CClinicalTrials.gg
TerminatedNCT02864940MASHUpdated Apr 10, 2023Results posted

Memory Training in Aneurysmal Subarachnoid Hemorrhage Patients

An interventional study of Lumosity and Crossword puzzle in Ruptured Aneurysm, Memory Deficits and Subarachnoid Hemorrhage, sponsored by Rush University Medical Center. Terminated at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2023-04-10.

Sponsored by Rush University Medical Center · Not applicable, Interventional, and Treatment

Why this study was terminated
Unable to enroll
Phase
Not applicable
Study type
Interventional
Enrollment
38
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The study aim is to determine if periodic online cognitive exercises (Lumosity) improve memory function in ruptured cerebral aneurysm patients with disabling baseline memory deficits within the first 24 months after rupture. Half of the subjects will be randomized to use Lumosity-designed online cognitive exercises and half will serve as an active control group performing online crossword puzzles.

Read the detailed description

In this prospective randomized, control clinical trial subjects have a self-reported disabling memory deficit within the first two years of their ruptured cerebral aneurysm. Subjects will be recruited in the neurosurgery clinic setting, via email and phone screen, through social media and phone screen, or during a monthly support group for the patient population in question.

During the screening interview the inclusion and exclusion criteria are assessed and informed consent is obtained if needed.

Those who qualify for the study will undergo a baseline assessment involving Checklist for cognitive and emotional consequences following stroke (CLCE-24), Working memory questionnaire, Activity of Daily living Questionnaire, and a Lumosity Administered assessment.

After baseline assessments randomization will occur stratified according to duration since SAH \<12 or >12 months, to either a treatment group, which will include online access to structure-oriented activities (Lumosity), or an active control group(online crossword puzzles).

Subjects in the intervention group will undergo twenty training sessions over 10 weeks involving cognitive games selected from Lumocity. Games will be customized using an automated algorithm supplied by Lumosity, to determine performance in the various targeted skills, which include: task switching, logical reasoning, quantitative reasoning, response inhibition, numerical calculation, working memory, face-name recall, selective attention, spatial recall, spatial orientations, planning, and divided attention. The recommended duration of interaction is 2 hours per week for 10 weeks.

The control group uses a computerized crossword puzzle. the puzzle is offered in three different puzzle sizes, levels of complexity, and font sizes. these puzzles do not provide progressive challenge to the user by either increased speed, visual field size, number of distractors, or degree of difficulty of target stimulus differentiation.

02

Conditions studied

  • Ruptured Aneurysm
  • Memory Deficits
  • Subarachnoid Hemorrhage

Keywords

  • Memory
  • aneurysm
  • deficits
  • trouble
  • forgetful
  • ruptured
  • subarachnoid
  • hemorrhage
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Ruptured cerebral aneurysm-confirmed by study personnel within past year
  • Age 18 and older
  • Those with a modified Rankin 0 or 1
  • Baseline memory problem affecting daily life
  • Home computer or tablet with internet access

Exclusion criteria

Exclusion Criteria:

  • Unable to read or speak English
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
38 participants (actual)

Study arms

  • Experimental
    Intervention Arm

    Using the cognitive exercises on Lumosity for 10 weeks

    Device: Lumosity

  • Active comparator
    Control Arm

    Using online crossword puzzles for 10 weeks.

    Device: Crossword puzzle

Interventions

  • DeviceLumosity

    A web-based cognitive training platform that includes games designed with the purpose of improving the user's cognitive abilities

  • DeviceCrossword puzzle

    This game offers a choice between three puzzle sizes, three levels of complexity, and varying font sizes. It also includes optional help features such as filling in an unknown letter or word.

