Effect of 12-week home-based cognitive training on cognitive function and brain metabolism in patients with amnestic mild cognitive impairment

Figures & data

Figure 1 The flow diagram of enrollment.

Abbreviations: FU, follow-up; AE, adverse event.

Table 1 Baseline characteristics and demographics of subjects

	Home-based cognitive intervention group (n=25)	Control group (n=25)	P-value
Age, years	70.7 ± 7.5	69.7 ± 8.4	0.960^a
Female	13 (52%)	15 (60%)	0.569^c
Education, years	10.1 ± 3.3	10 ± 3.5	0.921^b
MMSE score	25.5 ± 2.5	25.9 ± 2.8	0.374^b
CDR-SB score	1.7 ± 0.7	1.4 ± 0.9	0.099^b
Modified ADAS-Cog score	24.6 ± 6.7	26.1 ± 7.7	0.737^a
GDS-15 (SGDS-K)	4.0 ± 4.4	3.0 ± 2.3	0.382^a
AChEI medication	16 (64%)	11 (44%)	0.542^c
Hypertension	15 (60%)	17 (68%)	0.556^c
Diabetes	1 (4%)	5 (20%)	0.082^c
Hyperlipidemia	9 (36%)	6 (24%)	0.355^c
Depression	1 (4%)	2 (8%)	0.552^c

Notes: ^aStudent’s t-test. ^bMann–Whitney U-test. ^cChi-square test.

Abbreviations: AChEI, acetylcholinesterase inhibitors; GDS-15, 15-item version of Geriatric Depression Score.

Table 2 Changes in efficacy outcomes at 12 and 24 weeks

Variables	Baseline		Difference (12 weeks)			Difference (24 weeks)
	Intervention group (n=25)	Control group (n=25)	Intervention group (n=25)	Control group (n=25)	P-value^1)	Intervention group (n=25)	Control group (n=24)	p^1)
Modified ADAS-Cog	24.6 ± 6.7	25.8 ± 7.1	−1.4 ± 4.7	−1.2 ± 2.8	0.827	−3.2±4.9	−1.1±4.2	0.070
MMSE	25.9 ± 2.7	26.2 ± 2.6	0.1 ± 2.4	−1.2 ± 1.9	0.061	0.2±2.4	−0.1±3.1	0.291
CDR-SB	1.3 ± 0.8	1.3 ± 0.8	−0.1 ± 0.2	−0.1 ± 0.7	1.000	0±0.2	0.1±0.9	0.745
Story memory recall	7.2 ± 4	8.4 ± 2.8	1 ± 3.6	0.2 ± 3	0.375	1.1±3.9	1±3.4	0.923
Story memory delayed recall	4.1 ± 3.4	5.9 ± 3.6	1 ± 2.5	0.5 ± 4	0.643	1.8±3.2	0.9±4.7	0.473
Story memory recognition	7.2 ± 1.6	7.2 ± 1.5	−0.2 ± 1.7	0.4 ± 1.6	0.218	0.1±1.2	0.8±2.7	0.256
Story memory total score	18.5 ± 7.4	21.5 ± 6.6	1.7 ± 5.9	0.2 ± 7.3	0.712	3.1±6.8	2.7±8.5	0.912
Digit span (forward)	6.4 ± 1.4	6.1 ± 1.5	0 ± 1.3	−0.6 ± 1.4	0.101	−0.4±1.2	−0.7±1.7	0.570
Digit span (backward)	3.6 ± 1.2	3.6 ± 0.9	−0.3 ± 1	−0.1 ± 1.3	0.540	0.1±1	−0.2±1.2	0.456
Digit span total score	10 ± 2.4	9.7 ± 2.2	−0.3 ± 1.9	−0.8 ± 2	0.401	−0.3±1.7	−1±2.6	0.364
Color-word strop	61.5 ± 30.4	68.2 ± 27.5	4.4 ± 26.8	1.6 ± 25.2	0.224	2.1±15.8	−0.4±15.6	0.122
COWAT (category)	11.2 ± 2.7	12.5 ± 3.1	0.4 ± 1.8	−0.7 ± 3.5	0.143	1.3±2.8	−1.1±3.4	0.006
COWAT (letter)	16.9 ± 6.7	20 ± 9	2.7 ± 4.5	−1.8 ± 8.3	0.025	3.1±5.8	−0.4±7.6	0.055
COWAT total	28.1 ± 7.9	32.4 ± 11	3.1 ± 4.6	−2.5 ± 8.2	0.005	4.4±6.8	−1.5±8.2	0.004
Digit-symbol test	39.9 ± 14.6	43.9 ± 14.7	2.4 ± 6.6	4.4 ± 15.7	0.413	4±7.9	5.7±15.2	0.322
GDS-15	4.0 ± 4.4	2.2 ± 2.7	−1.4 ± 2.4	0.6 ± 3.1	0.024	−1.9±3.2	0.8±2.2	0.004

