MedicalResearch.com Interview with:
Steven J. Hardy, Phd
Licensed Clinical Psychologist
Divisions of Hematology and Oncology
Children’s National Health System
Assistant Professor of Pediatrics and Psychiatry & Behavioral Sciences
George Washington School of Medicine and Health Sciences Washington, DC
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Children with sickle cell disease exhibit neurocognitive deficits as a consequence of either silent or overt cerebral infarction or disease-related non-infarct central nervous system effects (likely resulting from chronic anemia and hypoxic events). These complications often lead to impairment in executive functioning (e.g., working memory, attention, inhibition, cognitive flexibility), which can make it difficult to focus in class, plan for long-term school projects, remember and carry out multi-step tasks or assignments, and stay organized. The literature on interventions to reduce neurocognitive sequelae of sickle cell disease is extremely limited.
Our research team investigated a promising home-based, computerized cognitive training program (Cogmed) involving repeated practice on performance-adapted exercises targeting working memory with a sample of youth (ages 7 – 16) with sickle cell disease. Of the participants who have enrolled in the study (n = 70), 49% exhibited working memory deficits (<25% in the general population have a working memory deficit) and were randomized to an eight-week waitlist or to begin Cogmed immediately. Participants who used Cogmed demonstrated significant improvements on multiple measures of working memory, while those randomized to the waitlist group only exhibited such improvements after receiving Cogmed. Approximately 25% of participants completed the recommended number of Cogmed sessions (20 – 25 sessions). However, analyses revealed that participants who completed at least 10 sessions (about 50% of the participants) showed comparable levels of working memory improvement.
MedicalResearch.com: What should readers take away from your report?
Response: Cogmed can reduce neurocognitive sequelae of pediatric sickle cell disease. While youth with sickle cell disease face challenges to completing all 25 sessions of the intensive cognitive training program due to pain, fatigue, and frequent hospitalizations, Cogmed led to significant improvements in working memory even for participants who completed as few as 10 sessions.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: A multicenter study is needed to evaluate the effectiveness of home-based, computerized working memory training for children with sickle cell disease. Multi-modal approaches to addressing neurocognitive deficits in pediatric sickle cell disease also need further investigation.
MedicalResearch.com: Is there anything else you would like to add?
Response: Given the limited research on efficacious strategies for treating disease-related neurocognitive deficits in children with sickle cell disease, it is encouraging that Cogmed may offer one approach to addressing these problems and supporting progress toward academic goals.
Initial Results of a Randomized Controlled Trial of Computerized Working Memory Training in Pediatric Sickle Cell Disease
Outcomes Research—Non-Malignant Conditions
Saturday, December 3, 2016: 4:00 PM
Steven J Hardy, PhD1,2*, Kristina K Hardy, PhD1,2*, Shane M Wise, BS3*, Katie J Olson, MPH, PsyD1*, Amanda L Thompson, PhD1,2* and Emily Riehm Meier, MD4
1Children’s National Health System, Washington, DC
2George Washington University School of Medicine and Health Sciences, Washington, DC
3University of Maryland, College Park, MD
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