A comparative clinical study of the effectiveness of computer cognitive training in patients with post-stroke cognitive impairments without dementia
Introduction. A complex of computer neuropsychological programs was developed at KrasSMU, which in several pilot studies has shown effectiveness in cognitive training for patients with vascular cognitive impairments (VCI).
Objectives. The aim of the present study was to compare changes in cognitive status in those patients with post-stroke VCI who worked with neuropsychological computer programs, with those changes experienced by a group of similar patients who played entertaining computer games.
Methods. Patients in the early recovery period after a hemispheric stroke with VCI without dementia (N=26, age 40-67) were randomized into three groups. All patients underwent conventional treatment in a rehabilitation hospital. Patients in the intervention group had ten daily 40-minute training sessions with neuropsychological computer programs. Participants in the active control group played entertaining computer games, and kept an identical regimen. Patients in the passive control group received only conventional treatment. Cognitive, neurological, affective, and functional states were assessed before and after the training periods.
Results. Significant improvements were observed in the intervention group as compared to the passive control group on the Montreal Cognitive Assessment (MoCA, p=0.0004), the Clock Drawing Test (CDT, p=0.001), and the Frontal Assessment Battery (FAB, p=0.01). Differences between the groups of patients playing neuropsychological and entertaining games were statistically insignificant (Mann-Whitney U test, p>0.05), although in the intervention group there were improvements on every cognitive scale after the training period (Wilcoxon matched pairs test, p<0.05), while in the active control group, enhancements were evident only on some cognitive scales (p<0.05). No changes were observed in the passive control group.
Conclusions. Neuropsychological computer programs enhance cognitive status in patients with post-stroke VCI. It is possible that entertaining computer games can also improve cognitive functions. In all groups, no changes of functional state were observed before and after the training period.
Keywords: Cognitive training, computer cognitive training, stroke, cognitive rehabilitation, neuropsychological computer programs, vascular cognitive impairments, poststroke cognitive impairments.