Remote Neurotherapy: It is not experimental anymore

Robert DuWors, PhD

Brockton VA Medical Center – Faculty
DuWors_Robert poster

Scientific Abstract

Background: Remote neurotherapy is no longer experimental. It is clinically mainstream.  Cognitive rehabilitation interventions are based on empirically validated treatments designed to ameliorate impairments commonly experienced by individuals with TBI, HIV, stroke, and other neurological impairing diseases. There are data that support these efforts for treating cognitive deficits of children with HIV/Aids and cerebral malaria using Computerized Cognitive Remediation Training Programs (CCRTs).

Method: Literature Search and data from Private Practice

Results: Working Memory (WM) improved in all participants 1 month after adaptive Working Memory Training(WMT). Participants showed improved(decreased) brain activation on BOLD-fMRI, suggesting improved neural efficiency in HIV- patients. [1]

159 rural Ugandan children with Stage I or II HIV disease were a part of a randomized study.  The CCRT arm of the study had significantly greater gains through 3 months of follow-up compared to passive controls on overall Kaufman Assessment Battery for Children-2nd edition. [2]

The children with Cerebral Malaria (CM) in the CCRT intervention group had significant improvement on the CogState assessments pertaining to Working Memory and Attention. The CM CCRT group had greater improvements on the Child Behavior Check List (CBCL) Internalizing Symptoms. Consistent with the CM groups, the children with HIV in the CCRT intervention group also had significantly greater improvements than controls in the same domains. [5]

A common clinical concern is ecological validity.  Using magnetoencephalography (MEG) to evaluate changes in resting state connectivity between brain regions underpinning WM performance, they (Astle et.al) concluded that CCRT in children enhances neurophysiological brain connectivity intra and inter-hemispherically known to be related to verbal and visual-spatial WM respectively. [6]

Conclusions: CCRT intervention can be effective for neurocognitive rehabilitation generally and particularly in children with HIV and Malaria in low-resource settings, especially in children who are clinically stable on ARV treatment. CCRT has been proven to have ecological validity.

Live Zoom Session – March 9th

research Areas

Authors

Robert DuWors, PhD, Peter Lang, MD

Principal Investigator

Robert DuWors, PhD