Impact of Computerized Cognitive Training on Default Mode Network Connectivity in Subjects at Risk for Alzheimer’s Disease: A 78-week Randomized Controlled Trial

• Published in: Journal of Alzheimer's disease Vol. 91; no. 1; pp. 483 - 494
• Main Authors: Petrella, Jeffrey R., Michael, Andrew M., Qian, Min, Nwosu, Adaora, Sneed, Joel, Goldberg, Terry E., Devanand, Davangere P., Doraiswamy, P. Murali
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.01.2023
• Subjects: Alzheimer Disease - complications; Alzheimer Disease - diagnostic imaging; Alzheimer Disease - therapy; Brain - diagnostic imaging; Cognitive Dysfunction - complications; Cognitive Dysfunction - diagnostic imaging; Cognitive Dysfunction - therapy; Cognitive Training; Default Mode Network; Humans; Magnetic Resonance Imaging - methods; Nerve Net - diagnostic imaging; digital therapeutics; functional MRI; Alzheimer’s disease; biomarkers; mild cognitive impairment; default mode network; neuroplasticity
• ISSN: 1387-2877; 1875-8908
• DOI: 10.3233/JAD-220946

Background: Mild cognitive impairment (MCI) represents a high risk group for Alzheimer’s disease (AD). Computerized Cognitive Games Training (CCT) is an investigational strategy to improve targeted functions in MCI through the modulation of cognitive networks. Objective: The goal of this study was to examine the effect of CCT versus a non-targeted active brain exercise on functional cognitive networks. Methods: 107 patients with MCI were randomized to CCT or web-based crossword puzzles. Resting-state functional MRI (fMRI) was obtained at baseline and 18 months to evaluate differences in fMRI measured within- and between-network functional connectivity (FC) of the default mode network (DMN) and other large-scale brain networks: the executive control, salience, and sensorimotor networks. Results: There were no differences between crosswords and games in the primary outcome, within-network DMN FC across all subjects. However, secondary analyses suggest differential effects on between-network connectivity involving the DMN and SLN, and within-network connectivity of the DMN in subjects with late MCI. Paradoxically, in both cases, there was a decrease in FC for games and an increase for the crosswords control (p < 0.05), accompanied by lesser cognitive decline in the crosswords group. Conclusion: Results do not support a differential impact on within-network DMN FC between games and crossword puzzle interventions. However, crossword puzzles might result in cognitively beneficial remodeling between the DMN and other networks in more severely impaired MCI subjects, parallel to the observed clinical benefits.