05

What researchers measure

Primary outcomes

  1. CLCE-24

    Cognitive and Emotional Consequences CLCE-24-C, which consists of 13 items (e.g., problems with "doing two things at once" or "remembering new information" . The items involve multiple cognitive domains (including executive functioning, attention, memory, speed of processing and visuospatial perception) and are indicative of the cognitive complaints the patient experiences. The interviewer scores a "0" for the absence of complaints, a "1" for possible complaints and a "2" for the presence of complaints. Total scores range from 0-26 and higher scores indicate more cognitive complaints.

    Time frame: One year

  2. Working Memory

    Working Memory Questionnaire - 30 questions in 3 different domains of 10 questions each. First domain short term storage, second domain was attention, third domain executive aspects of working memory such as decision making, planning ahead or shifting. Each question 6 point Likert scale (0-5), three domains, maximal score 50 each for total score out of 150 with higher scores corresponding to more difficulties/complaints. Total score ranges from 0-150, with higher scores corresponding to more difficulties/complaints.

    Time frame: One Year

  3. Activity of Daily Living

    Activities of daily living: Each answered question was rated on a five-point Likert-type scale, ranging from 0 (no problem at all) to 4 (very severe problem in everyday life). Test is scored by taking the total score of a patient and dividing by the number of items rated and converted to percentiles, allows test to measure deficits seen with regular activities. Total score ranges from 0-100%. Test has a validated cut off points for determine positive results: 0-33% may indicate some impairment, 34-66% moderate impairment, 67+%: severe impairment. Higher values = worse outcomes

    Time frame: One year

06

Results

Posted Apr 10, 2023
Limitations and caveats
No subjects analyzed due to incomplete data, leading to unreliable or uninterpretable data.

Participant flow

Participant flow — Overall Study
MilestoneIntervention ArmControl Arm
Started2018
Completed77
Not completed1311
Withdrew: Never took part in intervention or control arm activities or completed post assessments1311

Outcome measures

PrimaryCLCE-24

Cognitive and Emotional Consequences CLCE-24-C, which consists of 13 items (e.g., problems with "doing two things at once" or "remembering new information" . The items involve multiple cognitive domains (including executive functioning, attention, memory, speed of processing and visuospatial perception) and are indicative of the cognitive complaints the patient experiences. The interviewer scores a "0" for the absence of complaints, a "1" for possible complaints and a "2" for the presence of complaints. Total scores range from 0-26 and higher scores indicate more cognitive complaints.

Time frame:
One year
Reported as:
Mean · score on scale
CLCE-24
score on scaleControl ArmIntervention Arm
CLCE-2412.6 (9 to 14)10.4 (7 to 15)
PrimaryWorking Memory

Working Memory Questionnaire - 30 questions in 3 different domains of 10 questions each. First domain short term storage, second domain was attention, third domain executive aspects of working memory such as decision making, planning ahead or shifting. Each question 6 point Likert scale (0-5), three domains, maximal score 50 each for total score out of 150 with higher scores corresponding to more difficulties/complaints. Total score ranges from 0-150, with higher scores corresponding to more difficulties/complaints.

Time frame:
One Year
Reported as:
Mean · Units on a scale
Working Memory
Units on a scaleControl ArmIntervention Arm
Working Memory35.8 (14 to 51.6)31.4 (9.2 to 53.3)
PrimaryActivity of Daily Living

Activities of daily living: Each answered question was rated on a five-point Likert-type scale, ranging from 0 (no problem at all) to 4 (very severe problem in everyday life). Test is scored by taking the total score of a patient and dividing by the number of items rated and converted to percentiles, allows test to measure deficits seen with regular activities. Total score ranges from 0-100%. Test has a validated cut off points for determine positive results: 0-33% may indicate some impairment, 34-66% moderate impairment, 67+%: severe impairment. Higher values = worse outcomes

Time frame:
One year
Reported as:
Mean · percentage of impairment
Activity of Daily Living
percentage of impairmentControl ArmIntervention Arm
Activity of Daily Living23.7 (10.7 to 35.7)18.9 (2.6 to 29.6)

Adverse events

Collected over All-Cause Mortality, Serious, and Other (Not Including Serious) Adverse Events were not monitored/assessed.. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Intervention Arm———
Control Arm———

Baseline characteristics

18 subjects in the control arm completed the pre-intervention assessments for CLCE-24, working memory and Activities of daily living. 20 subjects in the Intervention arm completed the pre-intervention assessments for CLCE-24, and Activities of daily living. 19 subjects completed the working memory assessment.

