WM deficits are common among kids who have sickle cell, a group of red blood cell disorders. WM is the ability to remember and use information and to remain focused for the time it takes to complete an activity. It is essential to such activities as acquiring language, completing school assignments, and remaining gainfully employed. The cognitive deficits are likely related to the high frequency of disease-related insults localized to the prefrontal cortex, a region of the brain that controls executive functioning including WM, says Steven J. Hardy, PhD, a pediatric psychologist in the Center for Cancer and Blood Disorders at Children’s National and the work’s lead author.
The research team enrolled kids aged 7 to 16 years old to complete the intervention. The youths were randomized to begin Cogmed training immediately, or to wait up to eight weeks before starting the program. Using loaner iPads, study participants completed progressively more challenging exercises to build visuospatial and verbal WM.
So far, 70 kids have completed baseline neuropsychological assessment. Of 34 with WM deficits, 17 began Cogmed immediately, and 17 were placed on a wait list and began the training weeks later. “Initial results suggest that a home-based, computerized WM training program leads to significant improvements in WM for youths with sickle cell disease. A dose-effect was observed, as participants who completed more Cogmed sessions evidenced the greatest improvements in WM,” Hardy and co-authors write.
“Feasibility is an issue,” Hardy adds. “We’ve got something that is helpful, but we struggle to get everyone to finish the recommended 20 sessions of the program. Because of the size of the trial, we had sufficient numbers to look at gradations in effect that are linked to how much time you spend using the program. We were able to show that doing at least 10 Cogmed sessions leads to comparable levels of WM improvement as kids who completed higher numbers of sessions.”
The kids have been creative in squeezing training sessions into busy schedules. “The iPads they use have a cellular connection,” he explains. “We have someone who is working on it right now who has a long ride to school. As he’s riding in the car with his mom, he works on Cogmed.”
Hardy presented the work, “Initial Results of a Randomized Controlled Trial of Computerized Working Memory Training in Pediatric Sickle Cell Disease,” during the 58th American Society of Hematology Annual Meeting & Exposition, held Dec. 3-6 and attended by 27,000. In addition to nearly 5,000 scientific abstracts about malignant and non-malignant blood diseases, the meeting’s Presidential Symposium will be devoted to the topic of sickle cell disease.
One lingering question is whether the computerized training creates lasting improvements to WM, which should help kids do better in school and in life. Other researchers have used neuroimaging to demonstrate important changes in brain function, including a boost in functional connectivity and differences in the expression of dopamine receptors after using Cogmed.
“These are actual changes that are happening at a neural level that affect how your brain works in the real world,” Hardy says.
A natural next phase for the work would be to repeat it in a larger group of kids by involving multiple centers in a variety of regions to gauge whether the memory boosts can be replicated.
Contact: Diedtra Henderson | Children’s National Health System | c: 443-610-9826/ o: 202-476-4500 | firstname.lastname@example.org
About Children’s National Health System
Children’s National Health System, based in Washington, DC, has been serving the nation’s children since 1870. Children’s National is a Leapfrog Group Top Hospital, Magnet® designated, and was ranked among the top 10 pediatric hospitals by U.S. News & World Report 2015-16. Home to the Children’s Research Institute and the Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National is one of the nation’s top NIH-funded pediatric institutions. With a community-based pediatric network, seven regional outpatient centers, an ambulatory surgery center, two emergency rooms, an acute care hospital, and collaborations throughout the region, Children’s National is recognized for its expertise and innovation in pediatric care and as an advocate for all children. For more information, visit ChildrensNational.org, or follow us on Facebook and Twitter.
About the American Society of Hematology
The American Society of Hematology (ASH) is the world’s largest professional society of hematologists dedicated to furthering the understanding, diagnosis, treatment and prevention of disorders affecting the blood. For more than 50 years, the Society has led the development of hematology as a discipline by promoting research, patient care, education, training and advocacy in hematology. ASH publishes Blood, the most cited peer-reviewed publication in the field. In 2016, ASH launched Blood Advances an online, peer-reviewed open-access journal.