Seven Pervasive Statistical Flaws in Cognitive Training Interventions

Effects of working memory training on cognitive and academic abilities in typically developing school-age children

Process-based working memory (WM) training in typically developing children usually leads to short- and long-term improvements on untrained WM tasks. However, results are mixed regarding far transfer to academic and cognitive abilities. Moreover, there is a lack of studies jointly evaluating the different types of transfer, using an adequate design and considering motivational factors. In addition, evidence is needed about how pre-training performance is related to individual differences in training-induced transfer. Therefore, this study aimed to implement and evaluate the efficacy of a computerized process-based WM training in typically developing school-age children. Near and far transfer effects were evaluated both immediately after training and after 6 months, as well as individual differences in training-induced transfer. The sample was composed of 89 typically developing children aged 9-10 years (M = 9.52, SD = 0.30), who were randomized to a WM training group or an active control group. They were evaluated at pre-training, post-training, and follow-up phases with measures of visuospatial and verbal WM, reading comprehension, math computation, and fluid intelligence. Results showed that the training group significantly improved performance in verbal WM and fluid intelligence compared to the active control group, immediately after training and after 6 months. Trained children with lower initial performance in verbal WM or fluid intelligence showed greater transfer gains. No group differences were found in motivational factors. Findings of this study suggest that process-based WM training may promote transfer to cognitive abilities and lead to compensation effects of individual differences in typically developing school-age children.

Popular interventions to enhance sustained attention in children and adolescents: A critical systematic review

There are a myriad of interventions promoting activities designed to help enhance sustained attention in children and adolescents. In this systematic review, we critically evaluate the evidence behind three popular sustained attention training approaches - cognitive attention training, meditation, and physical activity. Seven databases were searched in addition to secondary searches. Cognitive attention training, meditation training or physical activity intervention studies aimed at improving sustained attention (randomised-controlled or non-randomised-controlled designs) in samples of children and adolescents (3-18 years) were included. We screened 3437 unique articles. Thirty-seven studies satisfied inclusion criteria. In general, cognitive attention training (n = 14) did not reliably improve sustained attention. Physical activity (n = 15) and meditation interventions (n = 8) demonstrated somewhat more potential in enhancing sustained attention, but these effects should be considered preliminary and need to be replicated with greater methodological rigour. Cognitive attention training demonstrated very limited transfer to other aspects of attention. Notably, mindfulness training had rather consistent positive effects on selective attention. Across all three intervention types, there was very weak evidence for transfer to other aspects of cognition, behaviour, and academic achievement. The paper concludes with methodological recommendations for future studies to strengthen the evidence base.

Approximate arithmetic training does not improve symbolic math in third and fourth grade children

BACKGROUND

Prior studies reported that practice playing an approximate arithmetic game improved symbolic math performance relative to active control groups in adults and preschool children (e.g. Park & Brannon, 2013, 2014; Park et al., 2016; Szkudlarek & Brannon, 2018). However, Szkudlarek, Park and Brannon (2021) recently failed to replicate those findings in adults. Here we test whether approximate arithmetic training yields benefits in elementary school children who have intermediate knowledge of arithmetic.

METHOD

We conducted a randomized controlled trial with a pre and post-test design to compare the effects of approximate arithmetic training and visuo-spatial working memory training on standardized math performance in third and fourth grade children.

RESULTS

We found that approximate arithmetic training did not yield any significant gains on standardized measures of symbolic math performance.

CONCLUSION

A Bayesian analysis supports the conclusion that approximate arithmetic provides no benefits for symbolic math performance.

The Effectiveness of Working Memory Training for Children With Low Working Memory

OBJECTIVES

Subgroups of children may benefit more from working memory training than others. In this study, we aimed to examine whether response to the Cogmed Working Memory Training program differed for children with low IQ and elevated attention-deficit/hyperactivity disorder, emotional and behavioral symptoms, special health care needs, or by sex.

