A Randomized Controlled Trial to Evaluate if Computerized Cognitive Rehabilitation Improves Neurocognition in Ugandan Children with HIV.

Journal: AIDS research and human retroviruses

Volume: 32

Issue: 8

Year of Publication: 2017

Affiliated Institutions:  Departments of Psychiatry and Neurology & Ophthalmology, Michigan State University , East Lansing, Michigan. Department of Psychiatry, Makerere University School of Medicine , Kampala, Uganda . Department of Statistics and Probability, Michigan State University , East Lansing, Michigan. Department of Paediatrics and Child Health, Makerere University School of Medicine , Kampala, Uganda . Departments of Psychiatry, Neurology, and Psychology, School of Nursing, University of Michigan , Ann Arbor, Michigan.

Abstract summary 

Clinically stable children with HIV can have neuromotor, attention, memory, visual-spatial, and executive function impairments. We evaluated neuropsychological and behavioral benefits of computerized cognitive rehabilitation training (CCRT) in Ugandan HIV children.One hundred fifty-nine rural Ugandan children with WHO Stage I or II HIV disease (6 to 12 years; 77 boys, 82 girls; M = 8.9, SD = 1.86 years) were randomized to one of three treatment arms over a 2-month period.The CCRT arm received 24 one-hour sessions over 2 months, using Captain's Log (BrainTrain Corporation) programmed for games targeting working memory, attention, and visual-spatial analysis. These games progressed in difficulty as the child's performance improved. The second arm was a "limited CCRT" with the same games rotated randomly from simple to moderate levels of training. The third arm was a passive control group receiving no training. All children were assessed at enrollment, 2 months (immediately following CCRT), and 3 months after CCRT completion.The CCRT group had significantly greater gains through 3 months of follow-up compared to passive controls on overall Kaufman Assessment Battery for Children-second edition (KABC-II) mental processing index (p < .01), planning (p = .04), and knowledge (p = .03). The limited CCRT group performed better than controls on learning (p = .05). Both CCRT arms had significant improvements on CogState Groton maze learning (p < .01); although not on CogState attention/memory, TOVA/impulsivity, or behavior rating inventory for executive function and child behavior checklist (psychiatric behavior/symptom problems) ratings by caregiver.CCRT intervention can be effective for neurocognitive rehabilitation in children with HIV in low-resource settings, especially in children who are clinically stable on ARV treatment.

Authors & Co-authors:  Boivin Michael J MJ Nakasujja Noeline N Sikorskii Alla A Opoka Robert O RO Giordani Bruno B

Study Outcome 

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Statistics
Citations :  Ciaranello AL, Chang Y, Margulis AV, Bernstein A, Bassett IV, Losina E, et al. : Effectiveness of pediatric antiretroviral therapy in resource-limited settings: A systematic review and meta-analysis. Clin Infect Dis 2009;49:1915–1927
Authors :  5
Identifiers
Doi : 10.1089/AID.2016.0026
SSN : 1931-8405
Study Population
Male,Female
Mesh Terms
Anti-HIV Agents
Other Terms
Study Design
Randomized Control Trial,Case Control Trial,Cross Sectional Study
Study Approach
Country of Study
Uganda
Publication Country
United States