Dynamics of cognitive functions using the rehabilitation program of cognitive training

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OBJECTIVE

To study the efficiency of the neuropsychological rehabilitation of patients with mild cognitive impairments.

MATERIAL AND METHODS

The study included 103 elderly people, aged 59 to 88 years, including 90 women and 13 men with subjective complaints of memory loss (ICD-10: F06.70; F06.71; F06.78; F06.79). Participants were divided into experimental group (n=43) and comparison group (n=42). The estimated impact was the rehabilitation program «The psychosocial therapy and neurocognitive rehabilitation of elderly patients with cognitive impairments», within which the principle of complex stimulation of various parameters of the cognitive sphere was used in rehabilitation work with patients in the experimental group in accordance with the «Memory Clinic» program. The study was conducted using randomized, equalized comparison groups, and the principle of «triple-blind» research. Non-parametric statistics (SPSS) methods were used to assess differences.

RESULTS

A significant difference between the comparison and experimental groups has been identified, primarily in relation to high-level mental processes associated with the function of the third structural-functional block according to A.R. Luria. After the training, the number of correct answers significantly increased (t(42)=–2.67, p<0.001) in the experimental group, while in the comparison group the indicator did not change (t(41)=0.50, p=0.617). The number of false alarms in the experimental group decreased significantly (t(42)=2.13, p=0.039).

CONCLUSION

The results confirm the leading role of these processes in the hierarchy of mental functions, which suggests that they should primarily be targets of rehabilitation interventions.

Keywords:

neuropsychological rehabilitation

cognitive functions

efficiency of the cognitive rehabilitation

triple-blind study

Authors:

Kostyuk G.P.

Lomonosov Moscow State University;
Alexeev Psychiatric Hospital no. 1 of the Department of Health of Moscow

SPIN RSCI: 3424-4544
Scopus AuthorID: 57200081884
ORCID: 0000-0002-3073-6305

Tkhostov A.Sh.

Lomonosov Moscow State University;
Psychological Institute of the Russian Academy of Education

ORCID: 0000-0001-9676-4096

Skvortsov A.A.

National Research University Higher School of Economics

ORCID: 0000-0002-0471-4217

Kovyazina M.S.

Lomonosov Moscow State University;
Psychological Institute of the Russian Academy of Education;
Scientific Center of Neurology, Institute of Neurorehabilitation and Restorative Technologies

ORCID: 0000-0002-1795-6645

Kurmyshev M.V.

Alexeev Psychiatric Hospital no. 1 of the Department of Health of Moscow

ORCID: 0000-0001-7354-7216

Gusev A.N.

Lomonosov Moscow State University

ORCID: 0000-0002-9299-7092

Andryushenko A.V.

Lomonosov Moscow State University;
Alexeev Psychiatric Hospital no. 1 of the Department of Health of Moscow

ORCID: 0000-0002-7702-6343

Varako N.A.

Lomonosov Moscow State University;
Psychological Institute of the Russian Academy of Education;
Scientific Center of Neurology, Institute of Neurorehabilitation and Restorative Technologies

ORCID: 0000-0002-8310-8169

Savilov V.B.

Alexeev Psychiatric Hospital no. 1 of the Department of Health of Moscow

ORCID: 0000-0002-1425-1586

Kremlev A.E.

Lomonosov Moscow State University

ORCID: 0000-0002-5795-9605

Osipova N.G.

Alexeev Psychiatric Hospital no. 1 of the Department of Health of Moscow

ORCID: 0000-0002-3023-2393

Received:

27.09.2023

Accepted:

13.02.2024

List of references:

