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Neuroscientific models of maladaptive aging emphasize the loss of sensorimotor stimulation and reduced modulatory capacities as core processes in the development of maladaptive plastic changes of the brain and subsequent cognitive and bodily decline as determinants of frailty and multimorbidity in old age. The investigators plan to analyze anatomical, neurophysiological, and neuropsychological correlates of maladaptive plasticity in frail persons and plan to test how innovative interventions that target maladaptive plasticity alter brain function and neurocognitive skills. There are novel interventions that have been shown to target the neurocognitive deficits and enhance plasticity in brain areas that are affected first in the progress of aging. Specifically, sensory training has been employed to enhance relevant input to the brain and to improve neuromodulatory function and has yielded high effect sizes. The investigators will perform proof of concept studies to examine the utility of sensorimotor training and examine the role of brain-derived neurotrophic growth factor to enhance brain plasticity and memory functions, as well as their transfer to other cognitive domains. The investigators will implement motivational enhancement strategies using virtual reality in these treatments that can further boost training effects and plasticity, but have not been employed in these treatments so far. Biomarkers for the remediation of maladaptive changes will involve neuropsychological assessments, brain imaging, brain-derived neurotrophic factor (BDNF) levels, and BDNF genotype. Thus, the investigators will be able to comprehensively characterize dysfunctional plasticity and the specific mechanisms of the interventions that are employed and investigate innovative clinical trials.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sensorimotor training | Experimental | The participants will receive a tablet-based app for at home training that contains sensorimotor components. |
|
| Control training | Active Comparator | The participants will receive a tablet-based app for at home training that contains relaxing components. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Trainings app | Behavioral | Sensorimotor trainings app for at home Training (tablet-based) |
|
| Measure | Description | Time Frame |
|---|---|---|
| Neuroplasticity measures of brain Imaging I: brain responses at rest and task-based (sensorimotor) | Blood oxygenation level dependent (BOLD) signal changes | 2 months |
| Body parameter: weight and height | Information on weight and height will be combined to report BMI in kg/m^2 | 2 months |
| Body parameter: muscles | Muscle strength in electromyogram amplitudes | 2 months |
| Neuroplasticity measures of brain Imaging: brain size | Volume of different brain regions | 2 months |
| Neuroplasticity measures of brain Imaging: brain diffusion | Brain diffusion in fractional anisotropy values | 2 months |
| Measure | Description | Time Frame |
|---|---|---|
| Well-being | Questionnaire data on mood and mental health will be standardized and integrated into one mean score of well-being (computation of a mean values across the questionnaire scores) | 2-3 months |
| Cognitive health |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CIMH - Department of Cognitive and Clinical Neuroscience | Mannheim | 68159 | Germany |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37776754 | Derived | Beier F, Loffler M, Nees F, Bekrater-Bodmann R, Silvoni S, Desch S, Loffler A, Hausner L, Frolich L, Flor H. Effects of an app-based sensorimotor training in promoting neuroplasticity and neuropsychological functioning in frailty: A randomized controlled trial. Arch Gerontol Geriatr. 2023 Dec;115:105202. doi: 10.1016/j.archger.2023.105202. Epub 2023 Sep 17. | |
| 36109693 |
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Behavioral performance data during cognitive testing will be standardized integrated into one mean score of cognitive functioning (computation of a mean value across response times in the cogniitve tests)
| 2-3 months |
| Beier F, Loffler M, Nees F, Hausner L, Frolich L, Flor H. Sensory and motor correlates of frailty: dissociation between frailty phenotype and frailty index. BMC Geriatr. 2022 Sep 15;22(1):755. doi: 10.1186/s12877-022-03416-6. |
| 34082710 | Derived | Beier F, Loffler M, Nees F, Hausner L, Frolich L, Flor H. Promoting neuroplasticity and neuropsychological functioning in frailty through an app-based sensorimotor training: study protocol for a randomized trial. BMC Geriatr. 2021 Jun 3;21(1):343. doi: 10.1186/s12877-021-02293-9. |