Stroke
Conditions
Brief summary
This is an initial pilot study to test feasibility, participant engagement and satisfaction, and clinical and neurobiological target engagement of a behavioral treatment called ASCEND that combines computer-based cognitive training and coaching of cognitive strategies to improve daily cognitive functioning in individuals with stroke.
Interventions
BEHAVIORALASCEND
ASCEND is a behavioral intervention that combines computer-based cognitive exercise, strategy coaching with a neuropsychologist, and homework exercises in order to improve attention, working memory, and cognitive control after stroke.
Sponsors
Weill Medical College of Cornell University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
45 Years to 89 Years
Healthy volunteers
No
Inclusion criteria
* History of first-time stroke, minimum of 6 months prior to enrollment * English speaking * Ability to comprehend sufficiently to participate in the treatment. * Subjective or objective evidence of mild cognitive impairment * Willingness to participate in full study duration * Has computer that meets specification for the training program software. * Physically able to operate a computer keyboard and mouse. * Not concurrently receiving other cognitive rehabilitation services * Cognitively able to perform basic self-care activities (e.g., dressing, grooming, eating).
Exclusion criteria
* History of neurologic disease other than stroke * History of severe mental illness or substance use disorder, or current major depressive episode. * History of dementia or dependence in basic self-care activities due to cognitive deficits * Contraindications to MRI
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Participant satisfaction with ASCEND, as measured by the Client Satisfaction Questionnaire-8 (CSQ-8) | 5 weeks (at the conclusion of treatment) | The CSQ-8 is a self-report measure of participant satisfaction with the intervention. Scores range from 8-32 with higher scores indicating greater satisfaction. |
| Participant impression of ASCEND as a credible treatment to improve cognition, as measured by the Credibility and Expectancy Questionnaire (CEQ). | 5 weeks (at the conclusion of treatment) | The CEQ is a self-report measure that assesses participants' perceived benefit and improvement from the intervention. Each item is scored on a 1-9 Likert-type scale or as a percentage rating from 0% to 100% in 10% increments. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in divided attention and working memory, as measured by the Symbol-Digit Modalities Test | Baseline, 5 weeks | Performance-based measure of divided attention/working memory with scores ranging from 0-120, with higher scores indicating better performance. |
| Change in divided attention and processing speed, as measured by the Trail Making Test | Baseline, 5 weeks | Performance-based and timed measure of divided attention/processing speed with lower scores indicating better performance (faster completion time). |
| Change in selective attention and inhibitory control, as measured by the Stroop Test | Baseline, 5 weeks | Performance-based and timed measure of selective attention and inhibition, with higher scores indicating better performance. |
| Change in rapid working memory and mental arithmetic, as measured by the Paced Auditory Serial Addition Test (PASAT) | Baseline, 5 weeks | Performance-based and timed measure of rapid working memory, with higher scores indicating better performance. |
| Change in auditory attention and working memory, as measured by the Digit Span test | Baseline, 5 weeks | Performance-based measure of attention/working memory with scores ranging from 0-48, with higher scores indicating better performance. |
| Change in executive functioning as measured by the Weekly Calendar Planning Activity | Baseline, 5 weeks | Performance-based measure of executive functioning. Higher scores indicate better performance. |
| Change in self-reported executive functioning as measured by the Behavior Rating Inventory of Executive Function-Adult | Baseline, 5 weeks | Self-report measure of executive functioning. Higher scores indicate greater problems with executive dysfunction in daily life. |
| Change in self-reported cognitive symptoms due to stroke, as measured by the Patient Reported Evaluation of Cognitive State (PRECIS). | Baseline, 5 weeks | Self-report measure of cognitive difficulties after stroke. Scores range from 0-128 with higher scores indicating greater cognitive problems in daily life due to stroke. |
| Change in attention and working memory as measured by the Mental Control test | Baseline, 5 weeks | Performance-based measure of simple auditory attention and working memory. Scores range from 0-12 with higher scores indicating better performance. |
| Change in visual attention and working memory, as measured by the Symbol Span test | Baseline, 5 weeks | Performance-based measure of attention/working memory with scores ranging from 0-50, with higher scores indicating better performance. |
Countries
United States
Outcome results
None listed