No significant difference in outcomes was observe in children and adolescents with fragile X syndrome (FXS) receiving adaptive versus nonadaptive in-home cognitive training, according to a study publish online April 15 in the Journal of Neurodevelopmental Disorders.
The cognitive phenotype of FXS is characterize by prominent deficits in executive function (EF), including problems with working memory (WM), inhibitory control, cognitive flexibility/perseveration, and selective and divide attention. Most of these deficits have been document in both controll neuro psychological studies as well as brain functional magnetic resonance imaging (fMRI) studies showing abnormalities in frontal-striatal circuits.
Training program for patients
David Hessl, Ph.D., from the MIND Institute at the University of California Davis Medical Center; also colleagues evaluate the efficacy of Cogmed, a computer/tablet base working memory (WM) training program for patients with FXS. Participants (63 male and 37 female; mean age, 15.28 years) were randomly assign to either adaptive (difficulty level adjusted to performance) or nonadaptive (control) Cogmed training.
A next step in this research program be to evaluate whether cognitive training such as Cogmed or other attention training programs and potentially beneficial effects on attention and EF can be accelerate by target pharmacological treatment. At-home assessments of WM and executive function (EF) were conduct at baseline; so following 20 to 25 caregiver support sessions over five to six weeks; also at three months following completion of training.
The results of this control trial of working memory training in children and adolescents with FXS show that objectively-evaluate WM and some domains of EF, as well as parent and teacher report attention and EF relate behaviors significantly improve during the treatment period, with many changes maintain at follow-up after 3 months without training.
Full range of individuals
However, contrary to the primary study hypothesis; so degree of improvement between adaptive treatment and control groups did not differ significantly; so showing that progressively challenging the WM system by expanding span length (which adaptive Cogmed participants were able to achieve) did not provide add benefit in the full range of individuals with this disorder.
However, the primary hypothesis that participants; so completing the publically available adaptive training versions of the program; which will make significantly greater gains in standardize measures of working memory than those completing a non-adaptive “control” version was not confirm; so in fact both groups improve significantly on a variety of metrics.
However, no significant differences were note in improvement between the two groups; so indicating that progressively challenging the WM system by expanding span; so length did not provide add overall benefit. Future analyses examining inter-individual differences may help to link this intervention; to outcomes and potential transfer effects,” the authors write.