Abstract：
Cognitive training (CT) programs aim to improve cognitive performance and impede its decline. Thus, defining the characteristics of individuals who can benefit from these interventions is essential. Our objectives were to assess if the cognitive reserve (CR), APOE genotype (e4 carriers/non-carriers) and/or hippocampal volume might predict the effectiveness of a CT program. Participants were older adults without dementia (n = 226), randomized into parallel experimental and control groups. The assessment consisted of a neuropsychological protocol and additional data regarding total intracranial, gray matter, left/right hippocampus volume; APOE genotype; and Cognitive Reserve (CR). The intervention involved multifactorial CT (30 sessions, 90 min each), with an evaluation pre- and post-training (at six months); the control group simply following the center\'s routine activities. The primary outcome measures were the change in cognitive performance and the predictors of change. The results show that APOE-e4 non-carriers (79.1%) with a larger left hippocampal volume achieved better gains in semantic verbal fluency (R2 = .19). Subjects with a larger CR and a greater gray matter volume better improved their processing speed (R2 = .18). Age was correlated with the improvement in executive functions, such that older age predicts less improvement (R2 = .07). Subjects with a larger left hippocampal volume achieved more significant gains in general cognitive performance (R2 = .087). In conclusion, besides the program itself, the effectiveness of CT depends on age, biological factors like genotype and brain volume, and CR. Thus, to achieve better results through a CT, it is essential to consider the different characteristics of the participants, including genetic factors.Trial registration: Trial retrospectively registered on January 29th, 2020-(ClinicalTrials.gov -NCT04245579).
摘要：
认知训练（CT）计划旨在提高认知能力并阻止其下降。因此，确定可以从这些干预措施中受益的个人的特征至关重要。我们的目标是评估认知储备(CR)APOE基因型（e4携带者/非携带者）和/或海马体积可能预测CT程序的有效性。参与者是没有痴呆的老年人（n=226），随机分为平行实验组和对照组。评估包括神经心理学方案和关于总颅内的其他数据，灰质,左/右海马体积；APOE基因型；认知储备（CR）。干预涉及多因素CT(30次，每个90分钟)，在培训前和培训后（六个月）进行评估；对照组仅遵循中心的常规活动。主要结果指标是认知表现的变化和变化的预测因素。结果表明，左海马体积较大的APOE-e4非携带者（79.1％）在语义言语流畅性方面获得了更好的提高（R2=.19）。具有较大CR和较大灰质体积的受试者更好地提高了他们的处理速度(R2=.18)。年龄与执行功能的改善相关，因此，年龄较大预测改善较小(R2=.07)。具有较大左海马体积的受试者在一般认知表现方面获得了更显著的增益(R2=.087)。总之,除了程序本身，CT的有效性取决于年龄，生物学因素，如基因型和脑体积，和CR。因此，为了通过CT获得更好的结果，必须考虑参与者的不同特征，包括遗传因素。审判登记:1月29日追溯登记的审判,2020-（ClinicalTrials.gov-NCT04245579）。
