LearningRx Research: Brain Training for Early Alzheimer’s
Multidisciplinary Intervention Creates Neural Changes and Improvements in Cognition and Daily Function in Early Alzheimer’s: Study Shows Adaptation of Bredesen Protocol Promising in Slowing Clinical Cognitive Decline September 13, 2019 – The results of our study just published in the Open BioMedical (OBM) journal Integrative and Complementary Medicine highlight the benefits of a functional medicine approach to slowing cognitive decline in adults over age 55 with clinical cognitive impairment including mild cognitive impairment (MCI) and early Alzheimer’s disease. Researchers examined changes in cognitive skills, brain connectivity, and daily functioning following a multifaceted anti-neuroinflammatory intervention that included physical exercise, mental exercise, a grain-free/sugar-free diet, anti-inflammatory nutritional supplements, sleep optimization, and stress management within the context of a functional medicine practice for five patients with varying levels of cognitive impairment. The key findings include: • Improvement and stability in cognition. After the nine-month intervention, three of the five patients were no longer classified as cognitively impaired, while a fourth patient improved from moderately-to-severely impaired to mildly impaired. The fifth patient who entered the study with Stage 2 Alzheimer’s remained stable. • Improved daily functioning and outlook. Patients reported improved memory, attention, mental clarity, as well as increased energy, better mood, and improved outlook on life. • Changes in brain connectivity visible on fMRI. fMRI analyses revealed changes in the brain that suggest improved efficiency, as well as changes in network connectivity that correlated with changes on neuropsychological tests. The study was led by functional medicine physician Randolph James, MD, of True Life Medicine, neuroscientist Christina Ledbetter, PhD, of LSU Health Science Center and Dick Carpenter, PhD, from University of Colorado Colorado Springs, along with cognitive psychologist Amy Lawson Moore, PhD, and Terissa Miller, MS Psy, from Gibson Institute of Cognitive Research. Xymogen Pharmaceuticals (FL) donated the supplements for the study and Penrad Imaging (CO) conducted the fMRIs. “The MRI findings were indeed exciting,” says Ledbetter. “Not only that we could use functional MRI to detect changes in connections between regions of interest in the brain, but also that those changes directly correlated with changes on dementia assessments.” The intervention was an adaptation of the Bredesen Protocol, a novel multifaceted approach to reversing Alzheimer’s disease by targeting inflammation. Neuro-inflammation is a prominent finding in age-related cognitive impairment and Alzheimer’s Disease (AD). Numerous cellular pathways are associated with inflammatory responses and successful treatment of inflammation likely requires targeting these multiple pathways. Although the current study included the same variety of therapeutic approaches seen in Bredesen’s work, the study departed from Bredesen’s research protocols by including structured cognitive training delivered by clinicians in scheduled clinic appointments. “We wanted to increase compliance to this critical pillar of the intervention by adding the human delivery element. We weren’t convinced that computer games could provide the intensity, complexity, and motivation required to drive neuroplasticity, so we opted for human-delivered cognitive training,” says Moore. “It paid off. Patients were 100% compliant with this aspect of the intervention.” The current study also used standard neuroimaging and neuropsychological assessments for all patients to enable statistical analysis of the outcomes. The full study, “Feasibility of a Functional Medicine Approach to Slowing Clinical Cognitive Decline in Patients Over Age 55: A Multiple Case Study Report” is available at https://dx.doi.org/10.21926/obm.icm.1903054 ...
