Working Memory Training in Huntington's Disease

NCT02926820 | Completed

• 1 other identifier: NYGH 15-0001
• Study Type: interventional
• Target: 9
• Locations: 1 country
• Sites: 1

Brief Summary

There is a paucity of investigation into effective interventions to enhance cognitive function and/or mitigate cognitive decline in individuals with Huntington disease (HD). This study targeted working memory (WM), which is the ability to actively hold information in the mind in order to perform complex mental tasks, given reports of WM dysfunction in patients with HD. The investigators examined the feasibility of conducting a 5-week WM training program (Cogmed). Patient adherence and treatment tolerance were assessed. In addition, preliminary evidence for the efficacy of this training program on targeted cognitive abilities was examined. Nine patients with pre-manifest or early stage HD underwent training. Patients were assessed before the intervention and one week after completion.

Conditions

Huntington's Disease

Keywords

Huntington disease; cognitive rehabilitation; cognitive dysfunction

Outcome Measures

Primary Outcomes (1)

• Adherence to training (defined by completing the intervention within the recommended time frame)

  Adherence was defined as completion of at least 80% of the total 25 training sessions within 40 calendar days or less

  40 days

Secondary Outcomes (8)

• Digit Span subtest from the Wechsler Memory Scales - third edition

  Baseline (time 0) versus Post-intervention test score (up to 45 days post-baseline)

• Spatial Span subtest from the Wechsler Memory Scales - third edition

  Baseline (time 0) versus Post-intervention test score (up to 45 days post-baseline)

• Auditory Working Memory from the Woodcock Johnson Tests of Cognitive Ability - third edition

  Baseline (time 0) versus Post-intervention test score (up to 45 days post-baseline)

• Symbol span subtest from the Wechsler Memory Scales - fourth edition, reported in raw score units (total correct responses)

  Baseline (time 0) versus Post-intervention test score (up to 45 days post-baseline)

• Verbal Fluency subtest from the Delis-Kaplan Executive Function System

  Baseline (time 0) versus Post-intervention test score (up to 45 days post-baseline)

Other Outcomes (3)

• Qualitative experiences of training program as reported by the patient

  Post-interview follow-up, up to 45 days following baseline visit

• Tolerance (ratio of training time to breaks per day)

  Per session and through completion of training program, up to 40 days

• Cogmed Improvement Index

  Through completion of training program, up to 40 days

Study Arms (1)

Cognitive training

EXPERIMENTAL

Participants will undergo five weeks of cognitive training using the Cogmed QM program. All patients complete the same intervention.

Behavioral: Cogmed QM

Interventions

Cogmed QM BEHAVIORAL

The intervention consisted of 25 Cogmed sessions, typically completed over a five week period (i.e. 5 days per week), with each session lasting between 40-50 minutes per day. The program consists of 12 exercises that target visuo-spatial or verbal working memory. At each training session, participants completed 8 of the 12 exercises (order selected by the user), with 15 trials per exercise. Cogmed QM is an adaptive program, wherein task difficulty is adjusted to performance on each trial. The level of difficulty adjusts continuously and automatically, ensuring that each session provides an engaging, challenging level of WM capacity. Breaks were permitted, and encouraged, at the participants' discretion throughout the session.

Cognitive training

Eligibility Criteria

• Age: 20 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Laboratory-confirmed gene expansion of at least 36 CAG repeats
• Reported working memory difficulties on the Patient-Reported Outcomes in Cognitive Impairment (PROCOG) questionnaire
• Total Functional Capacity (TFC) score of at least 3, taken from the UHDRS
• Montreal Cognitive Assessment (MOCA) score of 19 or greater

You may not qualify if:

• History of head trauma/neurological event such as stroke
• Untreated psychiatric symptoms or substance abuse
• Visual or motor symptoms that would impede ability to complete the program and/or neuropsychological testing
• Nonfluency in English

Sponsors & Collaborators

• York University: lead
• North York General Hospital: collaborator

Study Sites (1)

North York General Hospital

Toronto, Ontario, M2K 1E1, Canada

Location

Related Publications (1)

• Sadeghi M, Barlow-Krelina E, Gibbons C, Shaikh KT, Fung WLA, Meschino WS, Till C. Feasibility of computerized working memory training in individuals with Huntington disease. PLoS One. 2017 Apr 28;12(4):e0176429. doi: 10.1371/journal.pone.0176429. eCollection 2017.

  PMID: 28453532 DERIVED

MeSH Terms

Conditions

Huntington Disease; Cognitive Dysfunction

Condition Hierarchy (Ancestors)

Basal Ganglia Diseases; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Dementia; Chorea; Dyskinesias; Movement Disorders; Heredodegenerative Disorders, Nervous System; Neurodegenerative Diseases; Genetic Diseases, Inborn; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Cognition Disorders; Neurocognitive Disorders; Mental Disorders

Study Officials

• Christine Till, PhD

  York University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor, Department of Psychology

Study Record Dates

• First Submitted: September 30, 2016
• First Posted: October 6, 2016
• Study Start: February 1, 2015
• Primary Completion: March 1, 2016
• Study Completion: March 1, 2016
• Last Updated: October 10, 2016

Record last verified: 2016-10

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)