Age, Categorical
Age, Categorical(Participants)Control ArmIntervention ArmTotal
<=18 years000
Between 18 and 65 years161935
>=65 years213
Sex: Female, Male
Sex: Female, Male(Participants)Control ArmIntervention ArmTotal
Female——0
Male——0
Race and Ethnicity Not Collected
Race and Ethnicity Not Collected(Participants)Control ArmIntervention ArmTotal
Count of participants——0
CLCE-24
CLCE-24(Number of complaints)Control ArmIntervention ArmTotal
Mean13.7 (8 to 21)12.1 (7 to 21)12.9 (7 to 21)
Working memory
Working memory(Units on a Scale)Control ArmIntervention ArmTotal
Mean36.17 (8 to 79)38 (12.5 to 85)37 (8 to 85)
Activity of Daily Living
Activity of Daily Living(percentage of impairment)Control ArmIntervention ArmTotal
Mean32 (6 to 82)23 (6.6 to 55.5)27.5 (6 to 82)
07

Study locations

1 site
  • Rush University Medical Center
    Chicago, Illinois 60612, United States
08

References and documents

Publications

  • Brisman JL, Song JK, Newell DW. Cerebral aneurysms. N Engl J Med. 2006 Aug 31;355(9):928-39. doi: 10.1056/NEJMra052760. No abstract available. PubMed 16943405 ↗
  • Rinkel GJ, Algra A. Long-term outcomes of patients with aneurysmal subarachnoid haemorrhage. Lancet Neurol. 2011 Apr;10(4):349-56. doi: 10.1016/S1474-4422(11)70017-5. PubMed 21435599 ↗
  • Passier PE, Visser-Meily JM, van Zandvoort MJ, Post MW, Rinkel GJ, van Heugten C. Prevalence and determinants of cognitive complaints after aneurysmal subarachnoid hemorrhage. Cerebrovasc Dis. 2010;29(6):557-63. doi: 10.1159/000306642. Epub 2010 Apr 8. PubMed 20375498 ↗
  • Sheldon S, Macdonald RL, Schweizer TA. Free recall memory performance after aneurysmal subarachnoid hemorrhage. J Int Neuropsychol Soc. 2012 Mar;18(2):334-42. doi: 10.1017/S1355617711001780. Epub 2012 Feb 13. PubMed 22325677 ↗
  • Sheldon S, Macdonald RL, Cusimano M, Spears J, Schweizer TA. Long-term consequences of subarachnoid hemorrhage: examining working memory. J Neurol Sci. 2013 Sep 15;332(1-2):145-7. doi: 10.1016/j.jns.2013.06.021. Epub 2013 Jul 18. PubMed 23871092 ↗
  • Al-Khindi T, Macdonald RL, Schweizer TA. Decision-making deficits persist after aneurysmal subarachnoid hemorrhage. Neuropsychology. 2014 Jan;28(1):68-74. doi: 10.1037/neu0000003. Epub 2013 Sep 16. PubMed 24040927 ↗
  • Chen M, Mangubat E, Ouyang B. Patient-reported outcome measures for patients with cerebral aneurysms acquired via social media: data from a large nationwide sample. J Neurointerv Surg. 2016 Jan;8(1):42-6. doi: 10.1136/neurintsurg-2014-011492. Epub 2014 Dec 1. PubMed 25452396 ↗
  • Levine B, Schweizer TA, O'Connor C, Turner G, Gillingham S, Stuss DT, Manly T, Robertson IH. Rehabilitation of executive functioning in patients with frontal lobe brain damage with goal management training. Front Hum Neurosci. 2011 Feb 17;5:9. doi: 10.3389/fnhum.2011.00009. eCollection 2011. PubMed 21369362 ↗