METHODS

We used data from the Memory Maestros trial, a population-based randomized controlled trial of the Cogmed program delivered at school (n = 226) compared to usual teaching (n = 226) in grade 1 children (mean age 6.9 years; SD 0.4) with low working memory. Cogmed comprises 20 to 25 sessions of 45-minute duration over 5 to 7 weeks. Children completed subtests from the Automated Working Memory Assessment to measure change in working memory from baseline to 6 months postrandomization.

RESULTS

After training, improved working memory standard scores (>1 SD) from baseline to 6 months were observed for approximately one-third of the children, with more than half maintaining stable scores (within 1 SD). However, similar outcomes were observed for children receiving usual teaching. Differential effect of Cogmed versus usual teaching was evident for children with elevated hyperactivity and/or inattention, who were less likely to show improved visuospatial working memory, but not for other subgroups studied.

CONCLUSIONS

Children with elevated hyperactivity and/or inattention were less likely to show clinically meaningful improvement after Cogmed; however, differential effects were not evident for children with low IQ and elevated emotional and behavioral symptoms, special health care needs, or by sex. More research is needed to determine if training can improve working memory and, if so, for whom.

A Systematic Review on Predictors of Working Memory Training Responsiveness in Healthy Older Adults: Methodological Challenges and Future Directions

Background: Research on predictors of working memory training responsiveness, which could help tailor cognitive interventions individually, is a timely topic in healthy aging. However, the findings are highly heterogeneous, reporting partly conflicting results following a broad spectrum of methodological approaches to answer the question “who benefits most” from working memory training.

Objective: The present systematic review aimed to systematically investigate prognostic factors and models for working memory training responsiveness in healthy older adults.

Method: Four online databases were searched up to October 2019 (MEDLINE Ovid, Web of Science, CENTRAL, and PsycINFO). The inclusion criteria for full texts were publication in a peer-reviewed journal in English/German, inclusion of healthy older individuals aged ≥55 years without any neurological and/or psychiatric diseases including cognitive impairment, and the investigation of prognostic factors and/or models for training responsiveness after targeted working memory training in terms of direct training effects, near-transfer effects to verbal and visuospatial working memory as well as far-transfer effects to other cognitive domains and behavioral variables. The study design was not limited to randomized controlled trials.

Results: A total of 16 studies including n = 675 healthy older individuals with a mean age of 63.0–86.8 years were included in this review. Within these studies, five prognostic model approaches and 18 factor finding approaches were reported. Risk of bias was assessed using the Quality in Prognosis Studies checklist, indicating that important information, especially regarding the domains study attrition, study confounding, and statistical analysis and reporting, was lacking throughout many of the investigated studies. Age, education, intelligence, and baseline performance in working memory or other cognitive domains were frequently investigated predictors across studies.

Conclusions: Given the methodological shortcomings of the included studies, no clear conclusions can be drawn, and emerging patterns of prognostic effects will have to survive sound methodological replication in future attempts to promote precision medicine approaches in the context of working memory training. Methodological considerations are discussed, and our findings are embedded to the cognitive aging literature, considering, for example, the cognitive reserve framework and the compensation vs. magnification account. The need for personalized cognitive prevention and intervention methods to counteract cognitive decline in the aging population is high and the potential enormous.

Registration: PROSPERO, ID CRD42019142750.

Perceptions of Brain Training: Public Expectations of Cognitive Benefits From Popular Activities

Many popular activities are thought by the general public to improve cognitive function. Such expectations can influence how often people engage in these activities, as well as the scientific evaluation of their putative cognitive benefits, e.g., via placebo effects. Here, we gathered survey data about the public's perceptions of nine different activities commonly thought to be cognitively stimulating, including "brain-training" games. Information was collected about the degree to which participants thought each activity was beneficial for improving cognitive function and how often they engaged in each activity. The patterns of correlation between ratings reveal details about the perception of cognitive benefits and its relation to engagement. They suggest that participants varied with respect to an overarching perception of the entire set of activities, which were perceived also as divided into three clusters. Frequency of engagement and perceived cognitive benefits were positively correlated across participants for each activity considered individually. But, when the activities were compared, the magnitude of their perceived benefits was not a good predictor of their frequency of engagement (and vice versa). Though small, there were systematic demographic differences. Women were more optimistic than men about cognitive benefits. Individual participants differed in the range of their ratings of benefit across activities, and these ranges were greater for younger than older participants, suggesting that perceptions of benefit are more differentiated among the young. Besides contributing to a better understanding of public expectations of cognitive benefits, the findings of this study are relevant to the critical evaluation of such benefits. Our survey can be viewed as providing an interface between expectations held by the general public and the design of studies examining the efficacy of cognitive training. The type of information it provides could be used in the selection of activities performed by an active control group, so that control activities match the treatment intervention as closely as possible with respect to such expectations.

