Controversies in Computerized Cognitive Training

Abstract

Computerized cognitive training (CCT) to improve cognitive functioning is of enormous interest and has been applied in a broad range of populations with goals of improving both cognition and community functioning. Recent reviews presenting negative conclusions about CCT efficacy have inconsistent definitions of the treatment targets and cognitive improvement. They do not present an accurate representation of the typical process of CCT and cognitive remediation (CR), especially as delivered in major mental illnesses such as schizophrenia. This review provides guidance on the definitions of CCT and CR, the uses of CCT and CR, and the definitions and measurements of cognitive and functional gains. The review focuses on schizophrenia and healthy aging, with each population receiving unique CCT or CR approaches and substantial extant literature with which to elucidate fundamental CCT and CR concepts and research findings. It is our conclusion that CCT has been shown in most studies to improve cognitive performance on untrained tests in healthy older people and in people with schizophrenia. Functional gains in schizophrenia appear to be limited to CR studies. Clearly defining CCT, CR, and levels of treatment-related gains will be critical for understanding the benefits of these widely used treatment programs.

Neurocognition and social cognition training as treatments for violence and aggression in people with severe mental illness

“…To evaluate such interventions, it is important to investigate multiple levels of efficacy, including near transfer of skills to improved performance on similar nontrained tasks, far transfer of skills to improved performance on more demanding tasks, and generalizable, or environmental, transfer of skills to improved real-world everyday functioning. While there has been debate over the efficacy of CCT due to overstated commercial claims, 31,32 several metaanalyses of CCT efficacy have found that it has smallto-moderate effect sizes. 33,34 The largest meta-analysis to date encompassing 40 independent studies involving 2104 participants showed that CCT provides small-tomoderate benefits in generalizable cognitive domains, particularly within relatively stable patients in both inpatient and outpatient settings.…”

The Effects of Gamification on Computerized Cognitive Training: Systematic Review and Meta-Analysis

“…Computer-based cognitive training typically involves systematic practice on computerized tasks designed to improve cognitive abilities, such as memory, attention, or processing speed [ 1 ]. Although reviews and meta-analyses have demonstrated that such training can be beneficial in enhancing various cognitive functions, interventions are limited by their repetitive and time-consuming character [ 2 , 3 ].…”

Cognitive Training and Transcranial Direct Current Stimulation in Mild Cognitive Impairment: A Randomized Pilot Trial

“…To date, pharmacological interventions have failed to show realizable benefits in mitigating cognitive decline in individuals with MCI and in preventing progression to AD (Andrieu et al, 2015). As a result, there is growing interest in exploring the benefits of non-pharmacological interventions such as lifestyle modifications (nutrition and exercise) (Morris, 2009; Erickson et al, 2011), cognitive training (Jean et al, 2010; Belleville et al, 2011; Chapman and Mudar, 2014; Chapman et al, 2017; Edward et al, 2017; Harvey et al, 2018), and repetitive non-invasive brain stimulation such as Transcranial Magnetic Stimulation (rTMS) and Transcranial Direct Current Stimulation (tDCS) (Flöel et al, 2012; Elder and Taylor, 2014).…”