The Impact of Exercise and Virtual Reality Executive Function Training on Cognition Among Heavy Drinking Veterans With Traumatic Brain Injury: A Pilot Feasibility Study.
The Impact of Exercise and Virtual Reality Executive Function Training on Cognition Among Heavy Drinking Veterans With Traumatic Brain Injury: A Pilot Feasibility Study.
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DOI：
10.3389/fnbeh.2022.802711
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发表时间：
2022
影响因子：
3
通讯作者：
Batki SL
中科院分区：
文献类型：
--
作者：
Pennington DL;Reavis JV;Cano MT;Walker E;Batki SL
执行功能（EF）是酒精使用障碍（AUD）和创伤性脑损伤（TBI）自我控制缺陷的基础。认知训练是一种针对TBI和AUD相关认知功能障碍的有前途的连续治疗方法。然而，在认知训练领域中存在与依从性和概括性相关的主要限制。身体活动与几种执行功能的认知表现增强有关，并可能增强认知训练的益处。虚拟现实提供了多感官体验，这可能比标准的认知训练系统更有效地参与大脑网络，最终导致更大的近距离和远距离转移效应。该试点研究旨在获得可行性数据和对丰富的虚拟现实（VR）EF训练（EFT）干预结合运动（NCT 03786276）的初步评估。使用一项为期8周的随机适应性设计研究，30名寻求AUD治疗的美国退伍军人在3周内完成了9次仅运动（n = 15）或游戏控制（n = 15），随后在第1阶段进行了为期4周的重复评估。23名参与者完成并进入第二阶段，在那里他们完成了多达9次VR-EFT加运动，并完成了为期8周的研究结束评估。主要结局包括保留参与者的可行性、可用性和使用VR-EFT的满意度。次要和探索性结果包括在三种治疗条件下对认知功能、酒精使用、酒精渴望和脑震荡后症状的变化进行组内评估。VR-EFT是可行的，具有中等可用性和高可接受性评级。最常见的VR相关不良反应是晕动病（n = 2/16，12.5%）。VR-EFT条件与II期期间抑制转换和视觉扫描的显著改善相关（均p <0.05）。仅限饮酒与认知抑制、认知灵活性、饮酒渴望减少和每周标准饮酒次数的显著改善相关（所有p ≤ 0.05）。在第1阶段，游戏控制条件与认知灵活性和视觉空间即时回忆的改善相关（均p <0.05）。招募和保留患有AUD和TBI的美国退伍军人参加练习加VR-EFT干预是可行的，但技术障碍可能会影响可用性。VR-EFT与执行功能领域的改善相关，这些领域的目标是在短短3周和9次VR-EFT暴露中。结果是有希望的，并表明需要一个更大的对照研究，以评估VR-EFT的疗效，以提高治疗结果的AUD寻求治疗的美国退伍军人与共同发生的AUD和TBI。www.ClinicalTrials.gov
Executive function (EF) underlies self-control deficits in alcohol use disorder (AUD) and traumatic brain injury (TBI). Cognitive training is a promising adjunctive treatment targeting TBI- and AUD- related cognitive dysfunction. However, major limitations related to compliance and generalizability in the field of cognitive training exist. Physical activity is associated with enhanced cognitive performance across several executive functions and may enhance the benefits of cognitive training. Virtual reality provides multisensory embodied experiences which are likely to engage brain networks more efficiently than standard cognitive training systems, ultimately resulting in greater near- and far-transfer effects. This pilot study aimed to obtain feasibility data and a preliminary assessment of an enriched virtual reality (VR) EF training (EFT) intervention combined with exercise (NCT03786276). Using an 8-week randomized adaptive design study, 30 AUD treatment seeking U.S. Veterans completed nine sessions of exercise-only (n = 15) or gameplay control (n = 15) over 3 weeks, followed by a week-4 repeat assessment in Phase 1. Twenty-three participants completed and moved onto Phase II, where they completed up to nine sessions of VR-EFT plus exercise and completed a week-8 end-of-study assessment. Primary outcomes included feasibility to retain participants, usability, and satisfaction of using VR-EFT. Secondary and exploratory outcomes included within group assessment of change in cognitive function, alcohol use, alcohol craving, and post-concussive symptoms among the three treatment conditions.VR-EFT was feasible with moderate usability and high acceptability ratings.The most common VR-related adverse effect was motion sickness (n = 2/16, 12.5%). The VR-EFT condition was associated with significant improvement in inhibition-switching and visual scanning (both p < 0.05) during Phase II. Exercise-only was associated with significant improvements in cognitive inhibition, cognitive flexibility, reductions in alcohol craving, and number of standard alcohol drinks per week (all p ≤ 0.05). The gaming-control condition was associated with improvement in cognitive flexibility and visuospatial immediate recall (both p < 0.05) during Phase 1. Recruitment and retention of U.S. veterans with AUD and TBI into an exercise plus VR-EFT intervention is feasible, but technological barriers may impact usability. VR-EFT was associated with improvement in executive function domains that were targeted in as little as 3-week and nine sessions of VR-EFT exposure. Results are promising and indicate the need for a larger controlled investigation to assess the efficacy of VR-EFT to enhance treatment outcomes among AUD treatment-seeking U.S. veterans with co-occurring AUD and TBI. www.ClinicalTrials.gov, Identifier: NCT03786276.
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影响因子：
3.7
作者：
Basak, Chandramallika;Boot, Walter R.;Voss, Michelle W.;Kramer, Arthur F.
通讯作者：
Kramer, Arthur F.
影响因子：
120.7
作者：
Ball, K;Berch, DB;Willis, SL
通讯作者：
Willis, SL
影响因子：
2.4
作者：
Belanger, Heather G.;Uomoto, Jay M.;Vanderploeg, Rodney D.
通讯作者：
Vanderploeg, Rodney D.
影响因子：
1.9
作者：
Ciesielski, KT;Waldorf, AV;Jung, RE
通讯作者：
Jung, RE
DOI：
10.3233/bpl-180075
发表时间：
2018-12-12
期刊：
Brain plasticity (Amsterdam, Netherlands)
影响因子：
--
作者：
Barnes, Jill N;Corkery, Adam T
通讯作者：
Corkery, Adam T