoding, maintenance, and retrieval. Crucially, we demonstrate that brain inflexibility is associated with slower and more fragmented transitions between latent brain states, and that brain inflexibility mediates the relation between age and cognitive inflexibility. Our study provides a novel neurocomputational framework for investigating latent dynamic circuit processes underlying brain flexibility and cognition in the context of aging.

Targeted cognitive game training enhances cognitive performance in multiple sclerosis patients treated with interferon beta 1-a

Background

Prevention of cognitive decline in Multiple Sclerosis (MS) is of major importance. We explored the effect of a 6 months computerized game training program on cognitive performance in MS patients with mild cognitive impairment.

Methods

This was a single-center, randomized prospective study. We enrolled in this study 100 eligible MS patients treated with Interferon-beta-1a (Rebif). All had mild cognitive impairment in either executive function or information processing speed. Patients were randomized 1:1 to either use the cognitive games platform by HappyNeuron (HN) or receive no intervention. Executive function and information processing speed scores were measured at 3 and 6 months from baseline to evaluate the effect of game training on cognitive scores.

Results

In both executive function and information processing speed, the game Training group showed significant improvement after 3 and 6 months. The Non-Training group showed mild deterioration in both domains at 3 months, and further deterioration that became significant at 6 months in executive function. Furthermore, at 6 months, the percent of patients in the Training group that improved or remained stable in both cognitive domains was significantly higher compared to the Non-Training group.

Conclusions

Our findings suggest that cognitive game training has a beneficial effect on cognitive performance in MS patients suffering from mild cognitive impairment. While further evaluation is required to assess the longevity of that effect, we nonetheless recommend to MS patients to be engaged in cognitive gaming practice as part of a holistic approach to treating their condition.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12984-021-00968-3.

What Can Neural Activity Tell Us About Cognitive Resources in Aging?

A reduction in cognitive resources has been originally proposed to account for age-related decrements in several cognitive domains. According to this view, aging limits the pool of available cognitive supplies: Compared to younger adults, elderly exhaust the resources more rapidly as task difficulty increases, hence a dramatic performance drop. Neurophysiological indexes (e.g., BOLD response and EEG activity) may be instrumental to quantify the amount of such cognitive resources in the brain and to pinpoint the stage of stimulus processing where the decrement in age-related resources is evident. However, as we discuss in this mini-review, the most recent studies on the neurophysiological markers of age-related changes lack a consistent coupling between neural and behavioral effects, which casts doubt on the advantage of measuring neural indexes to study resource deployment in aging. For instance, in the working memory (WM) domain, recent cross-sectional studies found varying patterns of concurrent age-related brain activity, ranging from equivalent to reduced and increased activations of old with respect to younger adults. In an attempt to reconcile these seemingly inconsistent findings of brain-behavior coupling, we focus on the contribution of confounding sources of variability and propose ways to control for them. Finally, we suggest an alternative perspective to explain age-related effects that implies a qualitative (instead of or along with a quantitative) difference in the deployment of cognitive resources in aging.

Training executive functions using an adaptive procedure over 21 days (10 training sessions) and an active control group

The degree to which executive function (EF) abilities (including working memory [WM], inhibitory control [IC], and cognitive flexibility [CF]) can be enhanced through training is an important question; however, research in this area is inconsistent. Previous cognitive training studies largely agree that training leads to improvements in the trained task, but the generalisability of this improvement to other related tasks remains controversial. In this article, we present a pre-registered experiment that used an adaptive training procedure to examine whether EFs can be enhanced through cognitive training, and directly compared the efficacy and generalisability across sub-components of EF using training programmes that target WM, IC, or CF versus an active control group. Participants (n = 160) first completed a battery of tasks that assessed EFs, then were randomly assigned to one of the four training groups, and completed an adaptive procedure over 21 days (10 training sessions) that targeted a specific sub-component of EF (or was comparatively engaging and challenging, but did not train a specific EF). At post-test, participants returned to the lab to repeat the battery of EF tasks. Results revealed robust direct training effects (i.e., on trained task), but limited evidence to support near (i.e., same EF, different task) and far (i.e., different EF and task) transfer effects. Where indirect training benefits emerged, the effects were more readily attributable to the overlapping training/assessment task routines, rather than more general enhancements to the underlying cognitive processes or neural circuits.

The effects of working memory training in children revealed by behavioral responses and ERP

BACKGROUND

Recent studies have examined the effect of computerized cognitive training on working memory (WM), but the behavioral and neural effects were uncertain. Also, few studies have explored WM training effects on children using event-related potentials. The purpose of our study was to investigate the effects of WM training in children, including the effects on behavioral performance and neurophysiological outcomes.

METHODS

Forty-four healthy children (mean age = 7.76 years, SD = 0.57 years, 18 females) were assigned to the training and control groups. Over 20 training sessions, the training group participated in the computation-span and spatial N-back tasks, whereas the control group joined in normal class activities. They all completed the pre- and post-test evaluation of WM tasks (digit span backwards task and N-back task).

RESULTS

The results showed that WM training led to improved performance in the digit span backwards task and 2-back task of post-test evaluation, shortened P3a and P3b latencies in nontarget trials during the spatial 1-back task, shortened P3a latency in target and nontarget trials, as well as increased P3b amplitude and shortened P3b latency in target trials during the spatial 2-back task.

