Computerized Cognitive Rehabilitation in Children after Severe Malaria

严重疟疾后儿童的计算机认知康复

基本信息

批准号：
8811141
负责人：
Michael Joseph Boivin
金额：
$ 46.21万
依托单位：
MICHIGAN STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-04-01 至 2018-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8811141
关键词：
Activities of Daily Living Acute Affect Africa African Age American Analysis of Covariance Area Attention Attention deficit hyperactivity disorder Auditory Brain Diseases Brain Injuries Brain Stem Car Phone Central Nervous System Diseases Cerebral Malaria Charge Child Child Behavior Checklist Childhood Clinic Clinical Research Communicable Diseases Communities Computers Control Groups Country Development Developmental Disabilities Disease Distal Economics Effectiveness Electroencephalography Encephalitis Enrollment Evaluation Future HIV Health Health Personnel Home environment Household Impaired cognition Impairment Incidence Income Infection Internet Intervention Intervention Studies Learning Learning Disorders Malaria Marketing Mediating Memory Memory impairment Meningitis Monitor Morbidity - disease rate Motor Neurocognitive Neurocognitive Deficit Neurocysticercosis Outcome Outcome Assessment Participant Performance Quality Control RANTES Randomized Randomized Controlled Trials Recruitment Activity Rehabilitation therapy Research Resources Risk Sahara Schistosomiasis School-Age Population Schools Seizures Services Severities Short-Term Memory Snow Source Survivors System Testing Therapeutic Training Training Programs Tumor Necrosis Factor-alpha Uganda Visit Visual Visuospatial Work active control base brain behavior chemokine child battery cognitive performance cognitive rehabilitation cognitive testing computerized cost cytokine design disability executive function follow-up group intervention human TNF protein improved innovation laptop mortality neuropsychological prevent programs psychosocial adjustment screening social attention teacher treatment program

项目摘要

DESCRIPTION (provided by applicant): Research Topic: We have documented in our prior work in Uganda that 1 out of 4 school-age survivors of cerebral malaria (CM) has persisting attention, memory, or learning impairment two years after illness. No viable treatment presently exists to prevent these disabilities, and hundreds of thousands of children are affected each year in sub-Sahara Africa. One hundred and fifty severe malaria survivors (5 to 12 yrs of age), and 150 healthy community control (CC) children recruited from their households will be our study participants. Fifty of these children will be randomly selected to receive 24 training sessions of a computerized cognitive rehabilitation therapy (CCRT) program called Captain's Log, marketed mostly for American children with attention and/or learning problems. A locked version of Captain's Log which does not direct the child's training in a progressive manner will be administered to an active control group, and no intervention for the passive control group. Children will undergo training in their homes or in a nearby clinic supervised by a field trainer. Study Aim 1: To evaluate the effectiveness of CCRT in improving neuropsychological performance and psychiatric outcomes in Ugandan children who survive severe malaria. Study Aim 2: To evaluate whether severity of malaria illness (e.g., immunological brain inflammation, EEG abnormalities) is predictive of neuropsychological benefit from CCRT. Outcome Assessments: The Kaufman Assessment Battery for Children, 2nd ed. (KABC-2), visual and auditory Tests of Variables of Attention (TOVA), CogState computerized neuropsychological screening test, Bruininks-Oseretsky Test of Motor Proficiency (2nd edition), and Achenbach Child Behavior Checklist (CBCL) will be administered before and after the 8-week training period and at 1-yr follow-up. Improvements in academic performance will also be evaluated. We have previously used all these assessments with Ugandan children surviving CM or with HIV to effectively evaluate neuropsychological and psychiatric problems, and to document the effectiveness of CCRT. Captain's Log has an internal evaluator feature which will help us monitor the specific training tasks to which the children best respond. Based on our prior research with CCRT intervention with CM survivors and in children with HIV, we expect CCRT to be effective in improving attention, memory, and learning; and that our assessments will be sensitive enough to document neuropsychological and psychiatric benefit. Analyses: We will compare neuropsychological and psychiatric gains over the 8-weeks of CCRT and at 1-yr follow-up for our intervention groups across the severe malaria and control children (3 by 2 ANCOVA controlling for quality of home environment). These gains will be significantly greater for the CCRT intervention children (Study Aim 1). More severe immunological and EEG indicators during malaria illness will show greater need for an improvement from CCRT (Study Aim 2). Conclusion: CCRT will prove effective and sustainable in rehabilitation for severe malaria. CCRT and computerized cognitive tests will prove viable for treating children in resource-poor settings.

