The Cognition and Flow Study: A Feasibility Randomized Controlled Trial of the Effects of Cognitive Training on Cerebral Blood Flow

Article type: Research Article

Authors: Beishon, Lucy C.^{a; *} | Panerai, Ronney B.^{a; b} | Budgeon, Charley^{c; d} | Subramaniam, Hari^e | Mukaetova-Ladinska, Elizabeta^{e; f} | Robinson, Thompson G.^{a; b} | Haunton, Victoria J.^{a; b}

Affiliations: [a] University of Leicester, Department of Cardiovascular Sciences, Leicester, UK | [b] NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK | [c] University of Leicester, Department of Cardiovascular Sciences, Leicester, UK | [d] School of Population and Global Health, University of Western Australia, Perth, Australia | [e] The Evington Centre, Leicestershire Partnership NHS Trust, Leicester, UK | [f] University of Leicester, Department of Neuroscience, Psychology and Behaviour, Leicester, UK

Correspondence: [*] Correspondence to: Lucy Beishon, Room 228, Level 2 Clinical Sciences Building, Leicester Royal Infirmary, Leicester, LE2 7LX, UK. Tel.: +44 0116 252 3134; E-mail: Lb330@le.ac.uk.

Abstract: Background:Cognitive training (CT) has demonstrated benefits for healthy older adults (HG) and mild cognitive impairment (MCI), but the effects on vascular function are unknown. Objective:This is a feasibility trial investigating the effects of CT on cerebral blood flow velocity (CBFv). Methods:Twenty HG, 24 with Alzheimer’s disease (AD), and 12 with MCI were randomized to 12 weeks of multi-domain CT or control. Outcomes included: cognition (Addenbrooke’s Cognitive Examination III), mood, quality of life (QoL), physical, and neurovascular function (transcranial Doppler ultrasonography measured task activation of CBFv responses). Data are presented as mean difference (MD) and 95% confidence interval (CI). Results:47 participants completed the trial. There were three dropouts from the training arm in the AD group, and one in the HG group. The intervention was acceptable and feasible to the majority of participants with a high completion rate (89%). The dropout rate was higher among participants with dementia. Few changes were identified on secondary analyses, but QoL was significantly improved in HG post-training (MD: 4.83 [95% CI: 1.13, 8.54]). CBFv response rate was not significantly different in HG (MD: 1.84 [95% CI: –4.81, 1.12]), but a significant increase was seen in the patient group (MD: 1.79 [95% CI: 0.005, 3.58]), requiring sample sizes of 56 and 84 participants respectively for a fully-powered trial. Conclusion:A 12-week CT program was acceptable and feasible in HG, AD, and MCI. CT may be associated with alterations in vascular physiology which require further investigation in an appropriately powered randomized controlled trial.

Keywords: Cerebral blood flow, cerebral hemodynamics, cognition, cognitive impairment, dementia

DOI: 10.3233/JAD-201444

Journal: Journal of Alzheimer's Disease, vol. 80, no. 4, pp. 1567-1581, 2021