Exploring the neural and behavioral correlates of cognitive telerehabilitation in mild cognitive impairment with three distinct approaches

Silvia Paola Caminiti; Sara Bernini; Sara Bottiroli; Micaela Mitolo; Riccardo Manca; Valentina Grillo; Micol Avenali; Roberto De Icco; Sabina Capellari; Giovanni Augusto Carlesimo; Annalena Venneri; Cristina Tassorelli

doi:10.3389/fnagi.2024.1425784

Exploring the neural and behavioral correlates of cognitive telerehabilitation in mild cognitive impairment with three distinct approaches

Front Aging Neurosci. 2024 Jun 27:16:1425784. doi: 10.3389/fnagi.2024.1425784. eCollection 2024.

Authors

Silvia Paola Caminiti¹, Sara Bernini², Sara Bottiroli^{1

2}, Micaela Mitolo^{3

4}, Riccardo Manca^{3

5}, Valentina Grillo^{1

2}, Micol Avenali^{1

2}, Roberto De Icco^{1

2}, Sabina Capellari^{4

6}, Giovanni Augusto Carlesimo^{7

8}, Annalena Venneri^{3

5}, Cristina Tassorelli^{1

2}

Affiliations

¹ Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
² IRCCS Mondino Foundation, Pavia, Italy.
³ Department of Medicine and Surgery, University of Parma, Parma, Italy.
⁴ IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
⁵ Department of Life Sciences, Brunel University London, Uxbridge, United Kingdom.
⁶ Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
⁷ Department of Systems Medicine, Tor Vergata University, Rome, Italy.
⁸ IRCCS S. Lucia Foundation, Rome, Italy.

Abstract

Background: Currently, the impact of drug therapies on neurodegenerative conditions is limited. Therefore, there is a strong clinical interest in non-pharmacological interventions aimed at preserving functionality, delaying disease progression, reducing disability, and improving quality of life for both patients and their caregivers. This longitudinal multicenter Randomized Controlled Trial (RCT) applies three innovative cognitive telerehabilitation (TR) methods to evaluate their impact on brain functional connectivity reconfigurations and on the overall level of cognitive and everyday functions.

Methods: We will include 110 participants with mild cognitive impairment (MCI). Fifty-five participants will be randomly assigned to the intervention group who will receive cognitive TR via three approaches, namely: (a) Network-based Cognitive Training (NBCT), (b) Home-based Cognitive Rehabilitation (HomeCoRe), or (c) Semantic Memory Rehabilitation Training (SMRT). The control group (n = 55) will receive an unstructured home-based cognitive stimulation. The rehabilitative program will last either 4 (NBTC) or 6 weeks (HomeCoRe and SMRT), and the control condition will be adapted to each TR intervention. The effects of TR will be tested in terms of Δ connectivity change, obtained from high-density electroencephalogram (HD-EEG) or functional magnetic resonance imaging at rest (rs-fMRI), acquired before (T0) and after (T1) the intervention. All participants will undergo a comprehensive neuropsychological assessment at four time-points: baseline (T0), within 2 weeks (T1), and after 6 (T2) and 12 months (T3) from the end of TR.

Discussion: The results of this RCT will identify a potential association between improvement in performance induced by individual cognitive TR approaches and modulation of resting-state brain connectivity. The knowledge gained with this study might foster the development of novel TR approaches underpinned by established neural mechanisms to be validated and implemented in clinical practice.Clinical trial registration: [https://classic.clinicaltrials.gov/ct2/show/NCT06278818], identifier [NCT06278818].

Keywords: brain connectivity; cognition; cognitive training; neurodegenerative diseases; non-pharmacological interventions; telerehabilitation.

Associated data

ClinicalTrials.gov/NCT06278818

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study is supported by the Italian Ministry of Health (Ricerca Corrente 2022-2024 - IRCCS Mondino Foundation, Pavia).