Read MoreLearningRx Research Bibliography
LearningRx Brain Training Research Studies Here is the most recent bibliography of LearningRx research: Carpenter, D., Ledbetter, C., & Moore, A.L. (2016). LearningRx cognitive training effects in children ages 8-14: A randomized controlled study. Applied Cognitive Psychology, 30(5), 815-826. doi: 10.1002/acp.3257. Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1002/acp.3257 Gibson, K., Carpenter, D.M., Moore, A.L., & Mitchell, T. (2015). Training the brain to learn: Beyond vision therapy. Vision Development and Rehabilitation, 1(2), 120-129. Retrieved from https://www.covd.org/page/VDR_1_2 Hill, O.W., Zewelanji, S., & Faison, O. (2016). The Efficacy of the LearningRx Cognitive Training Program: Modality and Transfer Effects. Journal of Experimental Education: Learning, Instruction, and Cognition, 84(3), 600-620. doi: 10.1080/00220973.2015.1065218. Jedlicka, E. (2017). LearningRx cognitive training for children and adolescents ages 5-18: Effects on academic skills, behavior, and cognition. Frontiers in Education, 2(62). doi: 10.3389/feduc.2017.00062. Retrieved from https://www.frontiersin.org/articles/10.3389/feduc.2017.00062/full Ishanpara, P. D. (2013). Cognitive rehabilitation with LearningRx: Preliminary improvements in memory after traumatic brain injury. Retrieved from ProQuest Dissertations and Theses. UMI No. 3574228 James, R., Moore, A.L., Carpenter, D., Miller, T., & Ledbetter, C. (2019). Feasibility of a Functional Medicine Approach to Slowing Clinical Cognitive Decline in Patients Over Age 55: A Multiple Case Study Report. OBM Integrative and Complementary Medicine, 4(3). doi: 10.21926/obm.icm.1903054 https://www.gibsonresearchinstitute.org/wp-content/uploads/2019/09/MCI-Intervention_James-et-al.pdf Ledbetter, C., Moore, A.L., Mitchell, T. (2017). Cognitive effects of ThinkRx cognitive rehabilitation training for eleven soldiers with brain injury: A retrospective chart review. Frontiers in Psychology, 8(825). doi: 10.3389/fpsyg.2017.00825. Retrieved from https://www.frontiersin.org/articles/10.3389/fpsyg.2017.00825/full Ledbetter, C., & Moore, A. (2018). Neuroimaging outcomes of a cognitive rehabilitation training program. Journal of Neuroimaging, 28(2), 225-233. doi: 10.1111/jon.12507. Retrieved from https://www.gibsonresearchinstitute.org/wp-content/uploads/2018/03/Neuroimaging-Outcomes-of-a-Cognitive-Rehabilitation-Training-Program_-J-of-Neuroimaging-excerpt.pdf Ledbetter, C., Faison, M.O., & Patterson, J. (2016). Correlation of cognitive training gains and resting state functional connectivity. Presented at Society for Neuroscience, November 2016, San Diego, CA. Retrieved from https://www.gibsonresearchinstitute.org/wp-content/uploads/2016/11/SFNposters_CLedbetter.pdf Luckey, A. J. (2009). Cognitive and academic gains as a result of cognitive training. Retrieved from ProQuest Dissertations and Theses. UMI No. 3391981 Moore, A.L., Carpenter, D.M., Ledbetter, C., & Miller, T.M. (2018). Clinician-delivered cognitive training for children with attention problems: Transfer effects on cognitive and behavior from the ThinkRx randomized controlled trial. Neuropsychiatric Disease and Treatment, 14, 1671-1683. doi: 10.2147/NDT.S165418. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6027847/ Moore, A.L., Carpenter, D.M., Miller, T.M., & Ledbetter, C., (2019). ThinkRx Cognitive Training for Adults over Age 50: Clinician-Caregiver Partners in Delivery as Effective as Clinician-Only Delivery. Psychology and Neuroscience, 12(2), 291-306. doi: 10.1037/pne0000162. Author’s copy available at https://www.gibsonresearchinstitute.org/wp-content/uploads/2019/02/ThinkRx-for-Adults-Over-50_Psy-and-Neuroscience_2019.pdf Moore, A.L., Carpenter, D.M., Miller, T.M., & Ledbetter, C. (2019). Comparing Two Methods of Delivering ThinkRx Cognitive Training to Children Ages 8-14: A Randomized Controlled Trial of Equivalency. Journal of Cognitive Enhancement, 3(3), 261-270. doi.org/10.1007/s41465-018-0094-z. Retrieved from https://link.springer.com/article/10.1007/s41465-018-0094-z Moore, A.L., & Ledbetter, C. (2019). The Promise of Clinician-Delivered Cognitive Training for Children Diagnosed with ADHD. Journal of Mental Health and Clinical Psychology, 3(3), 3-8. doi: 10.29245/2578-2959/2019/3.1180. Retrieved from https://www.mentalhealthjournal.org/articles/the-promise-of-cliniciandelivered-cognitive-training-for-children-diagnosed-with-adhd.pdf Moore, A.L., & Miller, T. (2018). Reliability and validity of the revised Gibson Test of Cognitive Skills, a computer-based test battery for assessing cognition across the lifespan. Psychology Research and Behavior Management, 11, 25-35. doi:10.2147/PRBM.S152781. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5813948/ Moore, A.L., James, R., Carpenter, D., Miller, T., & Ledbetter, C. (2018). MRI and Neuropsychological Outcomes following a Functional Medicine Intervention with Cognitive Training in Mild Cognitive Impairment (MCI): A Multiple Case Study. Presentation at American Psychological Association Annual Convention, August 2018, San Francisco, CA. Retrieved from https://www.gibsonresearchinstitute.org/wp-content/uploads/2019/01/2018-APA_MCI-Poster_Moore-et-al.pdf Moore, A.L., & Ledbetter, C. (2018). MRI, qEEG, & neuropsychological outcomes following cognitive rehabilitation training for severe traumatic brain injury: A clinical case study. Presentation at Brain Injury Summit, Jan 2018, Vail, CO. Retrieved from https://www.gibsonresearchinstitute.org/wp-content/uploads/2018/01/2018-TBI-Summit-Presentation_MooreLedbetter_web.pdf Moore, A.L., Ledbetter, C., & Carpenter, D. (2017). MRI and neuropsychological outcomes following cognitive rehabilitation training in traumatic...