CONCLUSIONS

These results suggested that WM training might enhance children's behavioral performance on WM tasks and brought about neurophysiological changes. This study gives insights into the potential of WM training effects on children's behavioral performance and neurophysiological outcomes.

A Game a Day Keeps Cognitive Decline Away? A Systematic Review and Meta-Analysis of Commercially-Available Brain Training Programs in Healthy and Cognitively Impaired Older Adults

The rising prevalence rates of age-related cognitive impairment are a worldwide public concern, bringing about a surge in the number of "brain training" programs commercially available to the general public. Numerous companies advertise that their products improve memory and protect against cognitive decline, though researchers have voiced concerns regarding the validity of such claims. To address this issue, the current meta-analytic investigation examined evidence from 43 studies (encompassing 2,636 participants) to evaluate the efficacy of commercial training programs within two separate populations: healthy older adults and older adults with mild cognitive-impairment (MCI). Seven programs were identified: BrainGymmer, BrainHQ, CogMed, CogniFit, Dakim, Lumosity, and MyBrainTrainer. Analyses yielded small, significant near-transfer effects for both healthy and MCI samples. Far-transfer was not observed for the MCI sample, whereas a small, significant effect was found for subjective but not objective measures of far-transfer in the healthy sample. Analyses of individual domains (combining near-and far-transfer outcomes) yielded significant transfer to executive-functioning, memory, and processing-speed in healthy older adults. After adjusting for publication bias, only the effect size for processing speed remained significant. Transfer to attention, objective everyday functioning, fluid-intelligence, and visuospatial domains was not significant. Thus, whilst "brain training" may be suitable for enjoyment and entertainment purposes, there is currently insufficient empirical evidence to support that such training can improve memory, general cognition, or everyday functioning. This area of research is still in its infancy and warrants further investigation to provide more substantial evidence regarding the efficacy of this rapidly expanding industry.

Functional brain changes associated with cognitive training in healthy older adults: A preliminary ALE meta-analysis

Accumulating evidence suggests that cognitive training (CT) programs may provide healthy older adults (OAs) with cognitive benefits that are accompanied by alterations in neural activity. The current review offers the first quantitative synthesis of the available literature on the neural effects of CT in healthy aging. It was hypothesized that OAs would evidence increased and decreased neural activations across various challenging CTs, and that these effects would be observed as significantly altered clusters within regions of the frontoparietal network (FPN). Online databases and reference lists were searched to identify peer-reviewed publications that reported assessment of neural changes associated with CT programs in healthy OAs. Among the 2097 candidate studies identified, 14 studies with a total of 238 participants met inclusionary criteria. GingerALE software was used to quantify neural effects in a whole-brain analysis. The activation likelihood estimation technique revealed significant increases in activation following CT in the left hemisphere middle frontal gyrus, precentral gyrus, and posterior parietal cortex, extending to the superior occipital gyrus. Two clusters of diminished neural activity following CT were identified within the right hemisphere middle frontal gyrus and supramarginal gyrus, extending to the superior temporal gyrus. These results provide preliminary evidence of common neural effects of different CT interventions within regions of the FPN. Findings may inform future investigations of neuroplasticity across the lifespan, including clinical applications of CT, such as assessing treatment outcomes.

Working memory training: Taking a step back to retool and create a bridge between clinical and neuroimaging research methods

Improvements in patient outcomes and mortality after brain injury alongside increasing ageing population have resulted in an increasing need to develop cognitive interventions for individuals experiencing changes in their cognitive function. One topic of increasing research interest is whether cognitive functions such as attention, memory and executive functioning can be improved through the use of working memory training interventions. Both clinical and neuroimaging researchers are working to evidence this, but their efforts rarely come together. We discuss here several issues that may be hindering progress in this area, including the tools researchers utilize to measure cognition, the choice between employing active or passive control groups, the focus on transfer effects at the expense of well-characterized training effects, and the overall lack of neuroimaging studies in individuals with neurological disorders. We argue that the only way to advance the field is to build bridges between the disciplines of clinical neuropsychology and cognitive neuroscience. We suggest a multi-level framework to validate the efficacy of working memory interventions and other forms of cognitive training that combine both clinical and neuroimaging approaches. We conclude that in order to move forward we need to form multidisciplinary teams, employ interdisciplinary methods, brain imaging quality rating tools and build national and international collaborations based on open science principles.

Durable memories and efficient neural coding through mnemonic training using the method of loci

Mnemonic techniques, such as the method of loci, can powerfully boost memory. We compared memory athletes ranked among the world's top 50 in memory sports to mnemonics-naïve controls. In a second study, participants completed a 6-week memory training, working memory training, or no intervention. Behaviorally, memory training enhanced durable, longer-lasting memories. Functional magnetic resonance imaging during encoding and recognition revealed task-based activation decreases in lateral prefrontal, as well as in parahippocampal and retrosplenial cortices in both memory athletes and participants after memory training, partly associated with better performance after 4 months. This was complemented by hippocampal-neocortical coupling during consolidation, which was stronger the more durable memories participants formed. Our findings advance knowledge on how mnemonic training boosts durable memory formation through decreased task-based activation and increased consolidation thereafter. This is in line with conceptual accounts of neural efficiency and highlights a complex interplay of neural processes critical for extraordinary memory.