Inhibitory Processes Training for School-age Children: Transfer Effects

Inhibition refers to a basic executive component that can be conceptualized as consisted of different inhibitory processes (i.e., perceptual, cognitive and response inhibition). These processes emerge during the first years of life, and since then are involved in different relevant every day activities. Different individual and contextual factors can modulate their developmental trajectories. The possibility of train in separate ways each inhibitory process is a subject of analysis. In such a context, the aims of this work were: (a) to design, implement and evaluate training of perceptual, cognitive and response inhibition processes, in a sample of school-aged children (6 to 8 years old); and (b) to analyze near, far, short- and long-transfer effects. An experimental design with three training groups (one for each inhibitory process) and an active control group was implemented. Near transfer effects were not observed. We found effects on a visuospatial working memory task in the short term, after the training in the response and cognitive inhibition, and effects on a fluid intelligence task in both the short and long term after the training in cognitive inhibition. The results contribute to a conceptualization of multidimensional inhibitory processes and the plausibility of training them during childhood.

Mapping differential responses to cognitive training using machine learning

We used two simple unsupervised machine learning techniques to identify differential trajectories of change in children who undergo intensive working memory (WM) training. We used self‐organizing maps (SOMs)—a type of simple artificial neural network—to represent multivariate cognitive training data, and then tested whether the way tasks are represented changed as a result of training. The patterns of change we observed in the SOM weight matrices implied that the processes drawn upon to perform WM tasks changed following training. This was then combined with K‐means clustering to identify distinct groups of children who respond to the training in different ways. Firstly, the K‐means clustering was applied to an independent large sample (N = 616, M_age = 9.16 years, range = 5.16–17.91 years) to identify subgroups. We then allocated children who had been through cognitive training (N = 179, M_age = 9.00 years, range = 7.08–11.50 years) to these same four subgroups, both before and after their training. In doing so, we were able to map their improvement trajectories. Scores on a separate measure of fluid intelligence were predictive of a child's improvement trajectory. This paper provides an alternative approach to analysing cognitive training data that go beyond considering changes in individual tasks. This proof‐of‐principle demonstrates a potentially powerful way of distinguishing task‐specific from domain‐general changes following training and of establishing different profiles of response to training.

Aerobic exercise modulates transfer and brain signal complexity following cognitive training

Although recent evidence has demonstrated the potent effect of physical exercise to increase the efficacy of cognitive training, the neural mechanisms underlying this causal relationship remain unclear. Here, we used multiscale entropy (MSE) of electroencephalography (EEG)-a measure of brain signal complexity-to address this issue. Young males were randomly assigned to either a 20-day dual n-back training following aerobic exercise or the same training regimen following a reading. A feature binding working memory task with concurrent EEG recording was used to test for transfer effects. Although results revealed weak-to-moderate evidence for exercise-induced facilitation on cognitive training, the combination of cognitive training with exercise resulted in greater transfer gains on conditions involving greater attentional demanding, together with greater increases in cognitive modulation on MSE, compared with the reading condition. Overall, our findings suggest that the addition of antecedent physical exercise to brain training regimen could enable wider, more robust improvements.

Effects of physical, virtual reality-based, and brain exercise on physical, cognition, and preference in older persons: a randomized controlled trial

Background

Physical exercise (PE), virtual reality-based exercise (VRE), and brain exercise (BE) can influence physical and cognitive conditions in older persons. However, it is not known which of the three types of exercises provide the best effects on physical and cognitive status, and which exercise is preferred by older persons. This study compared the effects of PE, VRE, and BE on balance, muscle strength, cognition, and fall concern. In addition, exercise effort perception and contentment in older persons was evaluated.

