Abstract 14916: Computerized Working Memory Training for Hypertensive Individuals With Executive Function Impairment: A Randomized Clinical Trial

Introduction: Hypertension is a risk factor for working memory (WM) impairment, and the Cogmed training has been tested as a non-pharmacological alternative to WM rehabilitation. However, the benefits of Cogmed for the hypertensive population are unknown. Therefore, we aimed to evaluate Cogmed’s effects on WM performance of hypertensive individuals with executive function (EF) impairment. Methods: We included 40 hypertensive patients (aged 40 to 70 years, 68% female) with EF impairment. They were randomized in a 1:1 ratio to receive ten weeks of adaptive Cogmed training or a non-adaptive control training based on online games. The primary outcome was the WM performance. The secondary outcomes were the performance in other neuropsychological tests, as well as the indirect neuronal activity measured using functional magnetic resonance imaging (fMRI) under two WM task conditions: low (memorization of 4 spatial locations) and high (memorization of 6 spatial locations). An intention-to-treat (ITT) and per-protocol (PP) analysis were performed. The fMRI images were evaluated with the FSL tools. Cognitive outcomes were analyzed with a mixed model for repeated measures. Results: Compared to the control group, the Cogmed group did not show significant improvement in WM or any other cognitive outcome post-training (ITT and PP analysis). However, under the WM-low load and WM-high load conditions, respectively, the Cogmed group had an activation decrease in the right superior parietal lobe (ITT and PP analysis) and left inferior frontal lobe (PP analysis) in comparison to the control group (p<0.05). Conclusions: The Cogmed showed no effects on WM performance of hypertensive individuals with EF impairment. However, activation decreases were observed in frontoparietal areas related to the WM network, suggesting intervention-related increases in neural efficiency.