Effect of action-based cognitive remediation on cognition and neural activity in bipolar disorder: study protocol for a randomized controlled trial

Abstract Background Cognitive impairment is present in bipolar disorder (BD) during the acute and remitted phases and hampers functional recovery. However, there is currently no clinically available treatment with direct and lasting effects on cognitive impairment in BD. We will examine the effect o...

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Main Authors: Caroline V. Ott, Maj Vinberg, Christopher R. Bowie, Ellen Margrethe Christensen, Gitte M. Knudsen, Lars V. Kessing, Kamilla W. Miskowiak
Format: Article
Language:English
Published: BMC 2018-09-01
Series:Trials
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13063-018-2860-8
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author Caroline V. Ott
Maj Vinberg
Christopher R. Bowie
Ellen Margrethe Christensen
Gitte M. Knudsen
Lars V. Kessing
Kamilla W. Miskowiak
author_facet Caroline V. Ott
Maj Vinberg
Christopher R. Bowie
Ellen Margrethe Christensen
Gitte M. Knudsen
Lars V. Kessing
Kamilla W. Miskowiak
author_sort Caroline V. Ott
collection DOAJ
description Abstract Background Cognitive impairment is present in bipolar disorder (BD) during the acute and remitted phases and hampers functional recovery. However, there is currently no clinically available treatment with direct and lasting effects on cognitive impairment in BD. We will examine the effect of a novel form of cognitive remediation, action-based cognitive remediation (ABCR), on cognitive impairment in patients with BD, and explore the neural substrates of potential treatment efficacy on cognition. Methods/design The trial has a randomized, controlled, parallel-group design. In total, 58 patients with BD in full or partial remission aged 18–55 years with objective cognitive impairment will be recruited. Participants are randomized to 10 weeks of ABCR or a control group. Assessments encompassing neuropsychological testing and mood ratings, and questionnaires on subjective cognitive complaints, psychosocial functioning, and quality of life are carried out at baseline, after 2 weeks of treatment, after the end of treatment, and at a six-month-follow-up after treatment completion. Functional magnetic resonance imaging scans are performed at baseline and 2 weeks into treatment. The primary outcome is a cognitive composite score spanning verbal memory, attention, and executive function. Two complete data sets for 52 patients will provide a power of 80% to detect a clinically relevant between-group difference on the primary outcome. Behavioral data will be analyzed using mixed models in SPSS while MRI data will be analyzed with the FMRIB Expert Analysis Tool (FEAT). Early treatment-related changes in neural activity from baseline to week 2 will be investigated for the dorsal prefrontal cortex and hippocampus as the regions of interest and with an exploratory whole-brain analysis. Discussion The results will provide insight into whether ABCR has beneficial effects on cognition and functioning in remitted patients with BD. The results will also provide insight into early changes in neural activity associated with improvement of cognition, which can aid future treatment development. Trial registration Clinicaltrials.gov, NCT03295305. Registered on 26 September 2017.
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spelling doaj.art-194e8236916c4671815ca99533859cba2022-12-22T01:47:55ZengBMCTrials1745-62152018-09-0119111010.1186/s13063-018-2860-8Effect of action-based cognitive remediation on cognition and neural activity in bipolar disorder: study protocol for a randomized controlled trialCaroline V. Ott0Maj Vinberg1Christopher R. Bowie2Ellen Margrethe Christensen3Gitte M. Knudsen4Lars V. Kessing5Kamilla W. Miskowiak6Copenhagen Affective Disorder Research Center (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, RigshospitaletCopenhagen Affective Disorder Research Center (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, RigshospitaletPsychology Department, Queen’s UniversityCopenhagen Affective Disorder Research Center (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, RigshospitaletNeurobiology Research Unit and Center for Experimental Medicine Neuropharmacology, RigshospitaletCopenhagen Affective Disorder Research Center (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, RigshospitaletCopenhagen Affective Disorder Research Center (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, RigshospitaletAbstract Background Cognitive impairment is present in bipolar disorder (BD) during the acute and remitted phases and hampers functional recovery. However, there is currently no clinically available treatment with direct and lasting effects on cognitive impairment in BD. We will examine the effect of a novel form of cognitive remediation, action-based cognitive remediation (ABCR), on cognitive impairment in patients with BD, and explore the neural substrates of potential treatment efficacy on cognition. Methods/design The trial has a randomized, controlled, parallel-group design. In total, 58 patients with BD in full or partial remission aged 18–55 years with objective cognitive impairment will be recruited. Participants are randomized to 10 weeks of ABCR or a control group. Assessments encompassing neuropsychological testing and mood ratings, and questionnaires on subjective cognitive complaints, psychosocial functioning, and quality of life are carried out at baseline, after 2 weeks of treatment, after the end of treatment, and at a six-month-follow-up after treatment completion. Functional magnetic resonance imaging scans are performed at baseline and 2 weeks into treatment. The primary outcome is a cognitive composite score spanning verbal memory, attention, and executive function. Two complete data sets for 52 patients will provide a power of 80% to detect a clinically relevant between-group difference on the primary outcome. Behavioral data will be analyzed using mixed models in SPSS while MRI data will be analyzed with the FMRIB Expert Analysis Tool (FEAT). Early treatment-related changes in neural activity from baseline to week 2 will be investigated for the dorsal prefrontal cortex and hippocampus as the regions of interest and with an exploratory whole-brain analysis. Discussion The results will provide insight into whether ABCR has beneficial effects on cognition and functioning in remitted patients with BD. The results will also provide insight into early changes in neural activity associated with improvement of cognition, which can aid future treatment development. Trial registration Clinicaltrials.gov, NCT03295305. Registered on 26 September 2017.http://link.springer.com/article/10.1186/s13063-018-2860-8BiomarkerBipolar disorderCognitionCognitive impairmentCognitive remediationFunctional magnetic resonance imaging
spellingShingle Caroline V. Ott
Maj Vinberg
Christopher R. Bowie
Ellen Margrethe Christensen
Gitte M. Knudsen
Lars V. Kessing
Kamilla W. Miskowiak
Effect of action-based cognitive remediation on cognition and neural activity in bipolar disorder: study protocol for a randomized controlled trial
Trials
Biomarker
Bipolar disorder
Cognition
Cognitive impairment
Cognitive remediation
Functional magnetic resonance imaging
title Effect of action-based cognitive remediation on cognition and neural activity in bipolar disorder: study protocol for a randomized controlled trial
title_full Effect of action-based cognitive remediation on cognition and neural activity in bipolar disorder: study protocol for a randomized controlled trial
title_fullStr Effect of action-based cognitive remediation on cognition and neural activity in bipolar disorder: study protocol for a randomized controlled trial
title_full_unstemmed Effect of action-based cognitive remediation on cognition and neural activity in bipolar disorder: study protocol for a randomized controlled trial
title_short Effect of action-based cognitive remediation on cognition and neural activity in bipolar disorder: study protocol for a randomized controlled trial
title_sort effect of action based cognitive remediation on cognition and neural activity in bipolar disorder study protocol for a randomized controlled trial
topic Biomarker
Bipolar disorder
Cognition
Cognitive impairment
Cognitive remediation
Functional magnetic resonance imaging
url http://link.springer.com/article/10.1186/s13063-018-2860-8
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