Cognitive Training for Visuospatial Processing in Children Aged 5½ to 6 Years Born Very Preterm With Working Memory Dysfunction
Catherine Gire
(1, 2)
,
Any Beltran Anzola
(2, 1)
,
Stéphane Marret
(3)
,
Laurence Foix L’hélias
(4, 5)
,
Jean‐christophe Rozé
(6, 7)
,
Michèle Granier
(8)
,
Hugues Patural
(9, 10)
,
Bénédicte Lecomte
(11, 12)
,
Bernard Guillois
(13)
,
Isabelle Souksi Medioni
(14)
,
Nathalie Bednarek Weirauch
(15)
,
Olivier Claris
(16)
,
Jean-Michel Hascoët
(17, 18)
,
Pierre Kuhn
(19)
,
Meriem Zahed
(1, 20)
,
Mohamed Boucekine
(2, 21)
,
Pierre-Yves Ancel
(22, 23)
,
Catherine Arnaud
(24, 25)
,
Gilles Cambonie
(26, 27)
,
Valérie Dorriere Datin
(13)
,
Barthélémy Tosello
,
Veronique Brevaut
,
Patricia Garcia
,
Tristan Desiles
,
Gwenaëlle Menard
,
Mélodie Pache
,
Ludovic-Mohamed Zahed
,
Delphine Mitanchez
,
Charlotte Coudronniere
,
Mireille Denaveaut Boulay
,
Elodie Falque
,
Magali Rebattel
,
Karine Voirin
,
Eliane Basson
,
Sophie Rubio Gurung
,
Mélanie Rodriguez
,
Hélène Deforge
,
Marie Lemarchand
,
Emeline Dubois
,
Stéphanie Iannuzzi
,
Julie Oertel
,
Anne de Saint Martin
,
Claire Zores Koenig
,
Hélène Musmeaux
,
Lucille Schneider
,
Claire Lerat
,
Angélique Pannetier
,
Isabelle Pin
,
Thierry Debillon
,
Karine Guichardet
,
Patrick Zander
,
Elie Saliba
,
Valérie Benhammou
,
Monique Kaminski
,
Laetitia Marchand-Martin
,
Samira Medjahed
,
Johanne Pirrello
,
Julie Berbis
,
Pascal Auquier
,
Karine Baumstarck
1
Hôpital Nord [CHU - APHM]
2 CEReSS - Centre d'études et de recherche sur les services de santé et la qualité de vie
3 CHU Rouen
4 CHU Trousseau [APHP]
5 UPMC - Université Pierre et Marie Curie - Paris 6
6 PhAN - Physiopathologie des Adaptations Nutritionnelles
7 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
8 Centre Hospitalier Sud Francilien
9 SAINBIOSE - Santé Ingénierie Biologie Saint-Etienne
10 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
11 CHU Estaing [Clermont-Ferrand]
12 IP - Institut Pascal
13 CHU Caen
14 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
15 CHU Reims - Hôpital universitaire Robert Debré [Reims]
16 UCBL - Université Claude Bernard Lyon 1
17 DevAH - Développement, Adaptation et Handicap
18 Maternité Régionale Adolphe Pinard [Nancy]
19 UNISTRA - Université de Strasbourg
20 CHU Montpellier
21 TIMONE - Hôpital de la Timone [CHU - APHM]
22 EPOPé [CRESS - U1153 / UMR_A 1125] - Obstetrical, Perinatal and Pediatric Epidemiology | Épidémiologie Obstétricale, Périnatale et Pédiatrique
23 CIC 1417 - CIC Cochin Pasteur
24 Equipe SPHERE (CERPOP)
25 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
26 Hôpital Arnaud de Villeneuve [CHU Montpellier]
27 Pathogénèse et contrôle des infections chroniques (PCCI)
2 CEReSS - Centre d'études et de recherche sur les services de santé et la qualité de vie
3 CHU Rouen
4 CHU Trousseau [APHP]
5 UPMC - Université Pierre et Marie Curie - Paris 6
6 PhAN - Physiopathologie des Adaptations Nutritionnelles
7 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
8 Centre Hospitalier Sud Francilien
9 SAINBIOSE - Santé Ingénierie Biologie Saint-Etienne
10 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
11 CHU Estaing [Clermont-Ferrand]
12 IP - Institut Pascal
13 CHU Caen
14 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
15 CHU Reims - Hôpital universitaire Robert Debré [Reims]
16 UCBL - Université Claude Bernard Lyon 1
17 DevAH - Développement, Adaptation et Handicap
18 Maternité Régionale Adolphe Pinard [Nancy]
19 UNISTRA - Université de Strasbourg
20 CHU Montpellier
21 TIMONE - Hôpital de la Timone [CHU - APHM]
22 EPOPé [CRESS - U1153 / UMR_A 1125] - Obstetrical, Perinatal and Pediatric Epidemiology | Épidémiologie Obstétricale, Périnatale et Pédiatrique
23 CIC 1417 - CIC Cochin Pasteur
24 Equipe SPHERE (CERPOP)
25 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
26 Hôpital Arnaud de Villeneuve [CHU Montpellier]
27 Pathogénèse et contrôle des infections chroniques (PCCI)
Jean‐christophe Rozé
- Function : Author
- PersonId : 1178599
- ORCID : 0000-0003-3367-512X
Hugues Patural
- Function : Author
- PersonId : 949048
- ORCID : 0000-0003-3984-6356
- IdRef : 142302279
Barthélémy Tosello
- Function : Author
- PersonId : 1175367
- IdHAL : barthelemy-tosello
- ORCID : 0000-0002-1801-9944
- IdRef : 169130037
Veronique Brevaut
- Function : Author
Patricia Garcia
- Function : Author
Tristan Desiles
- Function : Author
Gwenaëlle Menard