Methods

Eighty-four older persons (n = 84) were randomly selected for PE, VRE, BE, and control groups. The exercise groups received 8-week training, whereas the control group did not. Balance was assessed by Berg Balance Scale (BBS) and Timed Up and Go test (TUG), muscle strength by 5 Times Sit to Stand (5TSTS) and left and right hand grip strength (HGS), cognition by Montreal Cognitive Assessment (MoCA) and Timed Up and Go test Cognition (TUG-cog), fall concern by Fall Efficacy Scale International (FES-I), exercise effort perception by Borg category ratio scale (Borg CR-10), and exercise contentment by a questionnaire.

Results

After exercise, PE significantly enhanced TUG and 5TSTS to a greater extent than VRE (TUG; p = 0.004, 5TSTS; p = 0.027) and BE (TUG; p = 0,012, 5TSTS; p < 0.001). VRE significantly improved MoCA (p < 0.001) and FES-I (p = 0.036) compared to PE, and 5TSTS (p < 0.001) and FES-I (p = 0.011) were improved relative to BE. MoCA was significantly enhanced by BE compared to PE (p < 0.001) and both MoCA and TUG-cog were improved compared to VRE (p = 0.04). PE and VRE significantly (p < 0.001) increased Borg CR-10 in all exercise sessions, whereas BE showed a significant improvement (p < 0.001) in the first 4 sessions. Participants had a significantly greater satisfaction with BE than controls (p = 0.006), and enjoyed VRE and BE more than PE (p < 0.001). Subjects in all exercise groups exhibited benefits compared to the control group (p < 0.001).

Conclusions

PE provided the best results in physical tests, VRE produced measurable improvements in physical and cognition scores, while BE enhanced cognition ability in older persons. Older persons preferred VRE and BE compared to PE. Both exercises are suggested to older persons to improve physical and cognitive conditions.

WOME: Theory-Based Working Memory Training - A Placebo-Controlled, Double-Blind Evaluation in Older Adults

Background: Scientifically evaluated cognitive intervention programs are essential to meet the demands of our increasingly aging society. Currently, one of the “hottest” topics in the field is the improvement of working memory function and its potential impact on overall cognition. The present study evaluated the efficacy of WOME (WOrking MEmory), a theory-based working memory training program, in a double-blind, placebo-controlled, and randomized controlled trial (www.drks.de, DRKS00013162).

Methods:N = 60 healthy older adults were allocated to (1) the WOME intervention, (2) an active low-level intervention, or (3) a passive control group. Overall, the intervention groups practiced twelve sessions of 45 min within 4 weeks of their respective training. Transfer effects were measured via an extensive battery of neuropsychological tests and questionnaires both pre-/post-training and at a 3-month follow-up.

Results:WOME led to a significant improvement in working memory function, demonstrated on a non-trained near transfer task and on two different composite scores with moderate to large effect sizes. In addition, we found some indication of relevant impact on everyday life. The effects were short-term rather than stable, being substantially diminished at follow-up with only little evidence suggesting long-term maintenance. No transfer effects on other cognitive functions were observed.

Conclusion:WOME is an appropriate and efficient intervention specifically targeting the working memory system in healthy older adults.

Trial Registration: German Clinical Trials Register (DRKS), Identifier: DRKS00013162.

Approximate Arithmetic Training Improves Informal Math Performance in Low Achieving Preschoolers