Sitzer DI, Twamley EW, Jeste DV. Cognitive training in alzheimer’s disease: A meta-analysis of the literature. Acta Psychiatrica Scandinavica. 2006;114(2):75-90. https://doi.org/10.1111/j.1600-0447.2006.00789.x
Reijnders J, van Heugten C, van Boxtel M. Cognitive interventions in healthy older adults and people with mild cognitive impairment: a systematic review. Ageing Res Rev. 2013;12:263-275. https://doi.org/10.1016/j.arr.2012.07.003
Sanjuán M, Navarro E, Calero MD. Effectiveness of Cognitive Interventions in Older Adults: A Review. Eur J Investig Health Psychol Educ. 2020;10:876-898. https://doi.org/10.3390/ejihpe10030063
Julien A, Danet L, Loisel M, et al. Update on the Efficacy of Cognitive Rehabilitation After Moderate to Severe Traumatic Brain Injury: A Scoping Review. Arch Phys Med Rehabil. 2023;104:315-330. https://doi.org/10.1016/j.apmr.2022.07.007
Cicerone KD, Dahlberg C, Kalmar K, et al. Evidence-based cognitive rehabilitation: recommendations for clinical practice. Arch Phys Med Rehabil. 2000;81:1596-1615. https://doi.org/10.1053/apmr.2000.19240
Appendix C: AAN Classification of Evidence for the Rating of a Therapeutic Study. Continuum. 2015;21:1169. https://doi.org/10.1212/01.CON.0000470920.20859.fe
Atkins D, Eccles M, Flottorp S, et al. Systems for grading the quality of evidence and the strength of recommendations I: critical appraisal of existing approaches The GRADE Working Group. BMC Health Serv Res. 2004;4:38. https://doi.org/10.1186/1472-6963-4-38
Cicerone KD, Dahlberg C, Malec JF, et al. Evidence-based cognitive rehabilitation: updated review of the literature from 1998 through 2002. Arch Phys Med Rehabil. 2005;86:1681-1692. https://doi.org/10.1016/j.apmr.2005.03.024
Tulliani N, Bissett M, Fahey P, et al. Efficacy of cognitive remediation on activities of daily living in individuals with mild cognitive impairment or early-stage dementia: a systematic review and meta-analysis. Syst Rev. 2022;11:156. https://doi.org/10.1186/s13643-022-02032-0
Bahar-Fuchs A, Clare L, Woods B. Cognitive training and cognitive rehabilitation for mild to moderate Alzheimer’s disease and vascular dementia. Cochrane Database Syst Rev. 2013;2013:CD003260. https://doi.org/10.1002/14651858.CD003260.pub2
Rojas GJ, Villar V, Iturry M, et al. Efficacy of a cognitive intervention program in patients with mild cognitive impairment. Int Psychogeriatr. 2013;25:825-831. https://doi.org/10.1017/S1041610213000045
Muñiz R, Serra CM, Reisberg B, et al. Cognitive-motor intervention in Alzheimer’s disease: long-term results from the Maria Wolff trial. J Alzheimers Dis. 2015;45:295-304.
Barban F, Annicchiarico R, Pantelopoulos S, et al. Protecting cognition from aging and Alzheimer’s disease: a computerized cognitive training combined with reminiscence therapy. Int J Geriatr Psychiatry. 2016;31:340-348. https://doi.org/10.1002/gps.4328
Pantoni L, Poggesi A, Diciotti S, et al. Effect of Attention Training in Mild Cognitive Impairment Patients with Subcortical Vascular Changes: The RehAtt Study. J Alzheimers Dis. 2017;60:615-624.
Belleville S, Hudon C, Bier N, et al. MEMO+: Efficacy, Durability and Effect of Cognitive Training and Psychosocial Intervention in Individuals with Mild Cognitive Impairment. J Am Geriatr Soc. 2018;66:655-663. https://doi.org/10.1111/jgs.15192
