Computer-assisted self-training to improce executive function versus unspecific training in patients after stroke, cardiac arrest or in Parkinson’s disease: A randomized controlled trial: the complex-trial

Background and aims: Patients with stroke and other conditions affecting the brain often experience impairments with working memory (WM), which can be devastating for the individual's ability to lead a normal life. Gold-standard for treatment is 1:1 sessions with neuropsychologist, but this approach is expensive and the majority of patients don't receive cognitive rehabilitation. Computer-Based Cognitive Rehabilitation (CBCR) is a promising method to increase availability and flexibility of cognitive rehabilitation while minimizing costs. CBCR consists of exercises targeted at specific cognitive functions and is carried out on the patient's computer at home. The current evidence for the efficacy of CBCR is sparse and there is especially a lack of studies comparing CBCR with active control conditions and measuring improvement with far-transfer ADL-function measures instead of near-transfer neuropsychological measures. Method(s): 600 patients with different brain-related conditions affecting WM will be included from various European sites: 400 with stroke (focal brain injury), 100 after heart attack (anoxic brain injury) and 100 with Parkinson's disease (neurodegenerative disease). Patients will be randomly allocated in a 1:1 ratio to specific CBCR-training targeting WM and general stimulating activities such as solitaire, puzzles etc. Both groups are to train five hours a week for eight weeks. The primary endpoint is the iADL-measure from MDS-HC at three months after the end of the intervention to assess any lasting effects of training. Secondary endpoints include neuropsychological tests and questionnaires concerning anxiety, depression, and quality of life. Result(s): Main results expected to be presented primo 2024.

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