1. Protocols for cognitive enhancement. A user manual for Brain Health Services-part 5 of 6
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Brioschi Guevara, Andrea, Bieler, Melanie, Altomare, Daniele, Berthier, Marcelo, Csajka, Chantal, Dautricourt, Sophie, Démonet, Jean-François, Dodich, Alessandra, Frisoni, Giovanni B., Miniussi, Carlo, Molinuevo, José Luis, Ribaldi, Federica, Scheltens, Philip, Chételat, Gael, [Brioschi Guevara,A, Bieler,M, Démonet,JF] Centre Leenaards de la Mémoire, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. [Altomare,D, Frisoni,GB, Ribaldi,F] Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland. [Altomare,D, Ribaldi,F] Memory Clinic, Geneva University Hospitals, Geneva, Switzerland. [Berthier,M] Unit of Cognitive Neurology and Aphasia, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Malaga, Spain. [Berthier,M] Instituto de Investigación Biomédica de Málaga – IBIMA, Malaga, Spain. [Csajka,C] Center for Research and Innovation in clinical Pharmaceutical Sciences, University Hospital and University of Lausanne, Lausanne, Switzerland. [Csajka,C] School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland. [Csajka,C] Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland. [Dautricourt,S, Chételat,G] Normandie Univ, UNICAEN, INSERM, PhIND 'Physiopathology and Imaging of Neurological Disorders', Institut Blood and Brain @ Caen-Normandie, Cyceron, France. [Dodich,A, Miniussi,C] Center for Mind/ Brain Sciences – CIMeC, University of Trento, Rovereto, Italy. [Molinuevo,JL] Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain. [Ribaldi,F] Laboratory of Alzheimer’s Neuroimaging and Epidemiology (LANE), Saint John of God Clinical Research Centre, Brescia, Italy. [Ribaldi,F] Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy. [Scheltens,P] Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit., This paper was the product of a workshop funded by the Swiss National Science Foundation entitled 'Dementia Prevention Services' (grant number: IZSEZ0_193593). GBF received funding by: the EU-EFPIA Innovative Medicines Initiatives 2 Joint Undertaking (IMI 2 JU) 'European Prevention of Alzheimer’s Dementia consortium' (EPAD, grant agreement number: 115736) and 'Amyloid Imaging to Prevent Alzheimer’s Disease' (AMYPAD, grant agreement number: 115952), and the Swiss National Science Foundation: 'Brain connectivity and metacognition in persons with subjective cognitive decline (COSCODE): correlation with clinical features and in vivo neuropathology' (grant number: 320030_182772).
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Mindfulness meditation ,Acondicionamiento físico ,Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Central Nervous System Agents::Psychotropic Drugs::Antidepressive Agents [Medical Subject Headings] ,Drugs ,Anatomy::Nervous System::Central Nervous System::Brain [Medical Subject Headings] ,Cognitive intervention ,Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings] ,Brain health service ,Chemicals and Drugs::Organic Chemicals::Hydrocarbons::Hydrocarbons, Cyclic::Bridged Compounds::Adamantane::Amantadine::Memantine [Medical Subject Headings] ,Diseases::Nervous System Diseases::Neurologic Manifestations::Neurobehavioral Manifestations::Memory Disorders [Medical Subject Headings] ,Physical training ,Atención plena ,Anthropology, Education, Sociology and Social Phenomena::Social Sciences::Quality of Life [Medical Subject Headings] ,Subjective cognitive decline ,Disfunción cognitiva ,Meditación ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Clinical Protocols [Medical Subject Headings] ,Non-invasive brain stimulation ,Organisms::Eukaryota::Plants::Viridiplantae::Streptophyta::Embryophyta::Gymnosperms::Ginkgo biloba [Medical Subject Headings] ,Chemicals and Drugs::Enzymes and Coenzymes::Enzymes::Hydrolases::Esterases::Carboxylic Ester Hydrolases::Cholinesterases::Acetylcholinesterase [Medical Subject Headings] ,Cognitive enhancement - 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. Yes
- Published
- 2021