描述（由申请人提供）：研究主题：我们在乌干达之前的工作中记录到，四分之一的学龄脑型疟疾 (CM) 幸存者在患病两年后仍存在持续的注意力、记忆或学习障碍。目前尚无可行的治疗方法可以预防这些残疾，撒哈拉以南非洲每年有数十万儿童受到影响。 150 名严重疟疾幸存者（5 至 12 岁）和从家庭中招募的 150 名健康社区控制 (CC) 儿童将成为我们的研究参与者。其中 50 名儿童将被随机选择接受 24 次计算机化认知康复治疗 (CCRT) 计划的培训课程，该计划名为 Captain's Log，该计划主要针对有注意力和/或学习问题的美国儿童。锁定版本的船长日志不会以渐进的方式指导孩子的训练，将向主动对照组进行管理，而对被动对照组则不进行干预。孩子们将在现场培训师的监督下在家中或附近的诊所接受培训。研究目标 1：评估 CCRT 在改善乌干达严重疟疾幸存者的神经心理表现和精神结局方面的有效性。研究目标 2：评估疟疾疾病的严重程度（例如免疫性脑炎症、脑电图异常）是否可以预测 CCRT 带来的神经心理学益处。结果评估：考夫曼儿童评估电池，第二版。 (KABC-2)、注意力变量视觉和听觉测试 (TOVA)、CogState 计算机化神经心理学筛查测试、Bruininks-Oseretsky 运动能力测试（第二版）和阿亨巴赫儿童行为检查表 (CBCL) 将在前后进行8周的训练期和1年的随访期。还将评估学业成绩的提高。我们之前已经对乌干达患有 CM 或 HIV 的儿童进行了所有这些评估，以有效评估神经心理和精神问题，并记录 CCRT 的有效性。船长日志有一个内部评估器功能，可以帮助我们监控孩子们最能反应的具体训练任务。根据我们之前对 CM 幸存者和 HIV 儿童进行 CCRT 干预的研究，我们预计 CCRT 可有效改善注意力、记忆力和学习能力；我们的评估将足够敏感，能够记录神经心理学和精神病学的益处。分析：我们将比较严重疟疾儿童和对照儿童的干预组在 8 周 CCRT 和 1 年随访中的神经心理和精神方面的进展（控制家庭环境质量的 3 x 2 ANCOVA）。对于接受 CCRT 干预的儿童来说，这些收益将显着更大（研究目标 1）。疟疾疾病期间更严重的免疫学和脑电图指标将表明 CCRT 更需要改进（研究目标 2）。结论：CCRT 在重症疟疾康复中将被证明是有效且可持续的。 CCRT 和计算机认知测试将证明对于治疗资源匮乏地区的儿童是可行的。

项目成果

期刊论文数量（3）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

The cognitive burden of severe malaria in the Ugandan classroom and the effects of a computerized intervention.

乌干达课堂上严重疟疾的认知负担以及计算机干预的影响。

DOI：
10.1016/j.apnr.2021.151551
发表时间：
2022
期刊：
Applied nursing research : ANR
影响因子：
0
作者：
Miller,Katherine;Lori,Jody;Liu,Xuefeng;Boivin,Michael;Giordani,Bruno
通讯作者：
Giordani,Bruno

Daily Training efficiency during computerized cognitive rehabilitation training (CCRT): an analysis from a randomized trial in Ugandan children with and without severe malaria.

DOI：
10.1080/09297049.2021.1962266
发表时间：
2022-03
期刊：
Child neuropsychology : a journal on normal and abnormal development in childhood and adolescence
影响因子：
0
作者：
Larrivey V;Neva J;Finn K;Sikorskii A;Familiar-Lopez I;Ucheagwu V;Ezeamama A;Ruisenor-Escudero H;Nakasujja N;Boivin M;Giordani B
通讯作者：
Giordani B

Neuropsychological benefits of computerized cognitive rehabilitation training in Ugandan children surviving severe malaria: A randomized controlled trial.

计算机认知康复训练对乌干达严重疟疾幸存者的神经心理学益处：一项随机对照试验。

DOI：
10.1016/j.brainresbull.2018.03.002
发表时间：
2019-03
期刊：
Brain research bulletin
影响因子：
3.8
作者：
Boivin MJ;Nakasujja N;Sikorskii A;Ruiseñor-Escudero H;Familiar-Lopez I;Walhof K;van der Lugt EM;Opoka RO;Giordani B
通讯作者：
Giordani B