• Critical care medicine · Jul 2018

    Randomized Controlled Trial

    Working Memory Training Following Neonatal Critical Illness: A Randomized Controlled Trial.

    • Raisa M Schiller, Marlous J Madderom, Joost van Rosmalen, van Heijst Arno F J AFJ Department of Neonatology, Amalia Children's Hospital, Radboud University Medical Centre, Nijmegen, The Netherlands., Ivo de Blaauw, Elisabeth Utens, André B Rietman, Frank Verhulst, Dick Tibboel, Tonya White, and Hanneke IJsselstijn.
    • Intensive Care and Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
    • Crit. Care Med. 2018 Jul 1; 46 (7): 1158-1166.

    ObjectivesTo test the immediate and long-term effectiveness of Cogmed Working Memory Training following extracorporeal membrane oxygenation and/or congenital diaphragmatic hernia.DesignA nationwide randomized controlled trial assessing neuropsychologic outcome immediately and 1 year post Cogmed Working Memory Training, conducted between October 2014 and June 2017. Researchers involved in the follow-up assessments were blinded to group allocation.SettingErasmus MC-Sophia Children's Hospital, Rotterdam, and Radboud University Medical Center, Nijmegen, the Netherlands.PatientsEligible participants were neonatal extracorporeal membrane oxygenation and/or congenital diaphragmatic hernia survivors (8-12 yr) with an intelligence quotient greater than or equal to 80 and a z score less than or equal to -1.5 on at least one (working) memory test at first assessment.InterventionsCogmed Working Memory Training, comprising 25 45-minute training sessions for 5 consecutive weeks at home.Measurements And Main ResultsParticipants were randomized to Cogmed Working Memory Training (n = 19) or no intervention (n = 24) (two dropped out after T0). Verbal working memory (estimated coefficient = 0.87; p = 0.002) and visuospatial working memory (estimated coefficient=0.96, p = 0.003) significantly improved at T1 post Cogmed Working Memory Training but was similar between groups at T2 (verbal, p = 0.902; visuospatial, p = 0.416). Improvements were found at T2 on long-term visuospatial memory following Cogmed Working Memory Training (estimated coefficient = 0.95; p = 0.003). Greater improvements in this domain at T2 following Cogmed Working Memory Training were associated with better self-rated school functioning (r = 0.541; p = 0.031) and parent-rated attention (r = 0.672; p = 0.006).ConclusionsWorking memory improvements after Cogmed Working Memory Training disappeared 1 year post training in neonatal extracorporeal membrane oxygenation and/or congenital diaphragmatic hernia survivors. Gains in visuospatial memory persisted 1 year post intervention. Cogmed Working Memory Training may be beneficial for survivors with visuospatial memory deficits.

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