Feasibility of computerized working memory training in individuals with Huntington disease

Mahsa Sadeghi, Emily Barlow-Krelina, Clare Gibbons, Komal T Shaikh, Wai Lun Alan Fung, Wendy S Meschino, Christine Till, Mahsa Sadeghi, Emily Barlow-Krelina, Clare Gibbons, Komal T Shaikh, Wai Lun Alan Fung, Wendy S Meschino, Christine Till

Abstract

Objectives: Huntington disease (HD) is associated with a variety of cognitive deficits, with prominent difficulties in working memory (WM). WM deficits are notably compromised in early-onset and prodromal HD patients. This study aimed to determine the feasibility of a computerized WM training program (Cogmed QM), novel to the HD population.

Methods: Nine patients, aged 26-62, with early stage HD underwent a 25-session (5 days/week for 5 weeks) WM training program (Cogmed QM). Training exercises involved the manipulation and storage of verbal and visuospatial information, with difficulty adapted as a function of individual performance. Neuropsychological testing was conducted before and after training, and performance on criterion WM measures (Digit Span and Spatial Span), near-transfer WM measures (Symbol Span and Auditory WM), and control measures were evaluated. Post-training interviews about patient experience were thematically analyzed using NVivo software.

Results: Seven of nine patients demonstrated adherence to the training and completed all sessions within the recommended timeframe of 5 weeks. All adherent patients showed improvement on the Cogmed tasks as defined by the Improvement Index (M = 22.17, SD = 8.84, range = 13-36). All adherent patients reported that they found training helpful (n = 7), and almost all felt that their memory improved (n = 6). Participants also expressed that the training was difficult, sometimes frustrating, and time consuming.

Conclusions: This pilot study provides support for feasibility of computerized WM training in early-stage patients with HD. Results suggest that HD patients perceive benefits of intensive WM training, though a full-scale and controlled intervention project is needed to understand the size of the effect and reliability of changes over time.

Trial registration: ClinicalTrials.gov, Registry number NCT02926820.

Conflict of interest statement

Competing Interests: Wendy Meschino has received consulting fees from AstraZeneca and Novartis for work with other populations, outside of the submitted work. This does not alter our adherence to PLOS ONE policies on sharing data and materials. None of the other authors have any conflicts of interest to disclose.

Figures

Fig 1. Flowchart of participant enrollment, inclusion,…
Fig 1. Flowchart of participant enrollment, inclusion, and involvement.
Fig 2. Neuropsychological data (raw scores; pre-…
Fig 2. Neuropsychological data (raw scores; pre- and post-training) at the individual level plotted.

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