- Function : Author
Mélodie Pache
- Function : Author
Ludovic-Mohamed Zahed
- Function : Author
Delphine Mitanchez
- Function : Author
Charlotte Coudronniere
- Function : Author
Mireille Denaveaut Boulay
- Function : Author
Elodie Falque
- Function : Author
Magali Rebattel
- Function : Author
Karine Voirin
- Function : Author
Eliane Basson
- Function : Author
Sophie Rubio Gurung
- Function : Author
Mélanie Rodriguez
- Function : Author
Hélène Deforge
- Function : Author
Marie Lemarchand
- Function : Author
Emeline Dubois
- Function : Author
Stéphanie Iannuzzi
- Function : Author
Julie Oertel
- Function : Author
Anne de Saint Martin
- Function : Author
Claire Zores Koenig
- Function : Author
Hélène Musmeaux
- Function : Author
Lucille Schneider
- Function : Author
Claire Lerat
- Function : Author
Angélique Pannetier
- Function : Author
Isabelle Pin
- Function : Author
Thierry Debillon
- Function : Author
Karine Guichardet
- Function : Author
Patrick Zander
- Function : Author
Elie Saliba
- Function : Author
Valérie Benhammou
- Function : Author
Monique Kaminski
- Function : Author
Laetitia Marchand-Martin
- Function : Author
Samira Medjahed
- Function : Author
Johanne Pirrello
- Function : Author
Julie Berbis
- Function : Author
- PersonId : 1108837
- IdRef : 148075835
Pascal Auquier
- Function : Author
Karine Baumstarck
- Function : Author
Abstract
Importance Compared with term-born peers, children born very preterm generally perform poorly in executive functions, particularly in working memory and inhibition. By taking advantage of neuroplasticity, computerized cognitive training of working memory in those children could improve visuospatial processing by boosting visual inhibition via working memory. Objective To evaluate the long-term effect of cognitive working memory training on visuospatial processing in children aged 5½ to 6 years born very preterm who have working memory impairment. Design, Setting, and Participants This multicenter (18 French university hospitals), open-label randomized clinical trial with 2 parallel groups (EPIREMED) was conducted from November 2016 to April 2018, with the last follow-up during August 2019. Eligible children from the EPIPAGE 2 cohort were aged 5½ to 6 years, were born between 24 and 34 weeks’ gestation, and had a global intelligence quotient greater than 70 and a working memory index less than 85. Data were analyzed from February to December 2020. Intervention Children were randomized 1:1 to standard care management and a working memory cognitive training program (Cogmed software) for 8 weeks (25 sessions) (intervention) or to standard management (control). Main Outcomes and Measures The primary outcome was the visuospatial index score from the Wechsler Preschool and Primary Scale of Intelligence, 4th Edition. Secondary outcomes were working memory, intellectual functioning, executive and attention processes, language skills, behavior, quality of life, and schooling. Neurobehavioral assessments were performed at inclusion and after finishing training at 6 months (intermeditate assessment; secondary outcomes) and at 16 months (final assessment; primary outcome). Results There were 169 children randomized, with a mean (SD) age of 5 years 11 months (2 months); 91 (54%) were female. Of the participants, 84 were in the intervention group (57 of whom [68%] completed at least 15 cognitive training sessions) and 85 were in the control group. The posttraining visuospatial index score was not different between groups at a mean (SD) of 3.0 (1.8) months (difference, −0.6 points; 95% CI, −4.7 to 3.5 points) or 12.9 (2.6) months (difference, 0.1 points; 95% CI, −5.4 to 5.1 points). The working memory index score in the intervention group significantly improved from baseline at the intermediate time point (difference, 4.7 points; 95% CI, 1.2-8.1 points), but this improvement was not maintained at the final assessment. Conclusions and Relevance This randomized clinical trial found no lasting effect of a cognitive training program on visuospatial processing in children aged 5½ to 6 years with working memory disorders who were born very preterm. The findings suggest that this training has limited long-term benefits for improving executive function. Transient benefits seemed to be associated with the developmental state of executive functions. Trial Registration ClinicalTrials.gov Identifier: NCT02757794