Read MoreLearningRx Research: A Review of Brain Training for ADHD
Humans Are Better than Computers at Delivering Brain Training to Children with ADHD Researchers Explain How Clinician-Delivered Brain Training is More Beneficial than Computer Brain Games for Remediating Multiple Cognitive and Social-Emotional Struggles Frequently Associated with ADHD July 29, 2019 – Not only do children diagnosed with attention deficit hyperactivity disorder (ADHD) frequently struggle with memory and speed of information processing, they also navigate deficits in social cognition and self-esteem. Mainstream approaches to treating ADHD such as central nervous system stimulants and behavioral therapy do not adequately address these struggles. Although several companies market computerized brain training software for children with ADHD, these games also fall short in remediating the multiple cognitive and emotional deficits found in ADHD. In a review of ADHD intervention research published in the latest issue of the Journal of Mental Health and Clinical Psychology, we suggest that humans—not computers—are best suited for delivering brain training to children diagnosed with ADHD. The review outlines the benefits of working one-on-one with a human brain trainer, including increasing treatment compliance and motivation, reducing attrition, and making the leap from improvements on the trained tasks to transfer effects–or “real life” benefits outside the training environment. A clinician can provide instant and specific feedback, adapt the training tasks during the session, add complexity and intensity to the tasks, and help the client apply new skills to the outside world. The review was conducted by educational psychologist Amy Lawson Moore, PhD from Gibson Institute of Cognitive Research and clinical neuroscientist Christina Ledbetter, PhD from Louisiana State University Health Sciences Center who suggest that clinicians need to rethink their targets of treatment in this population. “ADHD is much more than a disorder of attention,” says Moore. “Children with ADHD typically have weaknesses in working memory, long-term memory, and processing speed as well as deficits in social cognition, self-esteem, and motivation. Therefore, it is critical that an intervention targets these multiple areas. We haven’t yet met a computer that can accomplish that. A human clinician, however, can.” The researchers reviewed existing research on several computer-based brain training programs, finding shortfalls with each of them. They suggest adoption of a clinician-delivered brain training methodology for children with ADHD and highlight the research on LearningRx as an example of one program that targets not only the complex cognitive deficits in ADHD but also the social-emotional struggles frequently associated with ADHD in children. The full article, entitled “The Promise of Clinician-Delivered Cognitive Training for Children Diagnosed with ADHD” can be found at https://www.mentalhealthjournal.org/articles/the-promise-of-cliniciandelivered-cognitive-training-for-children-diagnosed-with-adhd.html. Moore and Ledbetter have published multiple papers on clinician-delivered cognitive training, and have found that human delivery, complexity, and intensity are the keys to effective brain training, particularly with the ADHD population. “We have to intensely train a variety of cognitive skills—not just attention—if we want the intervention to effectively impact the child’s thinking, learning, and behavior,” says Ledbetter. “And we have to acknowledge the key role of the clinician in the training paradigm, particularly his or her impact on motivation and self-efficacy.” Their associated work on brain training can be found at...
Read MoreCan Brain Training Improve ACT Scores?
