Amnestic Mild Cognitive Impairment Clinical Trial
Official title:
Outcome Predictors of a Complex Cognitive Intervention in Amnestic Mild Cognitive Impairment (aMCI)
Cognitive training has been shown to be successful in patients with amnestic mild cognitive
impairment (aMCI), a group at high-risk for Alzheimer's disease (AD). Moreover, in a
randomized controlled trial, the investigators recently found that aMCI patients receiving a
cognitive intervention showed stable hypometabolism in FDG-PET, whereas patients in an
active control group showed pronounced hypometabolism on follow-up scans in regions
typically affected in AD.
Previous studies indicate that not all patients respond equally well to a cognitive
intervention. Identifying factors that predict response to treatment could help selecting
patients for a targeted intervention. A potentially important predictor is cognitive reserve
defined as premorbid cognitive performance. The hypothesis is that different levels of
cognitive reserve (high cognitive reserve vs. low cognitive reserve) have different
neurostructural and neurofunctional correlates and influence treatment response in a
different way. Moreover, the impact of white matter lesions on treatment effects will be
investigated.
The investigator will perform a complex cognitive training program. Forty patients with aMCI
(20 with high cognitive reserve, 20 with low cognitive reserve) will be recruited in this
study. Since the patients are recruited consecutively, an estimated overall number of 80
will be included and receive the training of whom about 40 will meet the inclusion criteria
for our cognitive-reserve-study (high or low cognitive reserve). Data of the whole group
will be used to analyze the potential impact of white matter lesions on response to the
intervention. Cognitive effects of the intervention will be evaluated by neuropsychological
testing. Neurofunctional and neurostructural changes depending on cognitive reserve will be
measured using resting state fMRI and diffusion tensor imaging (DTI).
For comparison, a group of 30 aMCI patients will be recruited as an active control group
receiving study investigations (neuropsychological testing as well as MRIs), and exercises
for self-study at home, not the complex cognitive intervention.
n/a
Observational Model: Case Control, Time Perspective: Prospective
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