Law LLF, Mok VCT, Yau MMK. Effects of functional tasks exercise on cognitive functions of older adults with mild cognitive impairment: a randomized controlled pilot trial. Alzheimers Res Ther. 2019;11:98. https://doi.org/10.1186/s13195-019-0548-2
Law LLF, Mok VCT, Yau MKS, Fong KNK. Effects of functional task exercise on everyday problem-solving ability and functional status in older adults with mild cognitive impairment-a randomised controlled trial. Age Ageing [Internet]. 2022;51(1):afab210. https://doi.org/10.1093/ageing/afab210
Emmanouel A, Kontrafouri E, Nikolaos P, et al. Incorporation of a working memory strategy in GMT to facilitate serial-order behaviour in brain-injured patients. Neuropsychol Rehabil. 2020;30:888-914. https://doi.org/10.1080/09602011.2018.1517369
Wilson BA, Evans JJ, Keohane C. Cognitive rehabilitation: a goal-planning approach. J Head Trauma Rehabil. 2002;17:542-555. https://doi.org/10.1097/00001199-200212000-00006
Wilson BA. Brain injury: recovery and rehabilitation. Wiley Interdiscip Rev Cogn Sci. 2010;1:108-118. https://doi.org/10.1002/wcs.15
Simon SS, Yokomizo JE, Bottino CMC. Cognitive intervention in amnestic Mild Cognitive Impairment: a systematic review. Neurosci Biobehav Rev. 2012;36:1163-1178. https://doi.org/10.1016/j.neubiorev.2012.01.007
Williams K, Herman R, Bontempo D. Reasoning Exercises in Assisted Living: a cluster randomized trial to improve reasoning and everyday problem solving. Clin Interv Aging. 2014;9:981-996. https://doi.org/10.2147/CIA.S62095
Giuli C, Papa R, Lattanzio F, Postacchini D. The Effects of Cognitive Training for Elderly: Results from My Mind Project. Rejuvenation Res. 2016;19:485-494. https://doi.org/10.1089/rej.2015.1791
Clare L. Rehabilitation for people living with dementia: A practical framework of positive support. PLoS Med. 2017;14:e1002245. https://doi.org/10.1371/journal.pmed.1002245
Nousia A, Siokas V, Aretouli E, et al. Beneficial Effect of Multidomain Cognitive Training on the Neuropsychological Performance of Patients with Early-Stage Alzheimer’s Disease. Neural Plast. 2018;2018:2845176. https://doi.org/10.1155/2018/2845176
Rovner BW, Casten RJ, Hegel MT, Leiby B. Preventing Cognitive Decline in Black Individuals With Mild Cognitive Impairment: A Randomized Clinical Trial. JAMA Neurol. 2018;75:1487-1493. https://doi.org/10.1001/jamaneurol.2018.2513
Park J-H. Does the virtual shopping training improve executive function and instrumental activities of daily living of patients with mild cognitive impairment? Asian J Psychiatr. 2022;69:102977. https://doi.org/10.1016/j.ajp.2021.102977
Woods B, Aguirre E, Spector AE, et al. Cognitive stimulation to improve cognitive functioning in people with dementia. Cochrane Database Syst Rev. 2012;CD005562. https://doi.org/10.1002/14651858.CD005562.pub2
Kelly ME, Loughrey D, Lawlor BA, et al. The impact of cognitive training and mental stimulation on cognitive and everyday functioning of healthy older adults: a systematic review and meta-analysis. Ageing Res Rev. 2014;15:28-43. https://doi.org/10.1016/j.arr.2014.02.004
Lam LC-W, Chan WC, Leung T, et al. Would older adults with mild cognitive impairment adhere to and benefit from a structured lifestyle activity intervention to enhance cognition?: a cluster randomized controlled trial. PLoS One. 2015;10:e0118173. https://doi.org/10.1371/journal.pone.0118173
Brain training lumosity does it really work. January 01, 2016. Accesed March 3.2023. https://www.consumer.ftc.gov/blog/2016/01/brain-training-lumosity-does-it-really-work
