Protocols for cognitive enhancement. A user manual for Brain Health Services—part 5 of 6

Alzheimer’s Research & Therapy

Philip Scheltens¹  José Luis Molinuevo²  Alessandra Dodich³  Carlo Miniussi³  Chantal Csajka⁴  Jean-François Démonet⁵  Andrea Brioschi Guevara⁵  Melanie Bieler⁵  Federica Ribaldi⁶  Giovanni B. Frisoni⁶  Daniele Altomare⁶  Gael Chételat⁷  Sophie Dautricourt⁷  Marcelo Berthier⁸ 

[1] Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC;Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation;Center for Mind/Brain Sciences – CIMeC, University of Trento;Center for Research and Innovation in clinical Pharmaceutical Sciences, University Hospital and University of Lausanne;Centre Leenaards de la Mémoire, Centre Hospitalier Universitaire Vaudois;Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva;Normandie Univ, UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders”, Institut Blood and Brain @ Caen-Normandie;Unit of Cognitive Neurology and Aphasia, Centro de Investigaciones Médico-Sanitarias, University of Malaga;

关键词: Subjective cognitive decline;    Cognitive enhancement;    Cognitive intervention;    Mindfulness meditation;    Physical training;    Non-invasive brain stimulation;   

DOI  :  10.1186/s13195-021-00844-1

来源: DOAJ

【 摘 要 】

Abstract Cognitive complaints in the absence of objective cognitive impairment, observed in patients with subjective cognitive decline (SCD), are common in old age. The first step to postpone cognitive decline is to use techniques known to improve cognition, i.e., cognitive enhancement techniques. We aimed to provide clinical recommendations to improve cognitive performance in cognitively unimpaired individuals, by using cognitive, mental, or physical training (CMPT), non-invasive brain stimulations (NIBS), drugs, or nutrients. We made a systematic review of CMPT studies based on the GRADE method rating the strength of evidence. CMPT have clinically relevant effects on cognitive and non-cognitive outcomes. The quality of evidence supporting the improvement of outcomes following a CMPT was high for metamemory; moderate for executive functions, attention, global cognition, and generalization in daily life; and low for objective memory, subjective memory, motivation, mood, and quality of life, as well as a transfer to other cognitive functions. Regarding specific interventions, CMPT based on repeated practice (e.g., video games or mindfulness, but not physical training) improved attention and executive functions significantly, while CMPT based on strategic learning significantly improved objective memory. We found encouraging evidence supporting the potential effect of NIBS in improving memory performance, and reducing the perception of self-perceived memory decline in SCD. Yet, the high heterogeneity of stimulation protocols in the different studies prevent the issuing of clear-cut recommendations for implementation in a clinical setting. No conclusive argument was found to recommend any of the main pharmacological cognitive enhancement drugs (“smart drugs”, acetylcholinesterase inhibitors, memantine, antidepressant) or herbal extracts (Panax ginseng, Gingko biloba, and Bacopa monnieri) in people without cognitive impairment. Altogether, this systematic review provides evidence for CMPT to improve cognition, encouraging results for NIBS although more studies are needed, while it does not support the use of drugs or nutrients.

【 授权许可】

Unknown