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Behavioral Intervention

Cognitive Training for Post-Stroke Cognitive Impairment

N/A

Recruiting

Led By Abhishek Jaywant, PhD

Research Sponsored by Weill Medical College of Cornell University

Eligibility Criteria Checklist

Specific guidelines that determine who can or cannot participate in a clinical trial

Must have

Physically able to operate a computer keyboard, tablet/iPad, and mouse.

Ability to comprehend sufficiently to participate in the treatment

Timeline

Screening 3 weeks

Treatment Varies

Follow Up baseline, end of study (approximately 2 weeks)

Awards & highlights

No Placebo-Only Group

Summary

This trial will test a new intervention to help improve working memory and executive function in stroke patients. The intervention combines computer-based cognitive training with coaching of cognitive strategies. The investigators hypothesize that, compared to an Enhanced Usual Care control condition, the ASCEND intervention will lead to improvements in working memory.

Who is the study for?

This trial is for English-speaking adults aged 30-89 who have had a stroke and are in acute inpatient rehab. They must understand the treatment, be able to use a computer, and show mild-moderate cognitive impairment without severe mental illness, substance abuse history, or other neurological disorders.

What is being tested?

The 'ASCEND-I' program is being tested against enhanced usual care to see if it improves working memory and executive functions after a stroke. It involves computer-based training and strategy coaching. Brain scans may help predict who will benefit most.

What are the potential side effects?

Since ASCEND-I involves non-invasive cognitive training and coaching strategies rather than medication or surgery, side effects are minimal but could include fatigue or frustration during tasks.

Eligibility Criteria

Inclusion Criteria

You may be eligible if you check “Yes” for the criteria below

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I can use a computer, tablet, or mouse without help.

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I understand what the treatment involves and can follow instructions.

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I am between 30 and 89 years old.

Timeline

Screening ~ 3 weeks3 visits

Treatment ~ Varies

Follow Up ~ baseline, end of study (approximately 2 weeks)

Screening ~ 3 weeks

Treatment ~ Varies

Follow Up ~baseline, end of study (approximately 2 weeks)

This trial's timeline: 3 weeks for screening, Varies for treatment, and baseline, end of study (approximately 2 weeks) for reporting.

Treatment Details

Study Objectives

Study objectives can provide a clearer picture of what you can expect from a treatment.

Primary study objectives

The primary objective is to determine whether ASCEND improves WM as assessed by computerized WM tasks from the Tablet-based Computer Assessment Tool (TabCAT) and the Weekly Calendar Planning Activity.

Secondary study objectives

Change from baseline in cognitive functioning, as measured by the NeuroQOL (Quality of Life in Neurological disorders) Cognitive Function Short Form.

Change from baseline in strategy use, as measured by the Weekly Calendar Planning Activity (WCPA)

Memory

+1 more

Awards & Highlights

No Placebo-Only Group

All patients enrolled in this study will receive some form of active treatment.

Trial Design

2Treatment groups

Experimental Treatment

Active Control

Group I: ASCEND-IExperimental Treatment1 Intervention

Computerized WM training with Rehacom will be implemented in daily 30-minute sessions that are scheduled prior to the participant's occupational therapy (OT) session as an adjunct to routine rehabilitation. Tasks are tailored to the participant's current ability level and are adaptive to performance changes. During these sessions, the study staff member will use guided questioning to help the participant anticipate challenges, reflect on performance, and link computerized exercises to the Multicontext sessions. The Multicontext treatment sessions will be delivered within the participant's OT session by an OT. The Multicontext approach helps individuals to self-discover WM-related error patterns and learn to anticipate WM performance challenges through repeated practice using functionally-relevant activities. The OT conducts guided questioning pre- and post-task to help the participant anticipate challenges and self-discover WM strategies.

Group II: Enhanced Usual CareActive Control1 Intervention

The control condition will account for the time spent with rehabilitation therapists and study staff and provide more general cognitive stimulation. The control group will receive usual, standard of care occupational therapy during OT by inpatient rehabilitation staff who are not trained in the Multicontext approach. The standard OT session often focuses on cognition in a non-standardized and non-targeted manner without the targeting of WM and guided self-discovery of the Multicontext approach. To control for the cognitive training element of ASCEND, individuals randomized to the control condition will meet with a study staff member for 30 minutes of general cognitive stimulation that includes word-searches, crossword puzzles, and/or jigsaw puzzles.

0 / 3Eligibility criteria met