Cognitive Rehabilitation in Sickle Cell Disease

Cognitive Impairment Clinical Trial

Official title:

Cognitive Rehabilitation of Children With Sickle Cell Disease: A Pilot Study

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01793740
• Other study ID #: Pro00035303
• Status: Completed
• Phase: N/A
• First received: February 14, 2013
• Last updated: August 19, 2014
• Start date: October 2012
• Est. completion date: July 2014

Study information

• Verified date: August 2014
• Source: Duke University
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Institutional Review Board
• Study type: Interventional

Clinical Trial Summary

The majority of school-age children with sickle cell disease (SCD) experience neurocognitive deficits, even in the absence of stroke. In particular, deficits in attention and working memory have emerged as two of the most common neurocognitive sequelae of SCD. Thus, the goal of the present proposal is to address feasibility and compliance of a novel computerized cognitive training program, Cogmed. Pilot data will also be collected to establish preliminary efficacy. Twenty-four children meeting initial age and diagnostic criteria will be identified and approached about participation by their attending physician during regularly-scheduled SCD clinic visits. Baseline assessments will include a brief measure of intellectual functioning, a brief cognitive testing battery evaluating processing speed and working memory, in addition to questionnaires regarding behavior and quality of life. Children will then be randomized to the computerized CT program Cogmed (n=12) or a waitlist control (n=12). Participants enrolled in the computerized CT program will be asked to complete 25-sessions of Cogmed over a five to eight week period (3 to 5 sessions per week). Following completion of the program, children and their parents will be asked to return to clinic for a follow-up visit. After a five to eight-week waiting period, children in the waitlist condition will also be asked to return to clinic for a second visit. Following this assessment, participants initially enrolled in the waitlist will be offered an opportunity to participant in the intervention. If interested, they will follow the same intervention protocol described above. These children will return to clinic for a third visit following completion of the intervention. Compliance rate and its confidence interval will be calculated for the overall study population. A t-test for binomial proportion with continuity correction will be used to examine whether the compliance rate is lower than the target. Participants' change in criterion outcomes will be evaluated (i.e., those neurocognitive measures such as attention, executive functioning and working memory, that are most closely related to the trained tasks).

Recruitment information / eligibility

• Status: Completed
• Enrollment: 18
• Est. completion date: July 2014
• Est. primary completion date: July 2014
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 8 Years to 16 Years

Eligibility

Inclusion Criteria:

• 1) Children with a diagnosis of SCD (all genotypes)

• 2) a T-score =75th percentile on either the Metacognition or Executive Composite of the BRIEF; and/or

• 3) a standard score =1 standard deviation below the mean (<90) on the tasks of executive function or WM from the Cogstate (mean=100; SD=10)

Exclusion Criteria:

• 1) Estimated IQ = 75), or motor, visual, or auditory handicap that prevents computer use;

• 2) a diagnosis of depression or a pervasive developmental disorder (by history);

• 3) clinical stroke (via record medical history); or

• 4) non-English fluency.

Study Design

Allocation: Randomized, Intervention Model: Crossover Assignment, Masking: Open Label, Primary Purpose: Treatment

Related Conditions & MeSH terms

• Anemia, Sickle Cell
• Cognition Disorders
• Cognitive Impairment
• Sickle Cell Disease

Intervention

Behavioral:
• Cogmed
Computer based program that aims to improve children's memory, attention, and processing speed.

Locations

Country	Name	City	State
United States	Duke Child and Family Study Center	Durham	North Carolina

Sponsors (1)

Lead Sponsor	Collaborator
Duke University

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Acceptance	Acceptance is defined by 50% of those approached are able to participate/consent to the study.	After the recruitment period has been completed (approximately 2-years)	No
Primary	Feasibility	Feasibility is defined as 75% of subjects completing 80% of the training program.	Post-study - Baseline to Post-Intervention, approximately 5 to 8-weeks after baseline assessment	No
Secondary	Efficacy	Efficacy will be defined by participant performance on cognitive outcome measures including executive functioning outcomes from the Cogstate.	Baseline to Post-Intervention, approximately 5 to 8-weeks after baseline assessment	No