Amit Lampit

Background A considerable number of published reviews have addressed the treatment effects of arts-based interventions for health outcomes in people with noncommunicable diseases (NCDs). It is important to summarise this evidence base to inform policy and practice, identify research gaps, and provide research recommendations. Methods We searched The Cochrane Database of Systematic Reviews, Web of Science, CINAHL, Medline, PsycINFO, and Embase for systematic reviews published between database inception and 7 September 2023. We included systematic reviews (SR) with meta-analyses that summarised the effects of arts-based interventions on psychological, physical, cognitive functioning, or quality of life outcomes in people with cancer, cardiovascular disease (CVD), chronic respiratory disease (CRD), diabetes, mental health conditions, or neurological conditions. Eligible effect sizes (ES) were converted to standardized mean difference (SMD) with 95% confidence intervals (CI). Overall ES were calculated for each NCD population as well as across the four outcome domains, supplemented with subgroup analysis on study-, outcome-, and intervention variables. For all meta-analyses, we used restricted likelihood multilevel meta-analysis to account for non-independence of ES within individual meta-analyses. We assessed methodological quality using the Measurement Tool to Assess Systematic Reviews-2 checklist. This umbrella review was registered with PROSPERO (CRD42023493088). Findings Our search resulted in 3,885 unique citations, of which 149 SR (including 573 ES) were included in our analyses. Music and dance interventions contributed 86.6% of ES estimates. We found medium overall treatment benefits for cancer (SMD 0.47, 95% CI 0.34–0.59), cardiovascular disease (SMD 0.47, 95% CI 0.35–0.58) and mental health conditions (SMD 0.49, 95% CI 0.39–0.58), a small-to-medium overall effect for neurological conditions (SMD 0.31, 95% CI 0.24–0.37), but not for chronic respiratory disease (SMD 0.37, 95% CI -0.07–0.80). Most reviews were of low methodological quality. Interpretation Our findings indicate that people with NCDs may benefit from arts-based interventions for physical, psychological, cognitive functioning and QoL outcomes. Therefore, arts-based interventions may be a valuable addition to traditionally first-line treatments such as psychotherapies, pharmacotherapies, and standard medical treatment for NCDs.

Completing cognitive training alongside physical activity may be an effective and efficient way to improve cognitive performance. To inform ongoing randomized controlled trials (RCTs) investigating the efficacy of physical and cognitive training, intervention fidelity and participant experience should be considered. This study aimed to provide a comprehensive account of the interventions and participant experiences within a concurrent physical and cognitive training RCT. In total, 107 healthy active young adults were recruited for a 12-week investigator-blinded RCT. Participants were assigned to one of three intervention groups: (1) concurrent physical and cognitive training, (2) separate physical and cognitive training, or (3) physical-only training. Measures of physical and perceived load including power output, cadence, exertion, enjoyment, and task load, were collected in weeks 3, 7, and 10 of the intervention. Cognitive training volume and load were collected for the concurrent and separate groups over the duration of the intervention. Measures of intervention acceptability included withdrawal rates and end-of-intervention participant feedback. Participant attendance at training sessions was high (concurrent: 92 ± 7%; separate: 96 ± 6%; physical-only: 93 ± 7%); with no difference between groups ( p = 0.220). There were no differences in physical load between groups; however, compared to the concurrent group, the separate group had a higher cognitive training volume ( p = 0.001) and training fitness ( p = 0.002). Overall, participants from all groups reported that they enjoyed the physical training and experienced improvements in memory and focus from cognitive training. Concurrent physical and cognitive training appears to be a well-tolerated and time-efficient approach for investigating methods of improving cognitive performance in younger adults.

: Background: Men with prostate cancer undergoing treatment commonly report poorer cognitive performance than their age-matched controls. Within other populations, modifiable risks factors including cognitive and physical activity can independently provide potent cognitive and neuroprotective benefits. However, greater benefits may be achieved by combining stimuli simultaneously (concurrently) to promote greater neurogenesis, connectivity, and improved cognitive outcomes. This approach has been tested in older populations with and without cognitive impairment, but initial acceptability, feasibility and efficacy are yet to be demonstrated in men affected by prostate cancer. This research aims to 1) demonstrate the acceptability and feasibility of a concurrent cognitive and physical training intervention against pre-set progression criteria and, 2) provide initial estimates of intervention effectiveness on cognitive function, fatigue and quality of life in men with prostate cancer on ADT. Methods: Seventy-six men diagnosed with prostate cancer receiving androgen deprivation therapy will be the recruitment target. This pilot and feasibility study will employ a randomised controlled trial design where participants will be assigned to one of four groups: 1) concurrent training – moderate intensity stationary cycling whilst simultaneously performing computerised cognitive training, 2) moderate intensity stationary cycling only, 3) computerised cognitive training only or 4) wait-list control group. Training will be completed twice a week for 8 weeks, building up to 60 minutes per session. Assessment of the first aim will include an appraisal of recruitment success, adherence, adverse events, subjective acceptability and the principle of no cognitive harm in response to the intervention. In line with aim two, additional measures will include a computerised cognitive battery and subjective questionnaires on cognition, fatigue and quality of life. Discussion: Internationally, many men continue to grapple with the debilitating effects of cognitive decline after a diagnosis and associated treatment with little, or no, evidence-based self-management strategies advised in practice. This timely research will explore the feasibility of concurrent training to treat the cognitive side-effects of androgen deprivation therapy and, in turn, inform the design of a future large-scale clinical trial. Trial Registration: This project was registered with the Australian and New Zealand Clinical Trials Registry: ACTRN12623000767606 on 13 ^th of July 2023.