Recent studies suggest that practice with approximate and non-symbolic arithmetic problems improves the math performance of adults, school aged children, and preschoolers. However, the relative effectiveness of approximate arithmetic training compared to available educational games, and the type of math skills that approximate arithmetic targets are unknown. The present study was designed to (1) compare the effectiveness of approximate arithmetic training to two commercially available numeral and letter identification tablet applications and (2) to examine the specific type of math skills that benefit from approximate arithmetic training. Preschool children (n = 158) were pseudo-randomly assigned to one of three conditions: approximate arithmetic, letter identification, or numeral identification. All children were trained for 10 short sessions and given pre and post tests of informal and formal math, executive function, short term memory, vocabulary, alphabet knowledge, and number word knowledge. We found a significant interaction between initial math performance and training condition, such that children with low pretest math performance benefited from approximate arithmetic training, and children with high pretest math performance benefited from symbol identification training. This effect was restricted to informal, and not formal, math problems. There were also effects of gender, socio-economic status, and age on post-test informal math score after intervention. A median split on pretest math ability indicated that children in the low half of math scores in the approximate arithmetic training condition performed significantly better than children in the letter identification training condition on post-test informal math problems when controlling for pretest, age, gender, and socio-economic status. Our results support the conclusion that approximate arithmetic training may be especially effective for children with low math skills, and that approximate arithmetic training improves early informal, but not formal, math skills.

Action Observation Plus Sonification. A Novel Therapeutic Protocol for Parkinson's Patient with Freezing of Gait

Freezing of gait (FoG) is a disabling symptom associated with falls, with little or no responsiveness to pharmacological treatment. Current protocols used for rehabilitation are based on the use of external sensory cues. However, cued strategies might generate an important dependence on the environment. Teaching motor strategies without cues [i.e., action observation (AO) plus Sonification] could represent an alternative/innovative approach to rehabilitation that matters most on appropriate allocation of attention and lightening cognitive load. We aimed to test the effects of a novel experimental protocol to treat patients with Parkinson’s disease (PD) and FoG, using functional, and clinical scales. The experimental protocol was based on AO plus Sonification. 12 patients were treated with 8 motor gestures. They watched eight videos showing an actor performing the same eight gestures, and then tried to repeat each gesture. Each video was composed by images and sounds of the gestures. By means of the Sonification technique, the sounds of gestures were obtained by transforming kinematic data (velocity) recorded during gesture execution, into pitch variations. The same 8 motor gestures were also used in a second group of 10 patients; which were treated with a standard protocol based on a common sensory stimulation method. All patients were tested with functional and clinical scales before, after, at 1 month, and 3 months after the treatment. Data showed that the experimental protocol have positive effects on functional and clinical tests. In comparison with the baseline evaluations, significant performance improvements were seen in the NFOG questionnaire, and the UPDRS (parts II and III). Importantly, all these improvements were consistently observed at the end, 1 month, and 3 months after treatment. No improvement effects were found in the group of patients treated with the standard protocol. These data suggest that a multisensory approach based on AO plus Sonification, with the two stimuli semantically related, could help PD patients with FoG to relearn gait movements, to reduce freezing episodes, and that these effects could be prolonged over time.

High-intensity training enhances executive function in children in a randomized, placebo-controlled trial

Background:

Exercise-induced cognitive improvements have traditionally been observed following aerobic exercise interventions; that is, sustained sessions of moderate intensity. Here, we tested the effect of a 6 week high-intensity training (HIT) regimen on measures of cognitive control and working memory in a multicenter, randomized (1:1 allocation), placebo-controlled trial.

Methods:

318 children aged 7-13 years were randomly assigned to a HIT or an active control group matched for enjoyment and motivation. In the primary analysis, we compared improvements on six cognitive tasks representing two cognitive constructs (N = 305). Secondary outcomes included genetic data and physiological measurements.

Results:

The 6-week HIT regimen resulted in improvements on measures of cognitive control [BFM = 3.38, g = 0.31 (0.09, 0.54)] and working memory [BFM = 5233.68, g = 0.54 (0.31, 0.77)], moderated by BDNF genotype, with met66 carriers showing larger gains post-exercise than val66 homozygotes.

Conclusions:

This study suggests a promising alternative to enhance cognition, via short and potent exercise regimens.

Funding:

Funded by Centre for Brain Research.

Clinical trial number:

NCT03255499.

Exercise has beneficial effects on the body and brain. People who perform well on tests of cardiovascular fitness also do well on tests of learning, memory and other cognitive skills. So far, studies have suggested that moderate intensity aerobic exercise that lasts for 30 to 40 minutes produces the greatest improvements in these brain abilities.