Open Letter to College Admission Offices: The Contribution of Cognitive Training to Improved College Entrance Exam Performance Research has shown us again and again that cognitive skills correlate with standardized math and language arts test scores, and that IQ scores are significant predictors of performance on college entrance exams. Thus, it is not only plausible but probable that strengthening the individual cognitive skills that comprise the composite IQ score can contribute to increased performance on standardized tests. Cognitive skill deficits—especially deficits in working memory, processing speed, and executive functions—are common among struggling students. Because cognitive skills are significant predictors of academic performance, interventions that remediate cognitive deficits are critical to maximizing a student’s academic success. Cognitive training programs like those offered at LearningRx brain training centers are a prime example of how an intervention can target and remediate weak cognitive skills through repeated engagement in intense mental tasks. By isolating weaknesses in cognition and exposing a student to concentrated remediation exercises targeting those weak skills, cognitive training can improve not only the trained skills but related ones as well. Unlike tutoring, cognitive training does not re-teach content but, instead, enhances the individual underlying learning skills such as working memory, long-term memory, processing speed, reasoning, attention, and visual and auditory processing—all skills that contribute to an individual’s ability to think and learn efficiently. What evidence do we have that cognitive training can help improve achievement test scores? Thanks to the amazing plasticity of the brain, we can document the malleability of cognition with changes on standardized measures of intelligence and by using functional Magnetic Resonance Imaging to illustrate changes in neural connectivity following an intervention. What’s more, those neural changes have been shown to correlate with changes on cognitive test scores. LearningRx measures student progress by administering both cognitive and achievement tests prior to beginning cognitive training and immediately after completing a cognitive training program. Among the 9,959 cognitive training clients who completed a reading intervention program between 2010 and 2018, the average gain in reading skills was 3.5 years, with the largest gain of 6.3 years in Sound Awareness following training. All changes were statistically significant. Among the 3,521 cognitive training clients who completed a math intervention between 2010 and 2018, the average gain in math skills was 3.2 years, with the largest gain of 3.6 years in Quantitative Concepts following training. All of those changes were also statistically significant. These same clients averaged a 15-point gain in overall IQ score along with statistically significant changes in individual cognitive skills—changes that have also been documented in multiple controlled trials and published peer-reviewed studies. How, then, can cognitive training improve scores on tests that measure knowledge of content? The need for multiple strong cognitive skills for effective test-taking applies across content areas and is independent from the content except for the ability to encode and recall prior knowledge. For example, a student needs strong sustained attention skills to focus on a test, particularly a lengthy one. He also needs strong memory skills. Not only must he be able to recall prior knowledge, he must have the working memory capacity to keep information in mind while using it to answer test questions. The Math section of the ACT requires recall and application of memorized mathematical formulas, without which a student cannot perform well. A student must also have strong reasoning skills, both inductive and deductive, as well as rapid processing speed. Tests like the ACT and SAT are notoriously fast-paced. He must be able to quickly but effectively read each question and the answer choices while using reasoning skills to determine...
Read MoreLearningRx Research: One-on-One Brain Training Improves Cognition and Daily Functioning for Adults over Age 50
New Research Shows LearningRx Cognitive Training Provides Hope for Older Adults with Memory Problems February 8, 2019 – The results of our study just published in the APA journal Psychology and Neuroscience highlight the benefits of human-delivered brain training for adults over age 50, including better cognition as well as improved mood and life skills. In the study with 292 adults between the ages of 50 and 94 with memory or attention problems, researchers found statistically significant changes in long-term memory, processing speed, auditory processing, fluid reasoning, working memory, and visual processing for both treatment groups following 79 hours of one-on-one cognitive training. In addition, they noted improvements in mood, including bolstered confidence, hope, perseverance, reduced anxiety, and overall outlook. Participants also reported changes in work performance, hobbies and sports, driving, and managing daily responsibilities. The study was led by Amy Lawson Moore, PhD at Gibson Institute of Cognitive Research along with Dick Carpenter, PhD from University of Colorado Colorado Springs, Christina Ledbetter, PhD from LSU Health Sciences Center, and Terissa Miller, MS Psy also of Gibson Institute. “This is the first study on LearningRx cognitive training to evaluate changes in cognition plus the transfer of training to real life benefits for older adults,” explains Dr. Moore. “Many studies on brain training have shown improvements in the trained skills, but this is the Holy Grail of cognitive training—transfer to life improvements. We think the human element of delivery is the secret to achieving this transfer. That will be our next research focus.” The study adds to the growing convergence of evidence on the benefits of LearningRx clinician-delivered cognitive training which continues to distinguish it from the “brain games” industry. Dr. Ledbetter, a clinical neuroscientist, states, “The intensity in which a human being can deliver the training tasks is not something that can be replicated by a computer game. We believe it is that intensity coupled with the motivation of working with a personal trainer that drives the changes we are seeing.” The training program used in the study included 35 training procedures with more than 1000 variations that are sequenced in order of difficulty. A metronome and timer are added to the tasks to increase intensity and prevent mental breaks. Each training session lasts 60-90 minutes and participants either attended all training sessions in the clinic or split the sessions with caregivers trained to deliver part of the training at home. In the current study, both delivery methods resulted in similar positive outcomes. The study abstract, “ThinkRx Cognitive Training for Adults Over Age 50: Clinician-Caregiver Partners in Delivery as Effective as Clinician-Only Delivery” is available at https://psycnet.apa.org/doiLanding?doi=10.1037%2Fpne0000162 The full article can be accessed here on the corresponding author’s website: https://www.gibsonresearchinstitute.org/wp-content/uploads/2019/02/ThinkRx-for-Adults-Over-50_Psy-and-Neuroscience_2019.pdf ...
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