Dorsolateral Prefrontal Functional Connectivity Predicts Working Memory Training Gains

Background: Normal aging is associated with working memory decline. A decrease in working memory performance is associated with age-related changes in functional activation patterns in the dorsolateral prefrontal cortex (DLPFC). Cognitive training can improve cognitive performance in healthy older adults. We implemented a cognitive training study to assess determinants of generalization of training gains to untrained tasks, a key indicator for the effectiveness of cognitive training. We aimed to investigate the association of resting-state functional connectivity (FC) of DLPFC with working memory performance improvement and cognitive gains after the training.

Method: A sample of 60 healthy older adults (mean age: 68 years) underwent a 4-week neuropsychological training, entailing a working memory task. Baseline resting-state functional MRI (rs-fMRI) images were acquired in order to investigate the FC of DLPFC. To evaluate training effects, participants underwent a neuropsychological assessment before and after the training. A second follow-up assessment was applied 12 weeks after the training. We used cognitive scores of digit span backward and visual block span backward tasks representing working memory function. The training group was divided into subjects who had and who did not have training gains, which was defined as a higher improvement in working memory tasks than the control group (N = 19).

Results: A high FC of DLPFC of the right hemisphere was significantly associated with training gains and performance improvement in the visuospatial task. The maintenance of cognitive gains was restricted to the time period directly after the training. The training group showed performance improvement in the digit span backward task.

Conclusion: Functional activation patterns of the DLPFC were associated with the degree of working memory training gains and visuospatial performance improvement. Although improvement through cognitive training and acquisition of training gains are possible in aging, they remain limited.

Reliability, sensitivity, and predictive value of fMRI during multiple object tracking as a marker of cognitive training gain in combination with tDCS in stroke survivors

Computerized cognitive training (CCT) combined with transcranial direct current stimulation (tDCS) has showed some promise in alleviating cognitive impairments in patients with brain disorders, but the robustness and possible mechanisms are unclear. In this prospective double-blind randomized clinical trial, we investigated the feasibility and effectiveness of combining CCT and tDCS, and tested the predictive value of and training-related changes in fMRI-based brain activation during attentive performance (multiple object tracking) obtained at inclusion, before initiating training, and after the three-weeks intervention in chronic stroke patients (>6 months since hospital admission). Patients were randomized to one of two groups, receiving CCT and either (a) tDCS targeting left dorsolateral prefrontal cortex (1 mA), or (b) sham tDCS, with 40s active stimulation (1 mA) before fade out of the current. Of note, 77 patients were enrolled in the study, 54 completed the cognitive training, and 48 completed all training and MRI sessions. We found significant improvement in performance across all trained tasks, but no additional gain of tDCS. fMRI-based brain activation showed high reliability, and higher cognitive performance was associated with increased tracking-related activation in the dorsal attention network and default mode network as well as anterior cingulate after compared to before the intervention. We found no significant associations between cognitive gain and brain activation measured before training or in the difference in activation after intervention. Combined, these results show significant training effects on trained cognitive tasks in stroke survivors, with no clear evidence of additional gain of concurrent tDCS.

Object-Location Memory Training in Older Adults Leads to Greater Deactivation of the Dorsal Default Mode Network

Substantial evidence indicates that cognitive training can be efficacious for older adults, but findings regarding training-related brain plasticity have been mixed and vary depending on the imaging modality. Recent years have seen a growth in recognition of the importance of large-scale brain networks on cognition. In particular, task-induced deactivation within the default mode network (DMN) is thought to facilitate externally directed cognition, while aging-related decrements in this neural process are related to reduced cognitive performance. It is not yet clear whether task-induced deactivation within the DMN can be enhanced by cognitive training in the elderly. We previously reported durable cognitive improvements in a sample of healthy older adults (age range = 60-75) who completed 6 weeks of process-based object-location memory training (N = 36) compared to an active control training group (N = 31). The primary aim of the current study is to evaluate whether these cognitive gains are accompanied by training-related changes in task-related DMN deactivation. Given the evidence for heterogeneity of the DMN, we examine task-related activation/deactivation within two separate DMN branches, a ventral branch related to episodic memory and a dorsal branch more closely resembling the canonical DMN. Participants underwent functional magnetic resonance imaging (fMRI) while performing an untrained object-location memory task at four time points before, during, and after the training period. Task-induced (de)activation values were extracted for the ventral and dorsal DMN branches at each time point. Relative to visual fixation baseline: (i) the dorsal DMN was deactivated during the scanner task, while the ventral DMN was activated; (ii) the object-location memory training group exhibited an increase in dorsal DMN deactivation relative to the active control group over the course of training and follow-up; (iii) changes in dorsal DMN deactivation did not correlate with task improvement. These results indicate a training-related enhancement of task-induced deactivation of the dorsal DMN, although the specificity of this improvement to the cognitive task performed in the scanner is not clear.

