Impact of Brain Fitness on the Hippocampus in Individuals with Mild Cognitive Impairment

It has been reported that sleep apnea, stress, anxiety, obesity, diabetes, sedentary lifestyle, depression, insomnia, and low levels of cardiovascular fitness either alone or together are associated with hippocampus (region in the brain) atrophy and cognitive impairment in aging. Researchers have begun to look at whether providing a multi-disciplinary program that addresses these factors could improve hippocampal atrophy and possibly have a positive impact on mild cognitive impairment.

Based on the MRI results, the researchers concluded that patients with objective cognitive impairment have the ability to improve their brain performance with an intensive set of multi-disciplinary treatments. Specifically, 84% of the patients had significant improvements in their attention, concentration, executive function, problem solving, or speed of cognitive processing. Additionally, a subset of patients showed reversal of hippocampal atrophy or growth above baseline volume.

The study group included patients who self-reported to a neurology practice and were found to have mild cognitive impairment. Patients were excluded from the study if they had mild subjective memory loss and normal cognitive function, Alzheimer’s disease or other forms of dementia, or active psychiatric conditions such as schizophrenia or bipolar disorder. The study population of 127 patients was 63% female, with an average age of 70.69 years. These 127 patients were enrolled in the Brain Fitness Program, which consisted of an intensive baseline evaluation followed by 3 interventions. The baseline evaluations included a neurology evaluation (including tests for vitamin deficiencies, sleep apnea, and depression), a cognitive assessment, MRI, and quantitative-EEG (brain mapping). A random subset of the population (n=17) had an additional MRI at the end of the program.

The 12-week Brain Fitness Program consisted of two hours each week of cognitive skills training, administered on a computer as game-like brain exercises to improve attention, memory, mental processing speed, and problem solving strategies. The protocol was personalized to address each person’s initial symptoms, concerns, or areas of cognitive health they would like to improve; and it was adjusted as they made improvements. The Brain Fitness Program also involved one hour each week of counseling and/or brain coaching, which included meditation training, cognitive behavioral therapy, and education about diet, exercise, stress reduction, and improving sleep.  Additionally, the Brain Fitness Program included two hours of neurofeedback therapy each week. In total, the Brain Fitness Program included 60 hours of treatment over the 12-week intervention period.

84% of the participants in the Brain Fitness Program had significant improvements in three or more of the 10 measures of cognitive function, and another 9% had improvement in 2 of the 10 measures of cognitive function. A subset of 17 patients received a follow-up brain MRI, with 9 of the 17 exhibiting growth in the size of their hippocampus of at least 1% in volume. One patient had an 8.6% increase in her hippocampal volume. An additional 3 of the 17 patients did not exhibit the expected atrophy in the hippocampus over the study period. The researchers concluded that a multi-disciplinary approach to cognitive health in an elderly population appears to offer promising results and warrants further evaluation in a larger population.

 

Fotuhi M, Lubinski B, Trullinger M, Hausterman N, Riloff T, Hadadi M, Raji CA. A Personalized 12-week “Brain Fitness Program” for Improving Cognitive Function and Increasing the Volume of Hippocampus in Elderly with Mild Cognitive Impairment. The Journal of Prevention of Alzheimer’s disease. 2016. 3(3): 133-137

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