Background: Huntington’s disease (HD) is a rare neurodegenerative disease that causes progressive cognitive, physical, and psychiatric symptoms. Computerised cognitive training (CCT) is a novel intervention that aims to improve and maintain cognitive functions through repeated practice. The effects of CCT have yet to be established in HD. This randomised pilot trial examined the feasibility of a large scale trial to assess efficacy of multidomain CCT in pre-manifest and early-stage HD. Methods: 28 participants were randomised to either at-home CCT (2 × 60 min sessions per week for 12 weeks; n = 13) or lifestyle education through monthly newsletters (n = 15). Participants completed cognitive tasks and questionnaires at baseline and follow up, either in person (n = 18) or via video teleconferencing (n = 10). Results: All participants were retained at follow up, and adherence to CCT ranged from 96 to 100%, with 11/13 participants completing all sessions. Preliminary analyses showed evidence of a large effect of CCT on task switching and response inhibition, compared to lifestyle education. There was no evidence of specific benefit to other cognitive domains (processing speed, basic and divided attention, working memory), or psychosocial functions (subjective cognition, mood, health-related quality of life). Discussion: Whilst retention and adherence rates were high, recruitment rates were low, suggesting that a large scale trial may be feasible with some modifications to increase recruitment rates, such as by reducing time burden associated with the study, and using a multi-site trial design. Potential effects on cognitive functioning warrant further investigation. Clinical trial registration: The trial was prospectively registered on the Australian New Zealand Clinical Trials Registry (ACTRN12622000908730).

Huntington's disease (HD) causes progressive cognitive decline, with no available treatments. Computerized cognitive training (CCT) has shown efficacy in other populations, but its effects in HD ar...

Family caregivers of people living with dementia need easy-to-access strategies to manage changing care needs. Music therapy is valuable for supporting dementia care, but not always accessible. Technologies could potentially facilitate accessible, home-based music therapy support, but need to be carefully evaluated. We conducted an 8-week field trial of a prototype mobile application, MATCH, with caregivers and people living with dementia. MATCH contains training videos and suggested playlists showing how to use music for specific care needs. MATCH, and music streaming broadly, enabled caregivers to add new strategies to their care repertoire, addressing a range of care needs and enhancing the care relationship. To make MATCH work, however, caregivers needed to fit it into complex care environments and existing technologies. We argue that digital therapeutic tools need to be adopted by caregivers to fit their individual contexts, and this can challenge assumptions about how therapeutic tools will work in practice.

Background: Cognitive and physical exercise interventions demonstrate efficacy in improving cognition in several populations but have not been reviewed in Huntington’s disease (HD). This systematic review aims to examine the effects of cognitive and physical interventions in HD.Method: Electronic databases (MEDLINE, EMBASE, PsycINFO, CENTRAL) were searched from inception through till 10 May 2021 for interventional studies of cognitive or physical exercise interventions in HD, with any control or no control. Clinical trial registries, theses databases and organisational websites were additionally searched. The primary outcome was change on objective measures of cognition. Additional outcomes included change in psychosocial, functional and neuroimaging outcomes. Risk of bias for each outcome domain was assessed independently by two reviewers using the Cochrane RoB 2 and ROBINS‐I tools. As studies reported multiple eligible outcomes in cognitive and psychosocial domains, composite effect sizes were calculated as standardized mean differences (Hedges’ g) with 95% CI.Result: Fifteen studies (three cognitive, five physical, seven multidomain interventions) were included. There were five randomized controlled trials, two non‐randomized controlled trials and eight single arm studies. Most studies were therefore considered at serious risk of bias due to confounding. Interventions that included cognitive training (alone or combined with exercise) tended to report larger cognitive effect sizes, whereas studies of physical exercise (alone or combined with cognitive rehabilitation or stimulation) reported negligible benefits. Studies of multidomain interventions had larger effects on psychosocial functioning. Functional outcomes were only available from studies of multidomain interventions, which had negligible benefits. Across interventions, structural brain changes were reported in cortical and subcortical regions, but regions of interest and analyses were heterogeneous. No studies reported functional brain changes.Conclusion: Our review indicates that cognitive training may benefit cognition in HD, while multidomain interventions may improve psychosocial function. Cognitive and physical interventions may promote structural brain changes, but functional brain changes are unclear. Larger randomised controlled trials are required to confirm the effects of cognitive or physical interventions in HD.

Purpose of Review The incidence of sport-related concussion (SRC) has been increasing in different sports and its impact on long-term cognitive function is increasingly recognized. In this study, we review the epidemiology, neuropathophysiology, clinical symptoms, and long-term consequences of SRC with a specific focus on cognition. Recent Findings Repeated concussions are associated with an increased risk of several neurologic diseases and long-term cognitive deficits. To improve cognitive outcomes in athletes with SRC, standardized guidelines for the assessment and management of SRC are vital. However, current concussion management guidelines lack procedures for rehabilitating acute and long-term cognitive symptoms. Summary Increased awareness for the management and rehabilitation of cognitive symptoms in SRC is needed in all clinical neurologists treating professional and amateur athletes. We propose cognitive training as a prehabilitation tool to alleviate the severity of cognitive symptoms and as a rehabilitative tool to improve cognitive recovery postinjury.