Propustina V, Stepanov G, Yurina D, et al. The Puzzles Test and the Red Shapes Test as new diagnostic tools for neglect syndrome. Eur Psychiatry. 2022;65:S879. https://doi.org/10.1192/j.eurpsy.2022.2281
Lurija AR. Vosstanovlenie funkcij mozga posle voennoj travmy. Izdatel’stvo Akademii medicinskih nauk SSSR; 1948. (In Russ.).
Cvetkova LS. Mozg i intellekt: Narushenie i vosstanovlenie intellektual’noj dejatel’nosti. MPSI; 2008. (In Russ.).
Kurmyshev MV, Savilov VB, Masjakin AV, Kostjuk GP. Klinika pamjati-innovacionnaja model’ reabilitacii kognitivnyh funkcij u ljudej pozhilogo vozrasta s mjagkim kognitivnym snizheniem v uslovijah otdelenija dnevnogo prebyvanija. Social’naja i Klinicheskaja Psihiatrija. 2018;28:50-54. (In Russ.).
Folstein MF, Folstein SE, McHugh PR. «Mini-mental state». A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189-198. https://doi.org/10.1016/0022-3956(75)90026-6
Borson S, Brush M, Gil E, et al. The Clock Drawing Test: utility for dementia detection in multiethnic elders. J Gerontol A Biol Sci Med Sci. 1999;54:M534-540. https://doi.org/10.1093/gerona/54.11.m534
Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67:361-370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x
Hachinski VC, Iliff LD, Zilhka E, et al. Cerebral blood flow in dementia. Arch Neurol. 1975;32:632-637. https://doi.org/10.1001/archneur.1975.00490510088009
Nasreddine ZS, Phillips NA, Bédirian V, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53:695-699. https://doi.org/10.1111/j.1532-5415.2005.53221.x
Juby A, Tench S, Baker V. The value of clock drawing in identifying executive cognitive dysfunction in people with a normal Mini-Mental State Examination score. CMAJ. 2002;167(8):859-864. PMID: 12406943; PMCID: PMC128397.
Weiser M, Freedman M, Leech L, et al. Clock drawing: a neuropsychological analysis. New York: Oxford Press; 1994.
Cova I, Mele F, Zerini F, et al. The Clock Drawing Test as a predictor of cognitive decline in non-demented stroke patients. J Neurol. 2022;269(1):342-349. Epub 2021 Jun 6. PMID: 34095964; PMCID: PMC8739305. https://doi.org/10.1007/s00415-021-10637-z
Psihicheskie rasstrojstva i rasstrojstva povedenija (F00—F99). Klass V MKB-10, adaptirovannyj dlja ispol’zovanija v Rossijskoj Federacii. M. 1998 Data obrashhenija: 11.05.23. (In Russ.). https://psychiatr.ru/download/1998?view=1&name=MKB-10_s_giperssylkami.pdf
Burygina LA, Gavrilova SI, Kostjuk GP, Pak MV. Psihosocial’naja terapija i nejrokognitivnaja reabilitacija pacientov pozhilogo vozrasta s kognitivnymi rasstrojstvami. Strukturno-funkcional’naja model’ reabilitacionnoj programmy «Klinika pamjati». Pod red. Kostjuka G.P. M.: KDU; 2019. (In Russ.).
Savilov VB, Kurmyshev MV, Jurchenko IJe, et al. Rannjaja diagnostika kognitivnyh rasstrojstv kak faktor snizhenija riska demencii u lic pozhilogo vozrasta: vozmozhnosti i resursy. Rossijskij Zhurnal Geriatricheskoj Mediciny. 2022;(1):32-36. (In Russ.). https://doi.org/10.37586/2686-8636-1-2022-32-36
Rubinshtejn SJa. Jeksperimental’nye metodiki patopsihologii. Serija «Mir psihologii». M.: ZAO Izd-vo JeKSMO-Press; 1999. (In Russ.).
Akhutina TV, Korneev AA, Matveeva EYu, et al. The develop-ment of integral indices for a computerized neuropsychological test battery for children. Russ J Cognit Sci. 2019;6:4-19.
Gusev AN. Psihologicheskie izmerenija: teorija, metody. M.: Aspekt Press; 2011. (In Russ.).