Abbreviations: MMSE, Mini mental status examination; CDR-SB, Clinical dementia rating-sum of box; COWAT, Controlled oral word association test; GDS, Geriatric depression scale.

Figure 2 Changes from baseline at 12 weeks and 24 weeks on efficacy outcomes. Cognitive training significantly improved ADAS-Cog score at 24 weeks (A), COWAT total score at 12 and 24 weeks (B) and GDS-15 at 12 and 24 weeks (C). (A) Changes from baseline at 12 weeks and 24 weeks on the Modified ADAS-Cog. (B) COWAT (total) score change from baseline on Intervention group vs Control (C) GDS-15 (SGDS-K) score change from baseline on Intervention group vs Control.

Abbreviation: COWAT, Controlled oral word association test.

Table 3 The basic demographic features of participants who performed PET CT comparing all participants

	Home-based cognitive intervention group, total (n=25)	Control group, total (n=25)	Home-based cognitive intervention group (PET group) (n=15)	Control group (PET group) (n=17)	P-value
Age, years	70.7 ± 7.5	69.7 ± 8.4	70.2 ± 8.3	71.4 ± 7.7	0.926^a
Female	13 (52%)	15 (60%)	8 (53.3%)	8 (47.1%)	0.866^b
Education, years	10.1 ± 3.3	10 ± 3.5	8.7 ± 2.7	10.1 ± 3.1	0.518 ^a
MMSE score	25.5 ± 2.5	25.9 ±	26.1 ± 2.3	25.9 ± 2.3	0.887^a
CDR-SB score	1.7 ± 0.7	1.4 ± 0.9	1.4 ± 0.8	1.7 ± 0.8	0.102^a
Modified ADAS-Cog score	24.6 ± 6.7	26.1 ± 7.7	24.5 ± 6.9	23.3 ± 6.7	0.611^a
GDS-15 (SGDS-K)	4.0 ± 4.4	3.0 ± 2.3	3.6 ± 4.4	2.9 ± 2.4	0.669^a
AChEI medication	16 (64%)	11 (44%)	7 (46.7%)	10 (58.8%)	0.477^b
Hypertension	15 (60%)	17 (68%)	9 (60.0%)	11 (64.7%)	0.932^b
Diabetes	1 (4%)	5 (20%)	3 (20.0%)	1 (5.9%)	0.214^b
Hyperlipidemia	9 (36%)	6 (24%)	5 (33.3%)	8 (47.1%)	0.485^b
Depression	1 (4%)	2 (8%)	1 (6.7%)	1 (5.9%)	0.948

Notes: ^aOne-way ANOVA. ^bChi-square test

Abbreviations: AChEI, acetylcholinesterase inhibitors; GDS-15, 15-item version of Geriatric Depression.

Figure 3 Distribution of SUVr before treatment (A), after treatment (B), and more than 20% increased region after treatment (C) in participant with change (Fig 3-1). Distribution of SUVr before treatment (D), after treatment (E), and  no increased region after treatment (F) in participant without change (Fig 3-2).