Recently, short high-intensity workouts that combine cardiovascular exercise and strength training have become popular. Studies have shown that these brief bouts of strenuous exercise improve physical health, but do these benefits extend to the brain? It would also be helpful to know if the effect that exercise has on the brain depends on an individual’s genetic makeup or physical health. This might help to match people to the type of exercise that will work best for them.

Now, Moreau et al. show that just 10 minutes of high-intensity exercise a day over six weeks can boost the cognitive abilities of children. In the experiments, over 300 children between 7 and 13 years of age were randomly assigned to one of two groups: one that performed the high-intensity exercises, or a ‘control’ group that took part in less active activities – such as quizzes and playing computer games – over the same time period. The children who took part in the high-intensity training showed greater improvements in cognitive skills than the children in the control group. Specifically, the high-intensity exercise boosted working memory and left the children better able to focus on specific tasks, two skills that are important for academic success.

Moreau et al. further found that the high-intensity exercises had the most benefit for the children who needed it most – those with poor cardiovascular health and those with gene variants that are linked to poorer cognitive skills. This suggests that genetic differences do alter the effects of exercise on the brain, but also shows that targeted exercise programs can offer everyone a chance to thrive.

Moreau et al. suggest that exercise need not be time consuming to boost brain health; the key is to pack more intense exercise in shorter time periods. Further work could build on these findings to produce effective exercise routines that could ultimately form part of school curriculums, as well as proving useful to anyone who wishes to improve their cognitive skills.

Evidence of Energetic Optimization during Adaptation Differs for Metabolic, Mechanical, and Perceptual Estimates of Energetic Cost

The theory that the sensorimotor system minimizes energetic cost during locomotion has long been supported by both computational models and empirical studies. However, it has yet to be determined if the behavior to which people converge when exposed to a novel perturbation during locomotion is also energetically optimal. We address this issue in the context of adaptation to walking on a split-belt treadmill, which can impose a left-right asymmetry in step lengths. In response to this asymmetry, participants gradually adjust their foot placement to adopt steps of equal length. Here, we characterized metabolic, mechanical, and perceptual estimates of energetic cost associated with a range of asymmetries to determine whether symmetry is the energetically optimal strategy for walking on a split-belt treadmill. We found that taking steps of equal length did not minimize metabolic cost or mechanical cost. In addition, perceptual estimates of cost were not sensitive to changes in asymmetry. However, symmetry was identified as the optimal strategy when energetic cost was estimated from a composite metric that combined both metabolic and mechanical costs. These results suggest that adaptation may arise from optimization of a composite estimate of effort derived from feedback about the interaction between the body and environment.

Working memory training in healthy young adults: Support for the null from a randomized comparison to active and passive control groups

Training of working memory as a method of increasing working memory capacity and fluid intelligence has received much attention in recent years. This burgeoning field remains highly controversial with empirically-backed disagreements at all levels of evidence, including individual studies, systematic reviews, and even meta-analyses. The current study investigated the effect of a randomized six week online working memory intervention on untrained cognitive abilities in a community-recruited sample of healthy young adults, in relation to both a processing speed training active control condition, as well as a no-contact control condition. Results of traditional null hypothesis significance testing, as well as Bayesian factor analyses, revealed support for the null hypothesis across all cognitive tests administered before and after training. Importantly, all three groups were similar at pre-training for a variety of individual variables purported to moderate transfer of training to fluid intelligence, including personality traits, motivation to train, and expectations of cognitive improvement from training. Because these results are consistent with experimental trials of equal or greater methodological rigor, we suggest that future research re-focus on: 1) other promising interventions known to increase memory performance in healthy young adults, and; 2) examining sub-populations or alternative populations in which working memory training may be efficacious.

Have Standard Tests of Cognitive Function Been Misappropriated in the Study of Cognitive Enhancement?

