vmPFC's role in adherence to cognitive training

认知训练被认为是延缓认知衰老和AD/ADRD的一种有前途的非药物干预措施。如果我们要了解干预的机制，并最大限度地从干预中获得长期利益，减缓甚至防止AD/ADRD的认知衰退和进展，确保遵守是至关重要的。建议的R61的目的是研究遵守基于视觉的处理速度(VSOP)训练的规定方案的作用机制，VSOP训练一直是认知老化的一线认知训练预防策略之一。我们的中心假设是，通过既定的共振频率呼吸(RFB)训练来加强腹内侧额前皮质(VmPFC)功能，将导致更多地坚持VSOP训练，这体现在在规定的干预期期间和之后的几个月里更多地参与和使用VSOP训练计划。我们将应用一个已建立的多维心理疲劳性框架来衡量认知训练中的有效投入。我们建议在0阶段机械干预研究中进行三组比较：遗忘型轻度认知损害(MCI)的RFB，AD/ADRD的临床前阶段(MCI，n=31)，健康对照组(HC，n=31)的RFB，以及MCI(n=31)的表象引导放松(IR)控制。所有参与者将参加为期8周的基于家庭的VSOP处方培训，并在干预后3个月和9个月提供两个为期2周的强化课程。RFB或IR将在每次VSOP培训之前，在规定和强化课程期间立即进行练习。其目的是确定RFB干预在依从性中的作用(目标1)；检查vmPFC功能与依从性之间的关系(目标2)；以及建立长期依从性的个性化预测模型(探索性目标3)。与认知训练的神经认知效应相比，在AD/ADRD的预防策略的制定中，如何确保坚持是一个未被充分研究的课题，这与AD/ADRD研究里程碑8.b中描述的研究计划相一致。这项拟议的研究将提供新的机制和临床相关信息，包括如何综合衡量坚持、坚持的潜在机制，以及提高对减缓或预防AD/ADRD的干预措施的坚持的潜在干预策略。

Cognitive training is considered a promising non-pharmacologic intervention for slowing cognitive aging and AD/ADRD. Ensuring adherence is essential if we are to understand the mechanisms of intervention, as well as to maximize long-term benefits from intervention in slowing or even preventing cognitive decline and progression of AD/ADRD. The objective of the proposed R61 is to examine the mechanisms of action underlying adherence to prescribed regimens of the vision-based speed of processing (VSOP) training, which has been among the first-line cognitive training preventative strategies for cognitive aging. Our central hypothesis is that strengthening the ventromedial prefrontal cortex (vmPFC) function, via an established resonance frequency breathing (RFB) training, will lead to greater adherence to VSOP training, reflected in greater engagement with and more use of the VSOP training program during and in the months following the prescribed intervention period. We will apply an established, multi-dimensional framework of mental fatigability for measuring effective engagement in cognitive training. We propose a 3-group comparison in a stage 0 mechanistic intervention study: RFB in amnestic mild cognitive impairment (MCI), a preclinical stage of AD/ADRD (MCI, n = 31), RFB in healthy control (HC, n = 31), and an imagery-guided relaxation (IR) control in MCI (n = 31). All participants will engage in an 8-week prescribed home-based VSOP training and two 2-week booster sessions provided at 3- and 9-months after intervention. RFB or IR will be practiced immediately before every VSOP training during the prescribed and booster sessions. The aims are to identify the role of RFB intervention in adherence (Aim 1); examine the relationship between the vmPFC function and adherence (Aim 2); and build a personalized predictive model for long-term adherence (exploratory Aim 3). Compared to neurocognitive effects of cognitive training, how to ensure adherence is an understudied topic in the development of prevention strategies for AD/ADRD, which aligns with research plans described in AD/ADRD Research Milestone 8.B. The proposed study will provide novel mechanistic and clinically relevant information on how to comprehensively measure adherence, the mechanism underlying adherence, and potential intervention strategies for enhancing adherence to interventions serving for slowing or preventing AD/ADRD.