Neurophysiological Aspects of Vision-based Speed of Processing Cognitive Training in Older Adults with Mild Cognitive Impairment

 描述(申请人提供)：轻度认知障碍(MCI)，特别是遗忘型，被认为是有症状的阿尔茨海默病(AD)前期，在老年人口中普遍存在。基于视觉的加工速度(VSOP)认知训练是在没有AD的社区居住的美国老年人中应用最广泛的行为干预措施之一，具有减缓认知衰退的潜力。它与MCI的特殊相关性得到了我们初步研究的汇聚证据的支持，包括最近完成的一项试点干预研究。然而，我们对VSOP训练的潜在益处的机制知之甚少，限制了我们进一步开发VSOP或其他形式的认知训练的能力。具体地说，我们不知道VSOP训练对认知成绩的影响是否以及如何通过神经可塑性相关的大脑变化来调节。由于最近的证据表明，神经可塑性在整个成年生活中都是可以诱导的，即使在MCI中，VSOP训练也可能促进神经可塑性并减缓神经退行性变。在这一早期阶段和新的研究人员应用中，我们将重点评估VSOP训练相对于精神休闲活动(MLA)是否以及如何改变患有MCI的老年人的认知和神经功能，最长可达6个月。这项研究将招募84名患有遗忘性MCI的参与者，并将其随机分配到VSOP训练组或MLA对照组。三个具体的研究目的是：(1)确定VSOP训练是否提高了与大脑结构和功能连通性变化相关的加工速度和注意力；(2)测试VSOP训练对大脑结构和功能影响的一种新的神经生理学途径；(3)考察VSOP训练对未训练的认知和功能领域的影响，以及潜在的神经生理变化在可能的迁移效应中的作用。通过检查多种神经和新的生理机制，将有前景的VSOP训练干预与认知表现的改善联系起来，这项应用试图挑战和改变目前关于认知训练的研究，这些研究仅仅考察训练对认知结果的影响。VSOP训练中神经和生理相关机制的发现将具有超越这一特殊干预的重要意义。最近的行为研究(如认知干预、体育锻炼、营养和生物反馈干预)的研究结果表明，要缓解AD高危人群的认知衰退，有必要针对易受AD神经病理影响的神经和外周生理通路进行干预。通过证明认知训练的有效性、可持续性和普适性，研究假设的确认可以支持立即转化为临床实践。

 DESCRIPTION (provided by applicant): Mild Cognitive Impairment (MCI), especially amnestic type, is considered a symptomatic pre-Alzheimer's disease (AD) phase, and is prevalent in the aging population. Vision-based speed of processing (VSOP) cognitive training is one of the most widely applied behavioral interventions in community-dwelling older Americans free of AD, holding potential to slow cognitive decline. Its particular relevance to MCI is supported by converging evidence from our preliminary studies, including a recently completed pilot intervention study. However, we know little about the mechanisms underlying the benefits of VSOP training, limiting our ability to further exploit VSOP or other forms of cognitive training. I particular, we do not know if and how the effects of VSOP training on cognitive performance are mediated by neuroplasticity-related brain changes. Since recent evidence suggests that neuroplasticity is inducible throughout adult life, even in MCI, it is possible that VSOP training promotes neuroplasticity and slows neurodegeneration. In this early stage and new investigator application, we will focus on assessing whether and how VSOP training, relative to mental leisure activities (MLA), alters cognitive and neural functions in older adults with MCI, up to 6 months after training. The study will enroll and randomize 84 participants with amnestic MCI to VSOP training or MLA control groups. Three specific research aims are to (1) determine whether VSOP training improves processing speed and attention that are associated with changes of brain structural and functional connectivity; (2) test a novel neurophysiological pathway of VSOP training effect on brain structure and function; (3) examine the effect of VSOP training on untrained cognitive and functional domains and the role of neurophysiological changes underlying possible transfer effects. By examining multiple neural and novel physiological mechanisms linking a promising VSOP training intervention to improvements in cognitive performance, this application seeks to challenge and shift current research on cognitive training that merely examines training effects on cognitive outcomes. Discovery of neural, and physiological-related mechanisms in VSOP training will have important implications beyond this particular intervention. Findings from recent behavioral studies (e.g., cognitive intervention, physical exercise, nutrition, and bio-feedback intervention) suggest that for cognitive decline to be mitigated in individuals at risk for AD, it will be necessary for interventions to target the neural and peripheral physiological pathways that are susceptible to AD neuropathology. Confirmation of the study hypotheses could support immediate translation to clinical practices by demonstrating the efficacy, sustainability, and generalizability of cognitve training.