Computerized working memory training evaluated with clinical assessments and quantitative EEG in very-low-birth –weight (VLBW) children at preschool age

Research institution: Norwegian Institute of Science and Technology

Researchers: Dr. Jon Skranes

Training program used in research: Cogmed RM

Status: Ongoing

Summary
Prematurely born children are at increased risk of neurological disabilities due to perinatal brain damage. As an increasing number of extremely low birth weight (ELBW; BW≤ 1000 g) children survive into childhood, there is greater prevalence of brain pathology and impairment in survivors. Impairments include cerebral palsy, mental retardation and impaired hearing and vision in children born extremely preterm (gestational age below 28 weeks). Survivors of preterm birth also experience motor problems, cognitive dysfunction and psychiatric and behavioural problems of varying severity. Studies using advanced MRI techniques performed in the newborn period and on later follow-up have shown high incidence of cerebral abnormalities in very low birth weight (VLBW; BW ≤ 1500g) children (Krageloh-Mann, Hagberg et al., 1992; Olsen, Vainionpaa et al., 1998; Stewart, Rifkin et al., 1999; Ajayi-Obe, Saeed et al., 2000; Nosarti, Al-Asady et al., 2002; Counsell, Rutherford et al., 2003; Inder, Wells et al., 2003; Allin, Henderson et al., 2004; Nosarti, Rushe et al., 2004). Further, abnormal MR findings and clinical problems seem to persist into adolescence and early adulthood (Allin, Matsumoto et al., 2001).

Recent studies have shown that hippocampus plays an important role in working memory (Olson, Page et al., 2006; Piekema, Kessels et al., 2006) and reduced hippocampal volume is associated with reduced working memory function (Isaacs, Lucas et al., 2000; Gimenez, Junque et al., 2004; Beauchamp, Thompson et al., 2008). The hippocampus is very vulnerable in preterm children (Abernethy, Palaniappan et al., 2002), and white matter injury, which is very common in preterm born children (Rees and Inder 2005; Thompson, Warfield et al., 2007), has been shown to result in reduced hippocampal volumes at term age (Thompson, Wood et al., 2008). Studies have indicated that working memory relies on a distributed network of brain regions which includes the hippocampus (Piekema, Kessels et al., 2006; Beauchamp, Thompson et al., 2008).

Aim
This study will compare quantitative EEG findings and cognitive and neuropsychological test results before and after training with the Cogmed JM program in a group of VLBW children of preschool age (ie.,5-6 years old). Fifteen children will train with the adaptive version of Cogmed followed 8 weeks later by the 15 children in the waitlist control group. It is hypothesized that children in the study may respond positively to the computerized training and show improved working memory to different degrees depending on the underlying neurological condition. Training may also benefit additional executive functions and have a generalizing effect on learning.