The Effects of Working Memory Training on Brain Activity

This study aimed to investigate if two weeks of working memory (WM) training on a progressive N-back task can generate changes in the activity of the underlying WM neural network. Forty-six healthy volunteers (23 training and 23 controls) were asked to perform the N-back task during three fMRI scanning sessions: (1) before training, (2) after the half of training sessions, and (3) at the end. Between the scanning sessions, the experimental group underwent a 10-session training of working memory with the use of an adaptive version of the N-back task, while the control group did not train anything. The N-back task in the scanning sessions was relatively easy (n = 2) in order to ensure high accuracy and a lack of between-group differences at the behavioral level. Such training-induced differences in neural efficiency were expected. Behavioral analyses revealed improved performance of both groups on the N-back task. However, these improvements resulted from the test-retest effect, not the training outside scanner. Performance on the non-trained stop-signal task did not demonstrate any transfer effect. Imaging analysis showed changes in activation in several significant clusters, with overlapping regions of interest in the frontal and parietal lobes. However, patterns of between-session changes of activation did not show any effect of training. The only finding that can be linked with training consists in strengthening the correlation between task performance accuracy and activation of the parietal regions of the neural network subserving working memory (left superior parietal lobule and right supramarginal gyrus posterior). These results suggest that the effects of WM training consist in learning that, in order to ensure high accuracy in the criterion task, activation of the parietal regions implicated in working memory updating must rise.

Effects of adaptive and non-adaptive three-week executive control training on interference control: Evidence from the N2, CRN, and ERN

The current pilot study investigated if interference control can be improved by a three-week at-home training comprising a flanker and a n-back task in healthy adults, thus exploring the training's suitability for future clinical application, i.e. as a treatment augmentation for psychological disorders. As training gains are assumed to be modulated by the amount of mismatch between task demands and brain resources, an adaptive and a non-adaptive training were contrasted in separate experiments. In the adaptive training, task difficulty was continuously adapted to participants' performance. In the non-adaptive training procedure, task difficulty remained stable on the lowest difficulty level. As deficits in interference control in psychological disorders often predominantly manifest on the electrophysiological level, the impact of the training procedures on medio-frontal negativities (N2, CRN, ERN) was investigated in addition to behavioral measures. The adaptive training led to significant improvements in interference control, as reflected in reduced response times and error rates in incompatible trials. This was accompanied by specific and complementary changes in medio-frontal negativities: After the adaptive training the N2 in incompatible trials was larger and the CRN in incompatible trials was reduced. The non-adaptive training procedure led to generally faster response times but also an increased error rate, indicating a speed-accuracy trade-off. This was accompanied by global changes to medio-frontal negativities irrespective of compatibility, possibly indicating task disengagement. Taken together, the current studies demonstrate that an adaptive training procedure can improve interference control thereby opening up possible clinical applications.

Effects of multi-domain cognitive training on working memory retrieval in older adults: behavioral and ERP evidence from a Chinese community study

Working memory (WM) is a fundamental cognitive function that typically declines with age. Previous studies have shown that targeted WM training has the potential to improve WM performance in older adults. In the present study, we investigated whether a multi-domain cognitive training program that was not designed to specifically target WM could improve the behavioral performance and affect the neural activity during WM retrieval in healthy older adults. We assigned healthy older participants (70-78 years old) from a local community into a training group who completed a 3-month multi-domain cognitive training and a control group who only attended health education lectures during the same period. Behavioral and electroencephalography (EEG) data were recorded from participants while performing an untrained delayed match or non-match to category task and a control task at a pre-training baseline session and a post-training follow-up session. Behaviorally, we found that participants in the training group showed a trend toward greater WM performance gains than participants in the control group. Event-related potential (ERP) results suggest that the task-related modulation of P3 during WM retrieval was significantly enhanced at the follow-up session compared with the baseline session, and importantly, this enhancement of P3 modulation was only significant in the training group. Furthermore, no training-related effects were observed for the P2 or N2 component during WM retrieval. These results suggest that the multi-domain cognitive training program that was not designed to specifically target WM is a promising approach to improve WM performance in older adults, and that training-related gains in performance are likely mediated by an enhanced modulation of P3 which might reflect the process of WM updating.

Regional Gray Matter Volume Identifies High Risk of Unsafe Driving in Healthy Older People

In developed countries, the number of traffic accidents caused by older drivers is increasing. Approximately half of the older drivers who cause fatal accidents are cognitively normal. Thus, it is important to identify older drivers who are cognitively normal but at high risk of causing fatal traffic accidents. However, no standardized method for assessing the driving ability of older drivers has been established. We aimed to establish an objective assessment of driving ability and to clarify the neural basis of unsafe driving in healthy older people. We enrolled 32 healthy older individuals aged over 65 years and classified unsafe drivers using an on-road driving test. We then utilized a machine learning approach to distinguish unsafe drivers from safe drivers based on clinical features and gray matter volume data. Twenty-one participants were classified as safe drivers and 11 participants as unsafe drivers. A linear support vector machine classifier successfully distinguished unsafe drivers from safe drivers with 87.5% accuracy (sensitivity of 63.6% and specificity of 100%). Five parameters (age and gray matter volume in four cortical regions, including the left superior part of the precentral sulcus, the left sulcus intermedius primus [of Jensen], the right orbital part of the inferior frontal gyrus, and the right superior frontal sulcus), were consistently selected as features for the final classification model. Our findings indicate that the cortical regions implicated in voluntary orienting of attention, decision making, and working memory may constitute the essential neural basis of driving behavior.

Assessing the Effect of Training on the Cognition and Brain of Older Adults: Protocol for a Three-Arm Randomized Double-Blind Controlled Trial (ACTOP)

BACKGROUND

To prevent age-related cognitive impairment, many intervention programs offer exercises targeting different central cognitive processes. However, the effects of different process-based training programs are rarely compared within equivalent experimental designs.

OBJECTIVE

Using a randomized double-blind controlled trial, this project aims to examine and compare the impact of 2 process-based interventions, inhibition and updating, on the cognition and brain of older adults.

