Develop an ANS-based Personalized Cognitive Training for Mild Cognitive Impairment

为轻度认知障碍开发基于 ANS 的个性化认知训练

• 批准号: 10903126
• 负责人: Feng Vankee Lin
• 金额: $ 71.52万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-15 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10903126
• 关键词: Address; Aging; Alzheimer' s disease pathology; Autonomic nervous system; Behavior Therapy; Blood; Brain; Cardiac; Cardiovascular system; Categories; Clinical Trials; Cognitive; Data; Data Analyses; Dementia; Development; Dissociation; Double-Blind Method; Educational Intervention; Elderly; Frequencies; Functional Magnetic Resonance Imaging; Future; Health; Impaired cognition; Individual; Intervention; Interview; Learning; Link; Measures; Methods; Monitor; Nerve Degeneration; Neuronal Plasticity; Performance; Phase; Population; Questionnaires; Randomized; Randomized, Controlled Trials; Series; Signal Transduction; Task Performances; Testing; Time; Training; Training Programs; Work; attentional control; brain based; cognitive change; cognitive enhancement; cognitive function; cognitive reserve; cognitive task; cognitive training; comparison control; computerized; design; efficacy trial; feasibility testing; flexibility; follow-up; heart rate variability; improved; indexing; information processing; intervention refinement; mild cognitive impairment; neural; neural circuit; personalized approach; pilot test; pilot trial; precision medicine; prevent; processing speed; programs; prototype; response; theories; usability

Abstract Speed of processing training (SOPT), practicing to enhance the information processing efficiency while performing various perceptual and cognitive tasks, is the widest examined type computerized cognitive training among aging populations, including those with mild cognitive impairment (MCI). However, the efficacy of existing SOPTs in maintaining or improving older adults' cognitive health greatly varies across individuals. Our preliminary studies identified that the flexibility of autonomic nervous system (ANS) is associated with learning and cognitive and neural gains in existing SOPT in older adults with MCI. Our premise is that adaptation capacity, which is primarily reflected by ANS flexibility, is a key contributor to the neuroplasticity underlying broad and sustained effects of cognitive interventions. In this proposed study, we will combine this ANS response profile with the traditional learning index to develop a “personalization engine”, called pSOPT, for better reflecting individual adaptation capacity, and to test pSOPT's feasibility (R21 phase) and preliminary effect (R33 phase) in MCI. In R21 phase (intervention refinement, Stage Ia), we will establish a “personalization engine” for the SOPT by taking advantage of unique information derived from ANS assessment that links to learning and test the feasibility in MCI. Advanced time-series data analysis methods (e.g., shapelet analysis) will be used to develop a prototype of pSOPT based on the previously identified ANS shapelet. Compliance and usability of the pSOPT will be examined using interviews, questionnaires, and recorded performance data using a single group design in older adults with MCI (n = 10). Specific aims include (1) Use the identified ANS shapelet to develop a “personalization engine” that can modulate SOPT according to real-time measures of ANS; (2) Examine the feasibility of administering the pSOPT. In R33 phase (pilot test, Stage Ib), we will test the preliminary effects of the pSOPT in MCI. A pilot double-blinded randomized controlled trial (RCT). An MCI group (N = 50) will be randomized into a 6-week pSOPT (n = 25), or attention control (n = 25). Cardiac monitor-based ANS signals will be recorded throughout training sessions across groups. Learning is indexed by performing accurately across a consecutive set of trials in training tasks. Cognitive battery (measuring cognitive gains) and BOLD fMRI-based brain function (measuring neural gains) will be assessed at baseline, post training (7-week), and short-term follow-up (3-month); neurodegeneration (T1MRI and blood- based Alzheimer's pathology) assessed at baseline. Specific aims include (1) Compare changes of cognitive and neural gains between groups; (2) Explore whether pSOPT will enhance ANS flexibility in supporting cognitive gains against baseline neurodegeneration. This study is a prerequisite to efficiently launch an efficacy trial of pSOPT in slowing dementia progress.

抽象的 加工训练速度（SOPT），练习以提高信息处理效率，同时 执行各种感知和认知任务是最广泛的计算机认知培训 在老龄化人群中，包括患有轻度认知障碍的人（MCI）。但是，现有的效率 维持或改善老年人认知健康方面的SOPT在个人之间有很大不同。我们的 初步研究表明，自主神经系统（ANS）的灵活性与学习有关 MCI老年人现有SOPT的认知和神经收益。我们的前提是适应能力， 这主要由ANS灵活性反映，是导致神经塑性广泛的关键因素，并且 认知干预措施的持续影响。在这项拟议的研究中，我们将结合此ANS响应概况 使用传统的学习指数来开发“个性化引擎”，称为PSOPT，以便更好 反映个人适应能力，并测试PSOPT的可行性（R21阶段）和初步 MCI的效果（R33期）。在R21阶段（干预改进，IA阶段）中，我们将建立一个 通过利用来自ANS的独特信息，SOPT的“个性化引擎” 与学习和测试MCI的可行性有关的评估。高级时间序列数据分析 方法（例如，塑形分析）将用于开发基于先前鉴定的PSOPT的原型 Ans塑形。 PSOPT的合规性和可用性将使用访谈，问卷调查和 使用MCI的老年人（n = 10）的老年人中的单个组设计记录了性能数据。具体目的包括 （1）使用已识别的ANS塑形来开发“个性化引擎”，该引擎可以根据 ANS的实时度量； （2）检查管理PSOPT的可行性。在R33阶段（试验测试， IB阶段），我们将测试PSOPT在MCI中的初步影响。飞行员双盲随机分组 对照试验（RCT）。 MCI组（n = 50）将被随机分为6周的PSOPT（n = 25）或注意力 控制（n = 25）。基于心脏监视器的ANS信号将在整个跨组的培训课程中记录。 通过在训练任务中的一组试验中进行准确表演来索引学习。认知电池 （衡量认知能力）和基于fMRI的大脑功能（测量神经收益）将在 基线，培训后（7周）和短期随访（3个月）；神经变性（T1MRI和血液 - 基于基线的基于阿尔茨海默氏病的病理）。具体目的包括（1）比较认知的变化 群体之间的神经收益； （2）探索PSOPT是否会增强ANS灵活性支持认知 对基线神经退行性变化的增长。这项研究是有效启动有效试验的先决条件 PSOPT在减慢痴呆症进展方面。