Lurija AR. Lobnye doli i reguljacija psihicheskih processov: nejropsihologicheskie issledovanija. Pod red. Lurija A.R. i Homskoj E.D. Homskoj. PRE, editor. M.: MGU; 1966. (In Russ.).
Chan RCK, Shum D, Toulopoulou T, Chen EYH. Assessment of executive functions: review of instruments and identification of critical issues. Arch Clin Neuropsychol. 2008;23:201-216. https://doi.org/10.1016/j.acn.2007.08.010
Lurija AR. Osnovy nejropsihologii: Ucheb. posobie dlja vuzov po napravleniju i spec. psihologija. Izdatel’stvo «Piter»; 2023. (In Russ.).
Diamond A. Executive functions. Annu Rev Psychol. 2013;64:135-168. https://doi.org/https://doi.org/0.1146/annurev-psych-113011-143750
Duncan Roger Johnson Michaela Swale J. Frontal lobe deficits after head injury: Unity and diversity of function. Cogn Neuropsychol. 1997;14:713-741. https://doi.org/10.1080/026432997381420
Archibald SJ, Kerns KA. Identification and description of new tests of executive functioning in children. Child Neuropsychol. 1999;5:115-129. https://doi.org/10.1076/chin.5.2.115.3167
Miller EK, Cohen JD. An integrative theory of prefrontal cortex function. Annu Rev Neurosci. 2001;24:167-202. https://doi.org/10.1146/annurev.neuro.24.1.167
Hughes C. Executive functions and development: emerging themes. Infant Child Dev. 2002;11:201-209. https://doi.org/10.1002/icd.297
Hughes C, Graham A. Measuring executive functions in childhood: Problems and solutions? Child Adolesc Ment Health. 2002;7:131-142. https://doi.org/10.1111/1475-3588.00024
Gioia GA, Isquith PK. Ecological assessment of executive function in traumatic brain injury. Dev Neuropsychol. 2004;25:135-158. https://doi.org/10.1080/87565641.2004.9651925
Barkley RA. Executive Functions: What They Are, How They Work, and Why They Evolved. New York, Guilford Press; 2012.
Lurija AR. Vysshie korkovye funkcii cheloveka. Izdatel’stvo Piter Serija Mastera Psihologii. SPb, 2020. (In Russ.).
LuZabrodin JuM. Psihofizicheskie issledovanija. Lomov ORB, editor. M.: Nauka; 1977. (In Russ.).
Tkhostov A, Vinogradova M. The study of wishful thinking phenomenon in patients with personality disorders. Procedia Soc Behav Sci. 2013;86:578-583. https://doi.org/10.1016/j.sbspro.2013.08.617
Vygotskij LS. Sobranie sochinenij: v 6 t.: Osnovy defektologii. Pod red. T.A. Vlasovoj. M.: Pedagogika; 1982-1984. 1983. (In Russ.).
Cvetkova LS. Nejropsihologicheskaja reabilitacija bol’nyh. Rech’ i intellektual’naja dejatel’nost’. Izdatel’stvo NPO «MODJeK», Ucheb. posobie. 2-e izd., ispr. i dop. M.: Izdatel’stvo Moskovskogo psihologo-social’nogo instituta; Voronezh; 2004. (In Russ.).
Semenovich A. Nejropsihologicheskaja korrekcija v detskom vozraste. Metod zameshhajushhego ontogeneza. M.: Genezis; 2015. (In Russ.).
Baulina ME, Varako NA, Zinchenko YP, et al. Neuropsychological diagnostics and rehabilitation of patients with disorders of praxis in diseases of the brain of various etiology. Nat Psychol J. 2023;1(49):3-17. (In Russ.). https://doi.org/10.11621/npj.2023.0101
Leont’ev AN. Dejatel’nost’, soznanie, lichnost’. M.: Smysl; Izdatel’skij centr «Akademija»; 2005. (In Russ.).
Shcherbakov N, Varako N, Kovyazina M, et al. Dynamics of Neuropsychological Symptoms during the Training of Executive Functions in Neurological Patients. Healthcare (Basel) [Internet]. 2021;9. https://doi.org/10.3390/healthcare9121716

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