Online Cognitive Rehabilitation of Executive Dysfunction in Nonamnestic MCI

NCT ID: NCT04503798

Last Updated: 2020-08-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-08-20

Study Completion Date

2021-12-30

Brief Summary

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Nonamnestic mild cognitive impairment (naMCI) is a prodromal state characterized by deficits in executive functioning, a collection of higher-order abilities involved in organization, planning, inhibition, and complex reasoning. Research shows that individuals with naMCI have an increased risk of developing non-Alzheimer's dementia such as frontotemporal dementia and dementia with Lewy bodies, which pose substantial personal and societal costs. Accordingly, interventions that can successfully slow down or reverse the course of naMCI are needed.

Goal Management Training (GMT) is a cognitive rehabilitation platform that has been studied extensively, applied clinically, and manualized into kits for clinicians (Levine et al., 2000; Levine et al., 2007; Levine et al., 2011; Stamenova \& Levine, 2019). The purpose of GMT is to train individuals to periodically "STOP" what they are doing, attend to task goals, evaluate their performance, and monitor or check outcomes as they proceed. Recently, an online version of GMT has been developed and validated in order to circumvent barriers to attending in-person sessions.

The purpose of the current study is to determine if the online version of GMT is effective at improving self-reported executive dysfunction in individuals diagnosed with naMCI against a control group that is receiving treatment-as-usual from their care provider. It is hypothesized that, compared to the control group, individuals receiving GMT will report a decrease in executive function deficits.

Detailed Description

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Conditions

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Nonamnestic Mild Cognitive Impairment Cognitive Dysfunction Cognitive Disorder Neurocognitive Disorders Mental Disorder Cognitive Impairment, Mild

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants are screened, undergo a battery of tests at pre-test, and then are randomly assigned to one of two conditions: online GMT intervention or treatment-as-usual control group. After the intervention, the participants take the same test battery and complete it once more at 6 week follow-up.
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors
The study personnel who conduct screening and send pre/post-test surveys to participants are all blinded.

Randomizer is blinded to all participant pre-test outcomes. Care providers know what their participants are doing, but not aware of the full study design, including details of the other conditions or outcome test characteristics.

Study Groups

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Online Goal Management Training (GMT)

The online version of GMT with a therapist on the back-end monitoring progress and giving feedback throughout the program. Online GMT takes 5-9 weeks (self-paced) to complete 9 modules involving instructional video with interactive content, practice of cognitive strategies through games, and between-module exercises.

Group Type EXPERIMENTAL

Online Goal Management Training

Intervention Type BEHAVIORAL

Pre-recorded videos and games combine psycho-education, targeted skills training, and mindfulness practice to teach a system where participants can take control of their attention and cognitive faculties.

Treatment-as-usual control group

Participants randomized to this arm will receive no additional information or access to the intervention program. They will continue to receive treatment-as-usual from their care providers.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Online Goal Management Training

Pre-recorded videos and games combine psycho-education, targeted skills training, and mindfulness practice to teach a system where participants can take control of their attention and cognitive faculties.

Intervention Type BEHAVIORAL

Other Intervention Names

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GMT

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of nonamnestic mild cognitive impairment
* Available to participate in all testing and intervention sessions
* Access to a computer
* Computer familiarity
* Normal or corrected-to-normal vision and hearing

Exclusion Criteria

* Diagnosis of amnestic mild cognitive impairment or dementia
* Moderate to severe affective impairment defined by score above cut-off for depression on the Patient Health Questionnaire-9 (PHQ-9; Kroenke et al., 2001)
Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Centre for Aging and Brain Health Innovation

OTHER

Sponsor Role collaborator

Baycrest

OTHER

Sponsor Role lead

Responsible Party

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Brian Levine

Senior Scientist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Brian Levine, PhD

Role: PRINCIPAL_INVESTIGATOR

Baycrest Health Sciences

Locations

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Baycrest Health Sciences

Toronto, Ontario, Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Brian Levine, PhD

Role: CONTACT

416-785-2500 ext. 3593

Yushu Wang, MSc

Role: CONTACT

416-785-2500 ext. 2914

Facility Contacts

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Brian Levine, PhD

Role: primary

416-785-2500 ext. 3593

References

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Burgess PW, Alderman N, Evans J, Emslie H, Wilson BA. The ecological validity of tests of executive function. J Int Neuropsychol Soc. 1998 Nov;4(6):547-58. doi: 10.1017/s1355617798466037.

Reference Type BACKGROUND
PMID: 10050359 (View on PubMed)

Broadbent DE, Cooper PF, FitzGerald P, Parkes KR. The Cognitive Failures Questionnaire (CFQ) and its correlates. Br J Clin Psychol. 1982 Feb;21(1):1-16. doi: 10.1111/j.2044-8260.1982.tb01421.x.

Reference Type BACKGROUND
PMID: 7126941 (View on PubMed)

Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001 Sep;16(9):606-13. doi: 10.1046/j.1525-1497.2001.016009606.x.

Reference Type BACKGROUND
PMID: 11556941 (View on PubMed)

Levine B, Robertson IH, Clare L, Carter G, Hong J, Wilson BA, Duncan J, Stuss DT. Rehabilitation of executive functioning: an experimental-clinical validation of goal management training. J Int Neuropsychol Soc. 2000 Mar;6(3):299-312. doi: 10.1017/s1355617700633052.

Reference Type BACKGROUND
PMID: 10824502 (View on PubMed)

Levine B, Schweizer TA, O'Connor C, Turner G, Gillingham S, Stuss DT, Manly T, Robertson IH. Rehabilitation of executive functioning in patients with frontal lobe brain damage with goal management training. Front Hum Neurosci. 2011 Feb 17;5:9. doi: 10.3389/fnhum.2011.00009. eCollection 2011.

Reference Type BACKGROUND
PMID: 21369362 (View on PubMed)

Levine B, Stuss DT, Winocur G, Binns MA, Fahy L, Mandic M, Bridges K, Robertson IH. Cognitive rehabilitation in the elderly: effects on strategic behavior in relation to goal management. J Int Neuropsychol Soc. 2007 Jan;13(1):143-52. doi: 10.1017/S1355617707070178.

Reference Type BACKGROUND
PMID: 17166313 (View on PubMed)

Hampshire A, Highfield RR, Parkin BL, Owen AM. Fractionating human intelligence. Neuron. 2012 Dec 20;76(6):1225-37. doi: 10.1016/j.neuron.2012.06.022.

Reference Type BACKGROUND
PMID: 23259956 (View on PubMed)

Troyer AK, Murphy KJ, Anderson ND, Craik FI, Moscovitch M, Maione A, Gao F. Associative recognition in mild cognitive impairment: relationship to hippocampal volume and apolipoprotein E. Neuropsychologia. 2012 Dec;50(14):3721-8. doi: 10.1016/j.neuropsychologia.2012.10.018. Epub 2012 Oct 24.

Reference Type BACKGROUND
PMID: 23103838 (View on PubMed)

Stamenova V, Levine B. Effectiveness of goal management training(R) in improving executive functions: A meta-analysis. Neuropsychol Rehabil. 2019 Dec;29(10):1569-1599. doi: 10.1080/09602011.2018.1438294. Epub 2018 Mar 14.

Reference Type BACKGROUND
PMID: 29540124 (View on PubMed)

Other Identifiers

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#08-53

Identifier Type: -

Identifier Source: org_study_id

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