Working Memory Training Following Neonatal Critical Illness: A Randomized Controlled Trial*. Issue 7 (July 2018)

• Record Type: Journal Article
• Authors: Schiller, Raisa M.; Madderom, Marlous J.; van Rosmalen, Joost; van Heijst, Arno F. J.; de Blaauw, Ivo; Utens, Elisabeth; Rietman, André B.; Verhulst, Frank; Tibboel, Dick; White, Tonya; IJsselstijn, Hanneke
• Is Part Of: Critical care medicine. Volume 46:Issue 7(2018)
• Publication Date: 2018-07
• Subjects: congenital diaphragmatic hernia -- cognitive remediation -- extracorporeal membrane oxygenation -- memory -- neurodevelopmental disorders -- neuropsychology; Critical care medicine -- Periodicals; Soins intensifs -- Périodiques; 616.028
• DOI: 10.1097/CCM.0000000000003151
• Languages: English
• ISSNs: 0090-3493

Abstract

Abstract : Objectives: To test the immediate and long-term effectiveness of Cogmed Working Memory Training following extracorporeal membrane oxygenation and/or congenital diaphragmatic hernia. Design: A nationwide randomized controlled trial assessing neuropsychologic outcome immediately and 1 year post Cogmed Working Memory Training, conducted between October 2014 and June 2017. Researchers involved in the follow-up assessments were blinded to group allocation. Setting: Erasmus MC-Sophia Children's Hospital, Rotterdam, and Radboud University Medical Center, Nijmegen, the Netherlands. Patients: Eligible participants were neonatal extracorporeal membrane oxygenation and/or congenital diaphragmatic hernia survivors (8–12 yr) with an intelligence quotient greater than or equal to 80 and a z score less than or equal to –1.5 on at least one (working) memory test at first assessment. Interventions: Cogmed Working Memory Training, comprising 25 45-minute training sessions for 5 consecutive weeks at home. Measurements and Main Results: Participants were randomized to Cogmed Working Memory Training ( n = 19) or no intervention ( n = 24) (two dropped out after T0). Verbal working memory (estimated coefficient = 0.87; p = 0.002) and visuospatial working memory (estimated coefficient=0.96, p = 0.003) significantly improved at T1 post Cogmed Working Memory Training but was similar between groups at T2 (verbal, p = 0.902; visuospatial, p = 0.416). Improvements were found at T2 on long-term visuospatial memory following Cogmed Working Memory Training (estimated coefficient = 0.95; p = 0.003). Greater improvements in this domain at T2 following Cogmed Working Memory Training were associated with better self-rated school functioning ( r = 0.541; p = 0.031) and parent-rated attention ( r = 0.672; p = 0.006). Conclusions: Working memory improvements after Cogmed Working Memory Training disappeared 1 year post training in neonatal extracorporeal membrane oxygenation and/or congenital diaphragmatic hernia survivors. Gains in visuospatial memory persisted 1 year post intervention. Cogmed Working Memory Training may be beneficial for survivors with visuospatial memory deficits. Abstract : Supplemental Digital Content is available in the text.