METHODS

A total of 90 healthy older adults were randomly assigned to 1 of 3 training conditions: (1) inhibition (Stroop-like exercises), (2) updating (N-back-type exercises), and (3) control active (quiz game exercise). Training was provided in 12 half-hour sessions over 4 weeks. First, the performance gain observed will be measured on the trained tasks. We will then determine the extent of transfer of gain on (1) untrained tasks that rely on the same cognitive process, (2) complex working memory (WM) measurements hypothesized to involve 1 of the 2 trained processes, and (3) virtual reality tasks that were designed to mimic real-life situations that require WM. We will assess whether training increases cortical volume given that the volume of the cortex is determined by cortical area and thickness in regions known to be involved in WM or changes task-related brain activation patterns measured with functional magnetic resonance imaging. Dose effects will be examined by measuring outcomes at different time points during training. We will also determine whether individual characteristics moderate the effect of training on cognitive and cerebral outcomes. Finally, we will evaluate whether training reduces the age-related deficit on transfer and brain outcomes, by comparing study participants to a group of 30 younger adults.

RESULTS

The project was funded in January 2017; enrollment began in October 2017 and data collection was completed in April 2019. Data analysis has begun in June 2020 and the first results should be published by the end of 2020 or early 2021.

CONCLUSIONS

The results of this study will help understand the relative efficacy of 2 attentional control interventions on the cognition and the brain of older adults, as well as the moderating role of individual characteristics on training efficiency and transfer.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03532113; https://clinicaltrials.gov/ct2/show/NCT03532113.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/20430.

Rationale and Design of the PAIRED Trial: Partnered Dance Aerobic Exercise as a Neuroprotective, Motor, and Cognitive Intervention in Parkinson's Disease

Parkinson's disease (PD), an intractable condition impairing motor and cognitive function, is imperfectly treated by drugs and surgery. Two priority issues for many people with PD are OFF-time and cognitive impairment. Even under best medical management, three-fourths of people with PD experience “OFF-time” related to medication-related motor fluctuations, which severely impacts both quality of life and cognition. Cognitive deficits are found even in newly diagnosed people with PD and are often intractable. Our data suggest that partnered dance aerobic exercise (PDAE) reduces OFF-time on the Movement Disorders Society Unified Parkinson Disease Rating Scale-IV (MDS-UPDRS-IV) and ameliorates other disease features, which motivate the PAIRED trial. PDAE provides AE during an improvisational, cognitively engaging rehabilitative physical activity. Although exercise benefits motor and cognitive symptoms and may be neuroprotective for PD, studies using robust biomarkers of neuroprotection in humans are rare. We propose to perform a randomized, controlled trial in individuals with diagnosed mild–moderate PD to compare the efficacy of PDAE vs. walking aerobic exercise (WALK) for OFF-time, cognition, and neuroprotection. We will assess neuroprotection with neuromelanin-sensitive MRI (NM-MRI) and iron-sensitive (R2^*) MRI sequences to quantify neuromelanin loss and iron accumulation in substantia nigra pars compacta (SNc). We will use these biomarkers, neuromelanin loss, and iron accumulation, as tools to chart the course of neurodegeneration in patients with PD who have undergone long-term (16 months) intervention. We will randomly assign 102 individuals with mild–moderate PD to 16 months of PDAE or WALK. The 16-month intervention period will consist of Training (3 months of biweekly sessions) and Maintenance (13 months of weekly sessions) phases. We will assess participants at baseline, 3 months (immediately post-Training), and 16 months (immediately post-Maintenance) for OFF-time and behaviorally and physiologically measured cognition. We will acquire NM-MRI and R2^* imaging data at baseline and 16 months to assess neuroprotection. We will (1) examine effects of Training and Maintenance phases of PDAE vs. WALK on OFF-time, (2) compare PDAE vs. WALK at 3 and 16 months on behavioral and functional MRI (fMRI) measures of spatial cognition, and (3) compare PDAE vs. WALK for effects on rates of neurodegeneration.

Neural correlates of working memory training: Evidence for plasticity in older adults

Brain activity typically increases with increasing working memory (WM) load, regardless of age, before reaching an apparent ceiling. However, older adults exhibit greater brain activity and reach ceiling at lower loads than younger adults, possibly reflecting compensation at lower loads and dysfunction at higher loads. We hypothesized that WM training would bolster neural efficiency, such that the activation peak would shift towards higher memory loads after training. Pre-training, older adults showed greater recruitment of the WM network than younger adults across all loads, with decline at the highest load. Ten days of adaptive training on a verbal WM task improved performance and led to greater brain responsiveness at higher loads for both groups. For older adults the activation peak shifted rightward towards higher loads. Finally, training increased task-related functional connectivity in older adults, both within the WM network and between this task-positive network and the task-negative/default-mode network. These results provide new evidence for functional plasticity with training in older adults and identify a potential signature of improvement at the neural level.

Probing the relationship between late endogenous ERP components with fluid intelligence in healthy older adults

The world population is rapidly aging, bringing together the necessity to better understand the advancing age. This characterization may be used to aid early diagnosis and to guide individually-tailored interventions. While some event-related potential (ERP) components, such as the P300 and late positive complex (LPC), have been associated with fluid intelligence (Gf) in young population; little is known whether these associations hold for older people. Therefore, the main goal of this study was to assess whether these ERP components are associated with Gf in the elderly. Fifty-seven older adults performed a continuous performance task (CPT) and a visual oddball paradigm while EEG was recorded. Participants were divided into two groups, according to their performance in the Raven’s Advanced Progressive Matrices test: high-performance (HP) and low-performance (LP). Results showed that the HP group, compared to the LP group, had higher LPC amplitudes in the CPT and shorter P300 latencies in the oddball task, highlighting the role of ERP components as a potential electrophysiological proxy of Gf abilities in the elderly.

