JMIR Publications

ABSTRACT

Background:

Repetitive transcranial magnetic stimulation (rTMS) induces neural plasticity, which may be maximized via adjunctive interventions.

Objective:

We therefore examined the feasibility and acceptability of computerized cognitive training (CCT) in two open-label phase I trials of accelerated intermittent theta burst (iTBS) rTMS in amnestic mild cognitive impairment (aMCI; NCT04503096) and post-stroke MCI (psMCI; NCT04655963).

Methods:

Twenty-one participants with aMCI and 14 with psMCI received 24 sessions of accelerated iTBS over three days (8 sessions/day). During the 10–15-minute intervals between accelerated iTBS sessions, participants engaged in CCT via the BrainHQ platform. Participants were then asked and offered identical compensation to complete 20 minutes daily of BrainHQ during the 4-week follow-up period. A BrainHQ experience questionnaire was administered immediately post-accelerated iTBS treatment and at follow-up.

Results:

Both groups completed a comparable duration of BrainHQ exercises during treatment (median=107 [aMCI] and =111 [psMCI] minutes; P=.511). However, the groups demonstrated differential engagement in the follow-up period (median=450 [aMCI] and =142 [psMCI] minutes) in that participants with aMCI increased engagement over the 4 weeks, whereas use in the psMCI group decreased (P=.001). Both groups generally rated BrainHQ positively at both timepoints in terms of their experience with the platform, exercises, and perceived benefit for their mood and functioning.

Conclusions:

Despite high acceptability and feasibility of standardized dosing of CCT when interleaved with accelerated iTBS treatment, engagement with CCT can differ across MCI sub-groups during self-directed use in ways that may reflect their unique deficits or symptomatology. Clinical Trial: clinicaltrials.gov; NCT04503096; https://clinicaltrials.gov/study/NCT04503096?tab=history&a=9 clinicaltrials.gov; NCT04655963; https://clinicaltrials.gov/study/NCT04655963?tab=history