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The main objective is to compare changes in information processing speed after 30 days of intervention in participants with a dysexecutive mild cognitive impairment (MCI) and receiving either cognitive stimulation by adapted visual exercises (Emeraude® software) or the broadcasting of a television program without cognitive stimulation.
Secondary objectives are:
Attentional abilities are among the cognitive functions that are most frequently and earliest altered during aging, particularly in the case of neurodegenerative diseases such as Alzheimer's disease. This decline can be the cause of a cognitive complaint in the patient or his relatives from the prodromal stage of the disease. This mild cognitive impairment is not sufficiently advanced to have an impact on independence and autonomy, even though recent studies have reported an early modification of walking in this population, in particular in the case of a dysexecutive MCI. The current challenge is to develop strategies to prevent cognitive decline in these patients with MCI and to avoid conversion to major neurocognitive disorders. However, while "memory workshops" are offered to patients with amnestic MCI, no strategy is clearly identified for dysexecutive MCI.
Interestingly, the integration of sensory information is modified in patients with neurodegenerative diseases, and in particular visuomotor difficulties in the early stages. Measurements of evoked potentials during visual stimulation have shown that sensory responses are preserved but cognitive responses are reduced in patients with MCI. Based on this observation, an American team recently tested the effectiveness of computer-assisted visual cognitive exercises performed regularly for 8 weeks in patients without dementia, and reported an improvement in information processing speed and walking performance. These results lead us to hypothesize that regular cognitive stimulation exercises using adapted visual exercises could improve the attentional capacities and in particular the information processing speed (=mental speed) of elderly people with a dysexecutive MCI.
A complex brain stimulation software Emeraude® has recently been developed by the Centre Régional Basse Vision in Angers from a software used for more than 30 years in people with visual impairment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention group | Experimental |
| |
| Comparator group | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Visual cognitive stimulation exercises | Procedure | Patients included in Intervention group will receive a 30-minute session of complex visual stimuli on a touch screen (3 10-minute exercises : saccade exercises, then pursuit exercises, then matching exercises) every other day for 30 days, with increasing difficulty of the exercises as the sessions progress. |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in information processing speed | Changes in information processing speed is assessed by processing speed index | Baseline and after 30 days of intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in information processing speed of each subtest | This outcome is assessed by Symbol Search end Coding scores | Baseline and after 30 days of intervention |
| Changes in cognitive performance |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Marine ASFAR, MD | Contact | +33 2 41 35 47 25 | marine.asfar@chu-angers.fr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Angers University Hospital | Recruiting | Angers | France |
Data will be shared upon reasonable request. Only de-identified data will be shared. Any data collected during the study may be shared. The protocol will be shared initially. Other documents may be shared at a later date upon request (e.g., the CRF to allow a collaborator to select the data they wish to access). The recipients of the data will be researchers. The data will be available for any purpose deemed relevant by the study investigator, based on a protocol provided by the requester, after verification of the obtaining of regulatory approvals, including the favorable opinion of an ethics committee.
The data will be shared after signing a negotiated data transfer agreement ( data access agreement), for the duration specified in the agreement.
The data will be made available via secure transfer (sharing platform approved by the university hospital: BlueFiles or Oodrive).
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| ID | Term |
|---|---|
| D060825 | Cognitive Dysfunction |
| ID | Term |
|---|---|
| D003072 | Cognition Disorders |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
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|
| Broadcast of a television program | Procedure | Patients included in Comparator group will watch a 30-minute television program (AllĂ´ Docteurs) on a touch screen every other day for 30 days. |
|
This outcome is assessed by ADAS-cog score
| Baseline and after 30 days of intervention |
| Changes in executive functions (cognitive flexibility) | Cognitive flexibility is measured by time needed to perform the Trail-Making Test (TMT) part B minus A | Baseline and after 30 days of intervention |
| Changes in executive functions (cognitive inhibition) | Cognitive inhibition is measured by time needed to perform the interference task minus the time needed to perform the denomination task | Baseline and after 30 days of intervention |
| Changes in executive functions (working memory updating) | Working memory updating is assessed by digit span test | Baseline and after 30 days of intervention |
| Changes in walking performance | Changes in walking performance is assessed by changes in coefficient of variation of stride time | Baseline and after 30 days of intervention |
| Changes in quality of life | Quality of life is assessed by 36-Item Short Form Health Survey (SF-36) | Baseline and after 30 days of intervention |
| Correlations between changes in information processing speed index and the final level reached for each cognitive stimulation exercise | This outcome is assessed by the final level achieved for each cognitive stimulation exercise | After 30 days of intervention |