A randomised feasibility study of computerised cognitive training as a therapeutic intervention for people with Huntington's disease (CogTrainHD)

Emma Yhnell, Hannah Furby, Rachel S Lowe, Lucy C Brookes-Howell, Cheney J G Drew, Rebecca Playle, Gareth Watson, Claudia Metzler-Baddeley, Anne E Rosser, Monica E Busse, Emma Yhnell, Hannah Furby, Rachel S Lowe, Lucy C Brookes-Howell, Cheney J G Drew, Rebecca Playle, Gareth Watson, Claudia Metzler-Baddeley, Anne E Rosser, Monica E Busse

Abstract

Background: Huntington's disease (HD) is associated with a range of cognitive deficits including problems with executive function. In the absence of a disease modifying treatment, cognitive training has been proposed as a means of slowing cognitive decline; however, the impact of cognitive training in HD patient populations remains unclear. The CogTrainHD study assessed the feasibility and acceptability of home-based computerised executive function training, for people impacted by HD.

Methods: Thirty HD gene carriers were recruited and randomised to either executive function training or non-intervention control groups. Participants allocated to the intervention group were asked to complete executive function training three times a week for 30 min for 12 weeks in their own homes. Semi-structured interviews were conducted with participants and friends, family or carers, to determine their views on the study.

Results: 26 out of 30 participants completed the baseline assessments and were subsequently randomised: 13 to the control group and 13 to the intervention group. 23 of the 30 participants were retained until study completion: 10/13 in the intervention group and 13/13 in the control group. 4/10 participants fully adhered to the executive function training. All participants in the control group 13/13 completed the study as intended. Interview data suggested several key facilitators including participant determination, motivation, incorporation of the intervention into routine and support from friends and family members. Practical limitations, including lack of time, difficulty and frustration in completing the intervention, were identified as barriers to study completion.

Conclusions: The CogTrainHD feasibility study provides important evidence regarding the feasibility and acceptability of a home-based cognitive training intervention for people with HD. Variable adherence to the cognitive training implies that the intervention is not feasible to all participants in its current form. The study has highlighted important aspects in relation to both the study and intervention design that require consideration, and these include the design of games in the executive function training software, logistical considerations such as lack of time, the limited time participants had to complete the intervention and the number of study visits required. Further studies are necessary before computerised executive function training can be recommended routinely for people with HD.

Trial registration: ClinicalTrials.gov, Registry number NCT02990676.

Keywords: Adherence; Brain training; Cognition; Cognitive training; Executive function training; Feasibility; Huntington’s disease.

Conflict of interest statement

Competing interestsHannah Furby was employed at Cardiff University during data collection, but became an employee of F. Hoffmann La Roche, Ltd. on 8 Jan 2019. Roche has a drug for HD in clinical development. The other authors have no competing interests to declare.

© The Author(s) 2020.

Figures

Fig. 1
Fig. 1
CONSORT diagram illustrating participant flow throughout the CogTrainHD study

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