  • Westerberg H, Jacobaeus H, Hirvikoski T, Clevberger P, Ostensson ML, Bartfai A, Klingberg T. Computerized working memory training after stroke--a pilot study. Brain Inj. 2007 Jan;21(1):21-9. doi: 10.1080/02699050601148726. PubMed 17364516 ↗
  • Willis SL, Tennstedt SL, Marsiske M, Ball K, Elias J, Koepke KM, Morris JN, Rebok GW, Unverzagt FW, Stoddard AM, Wright E; ACTIVE Study Group. Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA. 2006 Dec 20;296(23):2805-14. doi: 10.1001/jama.296.23.2805. PubMed 17179457 ↗
  • Ball K, Berch DB, Helmers KF, Jobe JB, Leveck MD, Marsiske M, Morris JN, Rebok GW, Smith DM, Tennstedt SL, Unverzagt FW, Willis SL; Advanced Cognitive Training for Independent and Vital Elderly Study Group. Effects of cognitive training interventions with older adults: a randomized controlled trial. JAMA. 2002 Nov 13;288(18):2271-81. doi: 10.1001/jama.288.18.2271. PubMed 12425704 ↗
  • Jobe JB, Smith DM, Ball K, Tennstedt SL, Marsiske M, Willis SL, Rebok GW, Morris JN, Helmers KF, Leveck MD, Kleinman K. ACTIVE: a cognitive intervention trial to promote independence in older adults. Control Clin Trials. 2001 Aug;22(4):453-79. doi: 10.1016/s0197-2456(01)00139-8. PubMed 11514044 ↗
  • van Heugten C, Rasquin S, Winkens I, Beusmans G, Verhey F. Checklist for cognitive and emotional consequences following stroke (CLCE-24): development, usability and quality of the self-report version. Clin Neurol Neurosurg. 2007 Apr;109(3):257-62. doi: 10.1016/j.clineuro.2006.10.002. Epub 2006 Nov 28. PubMed 17126480 ↗
  • Vallat-Azouvi C, Pradat-Diehl P, Azouvi P. The Working Memory Questionnaire: a scale to assess everyday life problems related to deficits of working memory in brain injured patients. Neuropsychol Rehabil. 2012;22(4):634-49. doi: 10.1080/09602011.2012.681110. Epub 2012 Apr 27. PubMed 22537095 ↗
  • Johnson N, Barion A, Rademaker A, Rehkemper G, Weintraub S. The Activities of Daily Living Questionnaire: a validation study in patients with dementia. Alzheimer Dis Assoc Disord. 2004 Oct-Dec;18(4):223-30. PubMed 15592135 ↗
  • Wolinsky FD, Vander Weg MW, Howren MB, Jones MP, Dotson MM. A randomized controlled trial of cognitive training using a visual speed of processing intervention in middle aged and older adults. PLoS One. 2013 May 1;8(5):e61624. doi: 10.1371/journal.pone.0061624. Print 2013. PubMed 23650501 ↗

Study documents

  • Protocol and statistical analysis plan · Jun 24, 2015

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

09

Registry details

Key details

Study ID
NCT02864940
Lead sponsor
Rush University Medical Center
Collaborators
Lumos Labs, Inc.
Responsible party
Michael Chen, M.D. (Associate Professor of Neurology, Neurosurgery and Radiology, Rush University Medical Center) — Principal investigator
First posted
Aug 12, 2016
Start date
Jun 2016
Primary completion
Aug 15, 2018
Completion
Aug 28, 2018
Results posted
Apr 10, 2023
Last update
Apr 10, 2023

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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