Visual Working Memory of Chinese Characters and Expertise: The Expert's Memory Advantage Is Based on Long-Term Knowledge of Visual Word Forms

People unfamiliar with Chinese characters show poorer visual working memory (VWM) performance for Chinese characters than do literates in Chinese. In a series of experiments, we investigated the reasons for this expertise advantage. Experiments 1 and 2 showed that the advantage of Chinese literates does not transfer to novel material. Experts had similar resolution as novices for material outside of their field of expertise, and the memory of novices and experts did not differ when detecting a big change, e.g., when a character’s color was changed. Memorizing appears to function as a rather abstract representation of word forms because memory for characters’ fonts was poor independently of expertise (Experiment 3), though still visual. Distractors that were highly similar conceptually did not increase memory errors, but visually similar distractors impaired memory (Experiment 4). We hypothesized that literates in Chinese represent characters in VWM as tokens of visual word forms made available by long-term memory. In Experiment 5, we provided novices with visual word form knowledge. Participants subsequently performed a change detection task with trained and novel characters in a functional magnetic resonance experiment. We analyzed set size- and training-dependent effects in the intraparietal sulcus (IPS) and the visual word form area. VWM for trained characters was better than for novel characters. Neural activity increased with set size and at a slower rate for trained than for novel characters. All conditions approached the same maximum, but novel characters reached the maximum at a smaller set size than trained characters. The time course of the bold response depended on set size and knowledge status. Starting from the same initial maximum, neural activity at small set sizes returned to baseline more quickly for trained characters than for novel characters. Additionally, high performers showed generally more neural activity in the IPS than low performers. We conclude that experts’ better performance in working memory (WM) is caused by the availability of visual long-term representations (word form types) that allow a sparse representation of the perceived stimuli and make even small changes big because they cause a type change that is easily detected.

From Evaluation to Prediction: Behavioral Effects and Biological Markers of Cognitive Control Intervention

Although the intervention effectiveness of cognitive control is disputed, some methods, such as single-task training, integrated training, meditation, aerobic exercise, and transcranial stimulation, have been reported to improve cognitive control. This review of recent advances from evaluation to prediction of cognitive control interventions suggests that brain modularity may be an important candidate marker for informing clinical decisions regarding suitable interventions. The intervention effect of cognitive control has been evaluated by behavioral performance, transfer effect, brain structure and function, and brain networks. Brain modularity can predict the benefits of cognitive control interventions based on individual differences and is independent of intervention method, group, age, initial cognitive ability, and education level. The prediction of cognitive control intervention based on brain modularity should extend to task states, combine function and structure networks, and assign different weights to subnetwork modularity.

The gains of a 4-week cognitive training are not modulated by novelty

Cognitive training should not only improve performance of the trained task, but also untrained abilities. Exposure to novelty can improve subsequent memory performance, suggesting that novelty exposure might be a critical factor to promote the effects of cognitive training. Therefore, we combined a 4‐week working memory training with novelty exposure. Neuropsychological tests and MRI data were acquired before and after training to analyze behavior and changes in gray matter volume, myelination, and iron levels. In total, 83 healthy older humans participated in one of three groups: Two groups completed a 4‐week computerized cognitive training of a two‐back working memory task, either in combination with novel or with familiarized nature movies. A third group did not receive any training. As expected, both training groups showed improvements in task specific working memory performance and reaction times. However, there were no transfer or novelty effects on fluid intelligence, verbal memory, digit‐span, and executive functions. At the neural level, no significant micro‐ or macrostructural changes emerged in either group. Our findings suggest that working memory training in healthy older adults is associated with task‐specific improvements, but these gains do not transfer to other cognitive domains, and it does not lead to structural brain changes.

The Effect of Visual Working Memory Training Could Transfer Across Stimuli

Background

Working memory, as a fundamental cognitive ability, has been shown to improve with learning. However, little is known about the learning effect of visual working memory training and its generalization to other stimuli and tasks.

Methods

In the present study, we utilized a delayed match-to-sample task to measure the working memory of faces and houses. Subjects were trained ten days on this task and were tested on the same task and a memory span task before and after the training.

Results

The results showed that training significantly increased the accuracy of visual working memory. More importantly, such a learning effect could partly transfer to a visual working memory task with different stimuli. However, the learning effect may not transfer to a memory span task.

Conclusion

Our findings demonstrate that training might influence the common processing of different stimuli in a visual working memory task.

Review of the Neural Processes of Working Memory Training: Controlling the Impulse to Throw the Baby Out With the Bathwater

BACKGROUND

Smartphone technology has enabled the creation of many working memory training (WMT) Apps, with those peer-reviewed described in a recent review. WMT claims to improve working memory, attention deficits, hyperactivity and fluid intelligence, in line with plasticity brain changes. Critics argue that WMT is unable to achieve "far-transfer"-the attainment of benefits to cognition from one taught context to another dissimilar context-associated with improved quality of life. However, brain changes after a course of WMT in frontoparietal and striatal circuits-that often occur prior to behavioral changes-may be a better indicator of far-transfer efficacy, especially to improve impulse control commonly dysregulated in those with addictive disorders, yet not commonly examined in WMT studies.