In the past decade, there has emerged a vast research literature dealing with attempts to harness brain plasticity in older adults, with a view to improving cognitive function. Since cognitive training (CT) has shown restricted utility in this regard, attention has increasingly turned to interventions that use adjunct procedures such as motor training or physical activity (PA). As evidence builds that these have some efficacy, it becomes necessary to ensure that the outcome measures being used to infer causal influence upon cognitive function are subjected to appropriate critical appraisal. It has been highlighted previously that the choice of specific tasks used to demonstrate transfer to the cognitive domain is of critical importance. In the context of most intervention studies, standardized tests and batteries of cognitive function are de rigueur. The argument presented here is that the latent constructs to which these tests relate are not usually subject to a sufficient level of analytic scrutiny. We present the historical origins of some exemplar tests, and give particular consideration to the limits on explanatory scope that are implied by their composition and the nature of their deployment. In addition to surveying the validity of these tests when used to appraise intervention-related changes in cognitive function, we also consider their neurophysiological correlates. In particular, we argue that the broadly distributed brain activity associated with the performance of many tests of cognitive function, extending to the classical motor networks, permits the impact of interventions based on motor training or PA to be better understood.

Attentional Filter Training but Not Memory Training Improves Decision-Making

Decision-making has a high practical relevance for daily performance. Its relation to other cognitive abilities such as executive control and memory is not fully understood. Here we asked whether training of either attentional filtering or memory storage would influence decision-making as indexed by repetitive assessments of the Iowa Gambling Task (IGT). The IGT was developed to assess and simulate real-life decision-making (Bechara et al., 2005). In this task, participants gain or lose money by developing advantageous or disadvantageous decision strategies. On five consecutive days we trained 29 healthy young adults (20–30 years) either in working memory (WM) storage or attentional filtering and measured their IGT scores after each training session. During memory training (MT) subjects performed a computerized delayed match-to-sample task where two displays of bars were presented in succession. During filter training (FT) participants had to indicate whether two simultaneously presented displays of bars matched or not. Whereas in MT the relevant target stimuli stood alone, in FT the targets were embedded within irrelevant distractors (bars in a different color). All subjects within each group improved their performance in the trained cognitive task. For the IGT, we observed an increase over time in the amount of money gained in the FT group only. Decision-making seems to be influenced more by training to filter out irrelevant distractors than by training to store items in WM. Selective attention could be responsible for the previously noted relationship between IGT performance and WM and is therefore more important for enhancing efficiency in decision-making.

Motor-Enriched Learning Activities Can Improve Mathematical Performance in Preadolescent Children

Objective: An emerging field of research indicates that physical activity can benefit cognitive functions and academic achievements in children. However, less is known about how academic achievements can benefit from specific types of motor activities (e.g., fine and gross) integrated into learning activities. Thus, the aim of this study was to investigate whether fine or gross motor activity integrated into math lessons (i.e., motor-enrichment) could improve children's mathematical performance. Methods: A 6-week within school cluster-randomized intervention study investigated the effects of motor-enriched mathematical teaching in Danish preadolescent children (n = 165, age = 7.5 ± 0.02 years). Three groups were included: a control group (CON), which received non-motor enriched conventional mathematical teaching, a fine motor math group (FMM) and a gross motor math group (GMM), which received mathematical teaching enriched with fine and gross motor activity, respectively. The children were tested before (T0), immediately after (T1) and 8 weeks after the intervention (T2). A standardized mathematical test (50 tasks) was used to evaluate mathematical performance. Furthermore, it was investigated whether motor-enriched math was accompanied by different effects in low and normal math performers. Additionally, the study investigated the potential contribution of cognitive functions and motor skills on mathematical performance. Results: All groups improved their mathematical performance from T0 to T1. However, from T0 to T1, the improvement was significantly greater in GMM compared to FMM (1.87 ± 0.71 correct answers) (p = 0.02). At T2 no significant differences in mathematical performance were observed. A subgroup analysis revealed that normal math-performers benefitted from GMM compared to both CON 1.78 ± 0.73 correct answers (p = 0.04) and FMM 2.14 ± 0.72 correct answers (p = 0.008). These effects were not observed in low math-performers. The effects were partly accounted for by visuo-spatial short-term memory and gross motor skills. Conclusion: The study demonstrates that motor enriched learning activities can improve mathematical performance. In normal math performers GMM led to larger improvements than FMM and CON. This was not the case for the low math performers. Future studies should further elucidate the neurophysiological mechanisms underlying the observed behavioral effects.