Are two interventions are better than one? Combining cognitive training and non-invasive neurostimulation in older adults.

两种干预措施是否比一种更好？

• 批准号: 2073285
• 金额: --
• 依托单位: University of Manchester
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2018
• 资助国家: 英国
• 起止时间: 2018 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2073285
• 关键词: two; interventions; better; than; Combining

Introduction, Rationale & NoveltyAge-related cognitive decline presents an ever increasing challenge and public health issue. It can have a significant impact both an individuals' and their families' quality of life (QoL). Interventions which enhance the brain's natural ability to modify/restructure neural connections have been shown to enhance cognitive functioning, in both individuals with Mild Cognitive Impairment (MCI) and healthy older adults. Both cognitive training and neurostimulation interventions results are promising, demonstrating enhancement of cognitive function. However, direct evidence is needed to determine whether the success is 'domain-specific' or whether benefits are carried over to other cognitive demands and daily events, using Activities in Daily Living Measures (ADL). As people with MCI and their families have rated QoL as the principal factor they wish to foster, there is a need to investigate how interventions impact on QoL as an outcome measure in addition to cognitive and neural effects.Research aims:1. Acceptability and feasibility using cognitive training intervention combined with neurostimulation within the ageing population.2. Gather initial data on the effect of intervention on putative Electroencephalography (EEG) biomarkers.3. Gather initial data assessing whether the effect of combined cognitive and neurostimulation interventions is greater than either intervention alone.This project addresses methodological gaps and provides a comprehensive account of cognitive training and its mechanism in older adults by combining complementary techniques: non-invasive neurostimulation, EEG and QoL questionnaires. We expect that both interventions will increase cognitive function and quality of daily life, with those participants in the combined intervention demonstrating the greatest improvement.MethodThe Memory Alteration Test will be used to assess cognitive function/MCI classification. In line with previous research, ~60 participants (aged 70+) will be recruited.Participants will complete the following tasks before and after intervention: working/episodic/verbal memory tasks, visual-attention, processing speed, executive function, a QoL Questionnaire, Hospital Anxiety and Depression Score and an Activities of Daily Living Assessment. Participants will be randomly allocated to one of three conditions.Experimental Group Intervention Treatment Group Control GroupGroup 1 (n=20) Cognitive Intervention alone: 15 sessions of Computer-Assisted Cognitive TrainingGroup 2 (n=20) Neurostimulation alone: 15 sessions of tACSGroup 3 (n=20) Combined Cognitive Intervention and Neurostimulation: 15 sessions of tACS, concurrent with a cognitive training taskA 'Computer-Assisted Cognitive Training' (Cambridge Cognition Systems) intervention will be used and completed on iPad/computer software. Transcranial Alternating Current Stimulation (tACS) will be used for non-invasive electrical stimulation. tACS uses low level alternating currents applied via scalp electrodes to specific brain regions. As neural oscillations play a crucial role in the operational architecture of the brain, tACS may prove even more effective in enhancing cognitive functions. EEG will be acquired before and after cognitive training. 20 participants with MCI will receive cognitive training combined with neurostimulation protocol. Their results will be compared to the same intervention in age-matched controls. This will be a pilot study for feasibility of using our protocol in clinical populations.ImpactThis project furthers the understanding of successful ageing within social and biological sciences and contributes towards interventions that improve the lives of older adults and their families, reducing pressures on the healthcare system. The project will specifically emphasise improvements to QoL by targeting the deficits in cognitive decline which individuals are most aware of.

引言、基本原理和新颖性 与年龄相关的认知能力下降提出了日益严峻的挑战和公共卫生问题。它会对个人及其家庭的生活质量 (QoL) 产生重大影响。增强大脑修改/重组神经连接的自然能力的干预措施已被证明可以增强轻度认知障碍 (MCI) 个体和健康老年人的认知功能。认知训练和神经刺激干预的结果都是有希望的，证明了认知功能的增强。然而，需要直接证据来确定成功是否是“特定领域的”，或者使用日常生活措施中的活动（ADL）将益处转移到其他认知需求和日常活动中。由于 MCI 患者及其家人将生活质量视为他们希望培养的主要因素，因此有必要研究干预措施如何影响生活质量，作为除了认知和神经影响之外的结果衡量标准。研究目的：1。认知训练干预结合神经刺激在老龄化人群中的可接受性和可行性。2．收集关于干预对推定脑电图 (EEG) 生物标志物影响的初步数据。3．收集初始数据，评估认知和神经刺激干预措施相结合的效果是否大于单独干预措施的效果。该项目通过结合非侵入性神经刺激、脑电图和生活质量问卷等补充技术，解决了方法上的差距，并全面介绍了老年人的认知训练及其机制。我们预计这两种干预措施将提高认知功能和日常生活质量，联合干预措施的参与者表现出最大的改善。方法记忆改变测试将用于评估认知功能/MCI 分类。根据之前的研究，将招募约 60 名参与者（70 岁以上）。参与者将在干预前后完成以下任务：工作/情景/语言记忆任务、视觉注意力、处理速度、执行功能、生活质量问卷、医院焦虑和抑郁评分以及日常生活活动评估。参与者将被随机分配到三种条件之一。 实验组 干预 治疗组 对照组 第 1 组 (n=20) 仅认知干预：15 次计算机辅助认知训练 第 2 组 (n=20) 仅神经刺激：15 次 tACS 第 3 组 (n=20) 联合认知干预和神经刺激：15 次 tACS，同时进行认知训练 任务将使用“计算机辅助认知训练”（剑桥认知系统）干预并在 iPad/计算机软件上完成。经颅交流电刺激（tACS）将用于非侵入性电刺激。 tACS 使用通过头皮电极施加到特定大脑区域的低电平交流电。由于神经振荡在大脑的运作结构中发挥着至关重要的作用，tACS 可能在增强认知功能方面更有效。脑电图将在认知训练之前和之后采集。 20 名 MCI 参与者将接受结合神经刺激方案的认知训练。他们的结果将与年龄匹配的对照组的相同干预进行比较。这将是一项试点研究，旨在探讨在临床人群中使用我们的方案的可行性。影响该项目进一步加深了社会和生物科学领域对成功老龄化的理解，并有助于采取干预措施，改善老年人及其家人的生活，减轻医疗保健系统的压力。该项目将特别强调通过针对个人最清楚的认知衰退缺陷来改善生活质量。