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

Area of Science:

• Neuroscience
• Pediatric Medicine
• Cognitive Psychology

Background:

• Neonatal extracorporeal membrane oxygenation (ECMO) and congenital diaphragmatic hernia (CDH) can impact neurodevelopmental outcomes.
• Working memory deficits are common in survivors of these conditions.
• Cognitive training interventions aim to improve cognitive functions in at-risk populations.

Purpose of the Study:

• To evaluate the immediate and long-term effectiveness of Cogmed Working Memory Training (WMT) in children who survived neonatal ECMO and/or CDH.
• To assess the impact of WMT on verbal and visuospatial working memory.
• To determine if improvements persist one year after the intervention.

Main Methods:

• A nationwide randomized controlled trial was conducted with 8-12 year old survivors.
• Participants had pre-existing working memory deficits (z-score ≤ -1.5).
• The intervention group (n=19) received Cogmed WMT, while the control group (n=24) received no intervention. Neuropsychological outcomes were assessed immediately (T1) and one year (T2) post-intervention.

Main Results:

• Significant improvements in verbal and visuospatial working memory were observed immediately post-intervention (T1).
• At one-year follow-up (T2), these improvements were no longer significant for verbal working memory but persisted for visuospatial working memory.
• Long-term gains in visuospatial memory were associated with better self-rated school functioning and parent-rated attention.

Conclusions:

• Cogmed WMT shows immediate benefits for working memory in pediatric survivors of critical neonatal conditions.
• Long-term working memory improvements are not consistently maintained, with the exception of visuospatial memory.
• Cogmed WMT may offer specific benefits for visuospatial memory deficits in this population, potentially impacting daily functioning.