Plasticity-based Adaptive Cognitive Remediation for Alzheimer Disease

描述(申请人提供)：当前项目的主要目标是开发和评估基于脑可塑性的在线计算机化评估工具和培训计划的有效性，以预防和延迟阿尔茨海默病(AD)的发病。这一新的治疗策略旨在通过1)以旨在重新激活大脑系统的方式增加大脑系统中的前馈功率，以及2)通过直接行使最高级别的神经(DN)过程来重新连接和重振默认网络(DN)脑区。计算机化的评估将被嵌入到练习套件中，以进一步记录1)大脑中糖尿病肾病水平的操作，2)支持它们的复杂系统，以及3)重要的近距离和远距离转移训练目标的状态。此外，通过与健康状况、体育锻炼、社交活动、饮食、睡眠、情绪和自我效能相关的每周自我评估提供的生活方式统计和变化的简短自我报告将为评估现实世界的结果和产品模型的可接受性提供有用的数据。在第一个具体目标中，我们将组织一系列由正常年龄的成年人组成的小焦点小组，讨论和玩各种电脑游戏和认知训练程序。根据来自这些焦点小组的调查问卷和与他们的讨论，我们将定义一套增强功能，以使用户体验和游戏足够激励40小时的计划。然后，我们将采用既定的软件设计和开发方法，反复改进实施的设计，以完成与爱荷华大学研究团队合作在当地进行的可行性试验的增强计划的开发。鉴于在线评估和培训的易用性，该项目应导致开发一种新的、强大的工具，以评估和预防阿尔茨海默病的发病风险，并提供有效的辅助治疗，从而使更多的阿尔茨海默病前期人口对认知损害具有更强的复原力。

DESCRIPTION (provided by applicant): The primary objective of the current project is to develop and evaluate the efficacy of on-line brain plasticity-based computerized assessment tool and training program for the prevention and delay of the onset of Alzheimer's disease (AD). This novel therapeutic strategy is designed to re-connect and reinvigorate Default Network (DN) brain areas by 1) increasing feed-forward power in brain systems in ways that are designed to reactivate them, and by 2) directly exercising highest-level neurological (DN) processes. Computerized assessments will be embedded in the exercise suite to further document the status of 1) DN levels of operation in the brain, 2) the complex systems that support them, and 3) important near- and far-transfer targets for training. Also, brief self-report of lifestyle stats and change provided via weekly self-rated evaluations related to health status, physical exercise, social activities, diet, sleep, mood, and self-efficacy shall provide data useful both fo evaluating real-world outcomes and product model acceptability. In the first specific aim, we will organize a series of small focus groups composed of normally aged adults to discuss and play various computer games and cognitive training programs. Based on questionnaires from and discussions with these focus groups, we will define a set of enhancements to make the user experience and the game play sufficient to motivate the forty hours of program. We will then employ established methods of software design and development and iteratively refine the implemented design to complete the development of the enhanced program for a feasibility trial conducted locally, in collaboration with the research team at the University of Iowa. Given the ease of access of online-based assessment and training, this project should result in the development of a new, powerful tool to assess and prevent the risk of onset of AD, and to provide effective adjunctive therapy those results in far greater resilience against cognitive impairment in a substantially greater pre-AD population.