HARP-Project 1 Cognitive Training



Status:Active, not recruiting
Conditions:Healthy Studies
Therapuetic Areas:Other
Healthy:No
Age Range:60 - Any
Updated:1/30/2019
Start Date:October 4, 2017
End Date:April 30, 2019

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Emerging evidence from social neuroscience suggests that prefrontal cortex (PFC), insular and
anterior cingulate cortex (ACC) regulate social and emotional responses to acute threats to
social connectedness among young adults. Deficient neural reserve or overused neural
compensation resulting from neurodegeneration is commonly observed in these frontal regions
in old age. This aging-related "neural depletion" may have implications for how older adults
respond to social threats, potentially increasing maladaptive emotional and social behavioral
responses, such as social anxiety and social avoidance, which contribute to social
disconnectedness. The central hypothesis is that cognitive deficits and associated
aging-related 'neural depletion' in the frontal regions will contribute to maladaptive
social-emotional responses to a social stressor -- social exclusion. Ultimately, maladaptive
responses to acute social stress, such as social anxiety and avoidance, can compromise social
connectedness by increasing social strain and isolation. The investigators have recently
developed a neuroplasticity-based cognitive training program, called vision-based speed of
processing (VSOP) training, targeting multiple aspects of cognitive capacity (e.g.,
attention, working memory and inhibition) and incorporating the speed component to improve
the efficiency of these cognitive processes. VSOP training also targets several neural
networks seeded in ACC and insular (default mode network) or PFC (the frontal-striatal
network and central executive network). These networks also overlap with neural substrates of
emotion regulation. Notably, VSOP training appears to improve emotion regulation, as
depressive symptoms were reduced in older adults following VSOP training. Finally, the
autonomic nervous system (ANS), critical to stress adaptation, is regulated by these frontal
regions. The objective of the proposed pilot study is to provide proof-of-concept for the
hypothesis that improvements in older adults' cognitive capacity, frontal regions' neural
efficiency, and ANS function via the VSOP training will be associated with more adaptive
social-emotional response to social exclusion, which, in turn, should confer longer-term
protection for older adults' sense of social connectedness. Randomized Controlled Trial
Design: 30 older adults will be randomly assigned to engage in 6-week VSOP training, or to an
active control group. Differential changes from baseline to post-training in cognitive
capacity, neural efficiency, and ANS function, and sense of social connectedness, will be
compared between VSOP control groups. A social exclusion paradigm ('cyberball' task) will be
conducted post-training to evaluate VSOP training effects on social-emotional responses to
social exclusion, including anxiety and motivation for social affiliation.


Inclusion Criteria:

1. aged ≥ 60 years, community-dwelling, English-speaking, adequate vision and hearing for
testing, capacity to give consent based on clinician assessment;

2. Telephone Interview for Cognitive Status (TICS) ≥ 31, Geriatric Depression Scale < 7
(i.e., free of major depression that can interfere with neural efficiency for
social-emotional regulation), EXAMINER composite score (a comprehensive executive
function battery test package that is sensitive to frontal regions' neural efficiency
change) < .70 (i.e., reflecting decreased neural efficiency of frontal regions
compared to cognitively health older adults in general);

3. moderate social relation difficulties: identified by World Health Organization
Disability Assessment Scale (WHO-DAS), "Getting Along with Other People" domain, at
least "moderate" difficulties endorsed; from HARP Database Project screening)

Exclusion Criteria:

1. a self-report clinical diagnosis of dementia or mild cognitive impairment;

2. MRI contraindications (e.g., pacemaker, metallic implant, claustrophobia);
We found this trial at
4
sites
1 Johnsarbor Drive West
Rochester, New York 14620
Phone: 585-242-7009
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4560 Fairport Nine Mile Point Road
Fairport, New York 14450
Phone: 585-377-1810
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300 Hahnemann Trail
Pittsford, New York 14534
Phone: 585-641-6387
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Pittsford, NY
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535 Mount Hope Avenue
Rochester, New York 14620
Phone: 585-232-3130
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Rochester, NY
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