METHOD

In contrast to previous reviews, the aim here is to focus on the findings of brain imaging WMT training studies across various imaging modalities that use various paradigms, published via PubMed, Scopus, Medline, and Google Scholar.

RESULTS

35 brain imaging studies utilized fMRI, structural imaging (MRI, DTI), functional connectivity, EEG, transcranial direct current stimulation (tDCS), cerebral perfusion, and neurogenetic analyses with tasks based on visuospatial and auditory working memory, dual and standard n-back.

DISCUSSION

Evidence suggests that repeated WMT reduces brain activation in frontoparietal and striatal networks reflective of increased neural circuitry efficiency via myelination and functional connectivity changes. Neural effects of WMT may persist months after training has ended, lead to non-trained task transfer, be strengthened by auxiliary methods such as tDCS and be related to COMT polymorphisms. WMT could be utilized as an effective, non-invasive intervention for working memory deficits to treat impulse and affective control problems in people with addictive disorders.

Plasticity in brain activity dynamics after task-shifting training in older adults

Cognitive control is supported by a dynamic interplay of transient (i.e., trial-related) brain activation across fronto-parietal networks and sustained (i.e., block-related) activation across fronto-striatal networks. Older adults show disturbances in this dynamic functional recruitment. There is evidence suggesting that cognitive-control training may enable older adults to redistribute their brain activation across cortical and subcortical networks, which in turn can limit behavioral impairments. However, previous studies have only focused on spatial rather than on temporal aspects of changes in brain activation. In the present study, we examined training-related functional plasticity in old age by applying a hybrid fMRI design that sensitively tracks the spatio-temporal interactions underlying brain-activation changes. Fifty healthy seniors were assigned to a task-shifting training or an active-control group and their pretest/posttest activation-change maps were compared against 25 untrained younger adults. After training, older adults showed the same performance as untrained young adults. Compared to the control group, task-shifting training promoted proactive (i.e., early, cue-related) changes in transient mechanisms supporting the maintenance and top-down biasing of task-set representations in a specific prefrontal circuitry; reactive (i.e., late, probe-related) changes in transient mechanisms supporting response-selection processes in dissociable fronto-parietal networks; overall reductions of sustained activation in striatal circuits. Results highlight the importance of spatio-temporal interactions in training-induced neural changes in age.

Selectively Enhanced Development of Working Memory in Musically Trained Children and Adolescents

In the current longitudinal study, we investigated the development of working memory in musically trained and nontrained children and adolescents, aged 9-20. We measured working memory with the Digit Span (DS) forwards and backwards tests (N = 106) and the Trail-Making A and B (TMT-A and B; N = 104) tests three times, in 2011, 2013, and 2016. We expected that musically trained participants would outperform peers with no musical training. Indeed, we found that the younger musically trained participants, in particular, outperformed their nontrained peers in the TMT-A, TMT-B and DS forwards tests. These tests all primarily require active maintenance of a rule in memory or immediate recall. In contrast, we found no group differences in the backwards test that requires manipulation and updating of information in working memory. These results suggest that musical training is more strongly associated with heightened working memory capacity and maintenance than enhanced working memory updating, especially in late childhood and early adolescence.

Spatio-Temporal Neural Changes After Task-Switching Training in Old Age

In the present study, we aimed at examining selective neural changes after task-switching training in old age by not only considering the spatial location but also the timescale of brain activation changes (i.e., sustained/block-related or transient/trial-related timescales). We assigned a sample of 50 older adults to a task-switching training or an active single-task control group. We administered two task paradigms, either sensitive to transient (i.e., a context-updating task) or sustained (i.e., a delayed-recognition working-memory task) dynamics of cognitive control. These dynamics were captured by utilizing an appropriate event-related or block-related functional magnetic resonance imaging design. We captured selective changes in task activation during the untrained tasks after task-switching training compared to an active control group. Results revealed changes at the neural level that were not evident from only behavioral data. Importantly, neural changes in the transient-sensitive context updating task were found on the same timescale but in a different region (i.e., in the left inferior parietal lobule) than in the task-switching training task (i.e., ventrolateral PFC, inferior frontal junction, superior parietal lobule), only pointing to temporal overlap, while neural changes in the sustained-sensitive delayed-recognition task overlapped in both timescale and region with the task-switching training task (i.e., in the basal ganglia), pointing to spatio-temporal overlap. These results suggest that neural changes after task-switching training seem to be critically supported by the temporal organization of neural processing.

Cognitive training and neuroplasticity in mild cognitive impairment (COG-IT): protocol for a two-site, blinded, randomised, controlled treatment trial

INTRODUCTION

Mild cognitive impairment (MCI) is common in older adults and represents a high-risk group for progression to Alzheimer's disease (AD). Medication trials in MCI have generally failed, but new discoveries with brain plasticity in ageing have led to the study of cognitive training as a potential treatment to improve cognitive abilities. Computerised cognitive training (CCT) involves computerised cognitive exercises that target specific cognitive abilities and neural networks to potentially improve cognitive functioning through neuroplasticity.

