Researchers studied 83 military veterans with a history of mild traumatic brain injury (mTBI) and persistent cognitive impairment. Participants were randomized to an intervention group that used a commercially available brain training app, BrainHQ, or an active control group that played off-the shelf computer games like hangman, Boggle, and mahjong.
Both the intervention group and the control group games were designed to impact cognitive skills such as attention, memory, and reasoning. Participants were directed to use the app or computer games five days week for one hour daily over 12 weeks; they all had cognitive assessments at baseline, at the end of the intervention, and again at 12 weeks post-intervention.
Researchers created a composite cognitive function score from nine individual assessments, with a balancing summation of individual scores normalized to a mean of 100 and standard deviation of 15.
Composite cognitive scores improved significantly more with the app than with the computer games at the end of the 12-week intervention (+6.9 points), and after an additional 12 weeks of follow-up (+7.4 points), researchers report in Brain.
Mean improvement in the intervention group was 9.0 points from baseline to the end of training, compared with 2.3 points for the active control group. After an additional 12 weeks of follow-up, mean improvement from baseline in the intervention group was 9.4 points, compared with 1.9 points in the active control group.
"While the active control games engage attention and memory, they were not designed to rewire brain information processing," said lead study author Henry Mahncke, chief executive officer of Posit Science, the San Francisco-based company that sells the BrainHQ app and sponsored the trial.
"We can't assume that all types of cognitive stimulation are the same," Mahncke said by email. "Keeping your brain busy with brain games is different than training your brain with a validated cognitive training program."
One limitation of the study is that it was under-enrolled, limiting the statistical power to detect an effect size of 0.50, the study team notes. Another limitation is that even though researchers attempted to blind participants to their assigned group, it's possible that people in the active control group realized this, impacting their outcomes.
"Two key weaknesses are that they did not achieve enrollment target and had drop-outs," said Dr. Jack Tsao, a professor of neurology at the University of Tennessee Health Science Center in Memphis, who wasn't involved in the study.
The active intervention of cognitive training had a very modest effect, Dr. Tsao said by email. This is likely due to conscious practice and repetition improving outcomes in both groups.
"The take-home message is that home training can potentially improve cognitive performance, but more studies are needed before this approach should be recommended routinely," Tsao said.
SOURCE: https://bit.ly/3AySRwb Brain, online July 27, 2021.
By Lisa Rapaport
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