Sarah Ellen Braun1,2,3, Farah J Aslanzadeh4, Autumn Lanoye5,6, Stephanie Fountain-Zaragoza7, Mark G Malkin8,5, Ashlee R Loughan8,5. 1. Department of Neurology, Virginia Commonwealth University, Richmond, VA, USA. sarah.braun@vcuhealth.org. 2. Massey Cancer Center, Richmond, VA, USA. sarah.braun@vcuhealth.org. 3. Division of Neuro-Oncology, Department of Neurology, School of Medicine, VCU Massey Cancer Center, Virginia Commonwealth University, 401 College Street MCC G-105, P.O. Box 980037, Richmond, VA, 23298-0037, USA. sarah.braun@vcuhealth.org. 4. Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA. 5. Massey Cancer Center, Richmond, VA, USA. 6. Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA. 7. Department of Neurology, Medical University of South Carolina, Charleston, SC, USA. 8. Department of Neurology, Virginia Commonwealth University, Richmond, VA, USA.
Abstract
BACKGROUND: CogMed Working Memory Training (CWMT) is a computer-based program shown to improve working memory (WM) among those with cognitive impairments. No study to date has investigated its feasibility, acceptability, and satisfaction in adult patients with glioma, despite the well-documented incidence of WM impairment in this population. METHODS: Twenty patients with glioma and objective and/or perceived WM deficits enrolled in the study: 52% high-grade, 60% female, Mage = 47 (range = 21-72 years). Adverse events were monitored to determine safety. Feasibility and acceptability were assessed based on established metrics. Satisfaction was explored by exit-interviews. Neurocognitive tests and psychological symptoms were analyzed at baseline and post-CWMT to estimate effect sizes. RESULTS: Of 20 enrolled patients, 16 completed the intervention (80% retention rate). Reasons for withdrawal included time burden (n = 2); tumor-related fatigue (n = 1) or loss to follow-up (n = 1). No adverse events were determined to be study-related. Adherence was 69% with reasons for nonadherence similar to those for study withdrawal. The perceived degree of benefit was only moderate. Baseline to post-CWMT assessments showed medium to large effects on neurocognitive tasks. Psychological symptoms remained stable throughout the study period. CONCLUSIONS: CWMT was found to be safe and acceptable in adult patients with glioma. Enrollment, retention rates, and treatment adherence were all adequate and comparable to studies recruiting similar populations. Only moderate perceived benefit was reported despite demonstrated improvements in objectively-assessed WM. This may indicate that the time commitment and intervention intensity (5 weeks of 50-min training sessions on 5 days/week) outweighed the perceived benefits of the program. (Trial Registration Number: NCT03323450 registered on 10/27/2017).
BACKGROUND: CogMed Working Memory Training (CWMT) is a computer-based program shown to improve working memory (WM) among those with cognitive impairments. No study to date has investigated its feasibility, acceptability, and satisfaction in adult patients with glioma, despite the well-documented incidence of WM impairment in this population. METHODS: Twenty patients with glioma and objective and/or perceived WM deficits enrolled in the study: 52% high-grade, 60% female, Mage = 47 (range = 21-72 years). Adverse events were monitored to determine safety. Feasibility and acceptability were assessed based on established metrics. Satisfaction was explored by exit-interviews. Neurocognitive tests and psychological symptoms were analyzed at baseline and post-CWMT to estimate effect sizes. RESULTS: Of 20 enrolled patients, 16 completed the intervention (80% retention rate). Reasons for withdrawal included time burden (n = 2); tumor-related fatigue (n = 1) or loss to follow-up (n = 1). No adverse events were determined to be study-related. Adherence was 69% with reasons for nonadherence similar to those for study withdrawal. The perceived degree of benefit was only moderate. Baseline to post-CWMT assessments showed medium to large effects on neurocognitive tasks. Psychological symptoms remained stable throughout the study period. CONCLUSIONS: CWMT was found to be safe and acceptable in adult patients with glioma. Enrollment, retention rates, and treatment adherence were all adequate and comparable to studies recruiting similar populations. Only moderate perceived benefit was reported despite demonstrated improvements in objectively-assessed WM. This may indicate that the time commitment and intervention intensity (5 weeks of 50-min training sessions on 5 days/week) outweighed the perceived benefits of the program. (Trial Registration Number: NCT03323450 registered on 10/27/2017).
Authors: Torkel Klingberg; Elisabeth Fernell; Pernille J Olesen; Mats Johnson; Per Gustafsson; Kerstin Dahlström; Christopher G Gillberg; Hans Forssberg; Helena Westerberg Journal: J Am Acad Child Adolesc Psychiatry Date: 2005-02 Impact factor: 8.829