METHODS AND ANALYSIS

In a two-site study (New York State Psychiatric Institute/Columbia University Medical Center and Duke University Medical Center), we will randomise 100 patients with MCI (Wechsler Memory Scale-III Logical Memory II score 0-11; Folstein Mini Mental State Examination ≥23) to home-based CCT (suite of exercises: memory, matching, spatial recognition, processing speed) or a home-based active control condition (computerised crossword puzzle training (CPT)) with 12 weeks of intensive training followed by regular booster sessions up to 78 weeks. All patients will receive standard neuropsychological and functional assessments in clinic as well as structural/functional brain MRI scans at study entry and endpoint. We will test if CCT, versus CPT, leads to improved cognitive functioning, transfers to functional ability and tasks of everyday life and impacts hippocampal volume changes and changes in the default mode network of the brain measured by resting-state functional MRI.

ETHICS AND DISSEMINATION

The study will be conducted following ethics approval and written informed consent will be obtained from all subjects. Study results will be disseminated via publication, clinicaltrials.gov, media and conference presentations. This will be the first controlled long-term trial to evaluate the effects of home-based CCT versus computerised CPT on cognitive abilities and functional measures and neural outcomes as determined by MRI indices in patients with MCI. Positive results from trial may support further development of home-based CCT.

TRIAL REGISTRATION NUMBER

ClinicalTrials.gov identifier (NCT03205709).

Cognitive and neural plasticity in old age: A systematic review of evidence from executive functions cognitive training

Cognitive training is a popular intervention aimed at attenuating age-related cognitive decline, however, the effects of this intervention on brain structure and function have not been thoroughly explored. Core executive functions (working memory, inhibition, cognitive flexibility) are dependent upon prefrontal brain regions-one of the most vulnerable areas of age-related decline. They are also implicated in numerous cognitive processes and higher-order functions. Training executive functions should therefore promote cognitive and neural enhancements in old age. This systematic review examined the effects of executive functions training on brain and cognition amongst healthy older adults across 20 studies. Behavioral performance consistently improved on trained cognitive tasks, though mixed findings were reported for untrained tasks. Training-related structural changes were reported, evidenced through increases in grey matter and cortical volume. Functional changes were not consistent, though a general pattern of increased subcortical and decreased frontal and parietal activation emerged across studies, indicating that training may potentially reduce reliance on compensatory neural mechanisms. Training executive functions appears to promote cognitive and neural plasticity in old age, though further research is required to develop a more comprehensive framework which connects and elucidates the mechanisms underlying cognitive training, cognitive transfer, and cognitive aging.

Divergent Research Methods Limit Understanding of Working Memory Training

Working memory training has been a hot topic over the last decade. Although studies show benefits in trained and untrained tasks as a function of training, there is an ongoing debate on the efficacy of working memory training. There have been numerous meta-analyses put forth to the field, some finding overall broad transfer effects while others do not. However, discussion of this research typically overlooks specific qualities of the training and transfer tasks. As such, there has been next to no discussion in the literature on what training and transfer tasks features are likely to mediate training outcomes. To address this gap, here, we characterized the broad diversity of features employed in N-back training tasks and outcome measures in published working memory training studies. Extant meta-analyses have not taken into account the diversity of methodology at this level, primarily because there are too few studies using common methods to allow for a robust meta-analysis. We suggest that these limitations preclude strong conclusions from published data. In order to advance research on working memory training, and in particular, N-back training, more studies are needed that systematically compare training features and use common outcome measures to assess transfer effects.

Does working memory improvement benefit from sleep in older adults?

Working Memory (WM), is an important factor influencing many higher-order cognitive functions that decline with age. Repetitive training appears to increase WM, yet the mechanisms underlying this improvement are not understood. Sleep has been shown to benefit long-term memory formation and may also play a role in WM enhancement in young adults. However, considering age-related decline in sleep, it is uninvestigated whether sleep will facilitate WM in older adults. In the present work, we investigated the impact of a nap, quiet wakefulness (QW) and active wakefulness (AW) on within-day training on the Operation Span (OSPAN) task in older adults. Improvement in WM was found following a nap and QW, but not active wake. Furthermore, better WM was associated with shared electrophysiological features, including slow oscillation (SO, 0.5-1 Hz) power in both the nap and QW, and greater coupling between SO and sigma (12-15 Hz) in the nap. In summary, our data suggest that WM improvement in older adults occurs opportunistically during offline periods that afford enhancement in slow oscillation power, and that further benefits may come with cross-frequency coupling of neural oscillations during sleep.

Adaptive task difficulty influences neural plasticity and transfer of training

The efficacy of cognitive training is controversial, and research progress in the field requires an understanding of factors that promote transfer of training gains and their relationship to changes in brain activity. One such factor may be adaptive task difficulty, as adaptivity is predicted to facilitate more efficient processing by creating a prolonged mismatch between the supply of, and the demand upon, neural resources. To test this hypothesis, we measured behavioral and neural plasticity in fMRI sessions before and after 10 sessions of working memory updating (WMU) training, in which the difficulty of practiced tasks either adaptively increased in response to performance or was fixed. Adaptive training resulted in transfer to an untrained episodic memory task and activation decreases in striatum and hippocampus on a trained WMU task, and the amount of training task improvement was associated with near transfer to other WMU tasks and with hippocampal activation changes on both near and far transfer tasks. These findings suggest that cognitive training programs should incorporate adaptive task difficulty to broaden transfer of training gains and maximize efficiency of task-related brain activity.