Working-memory training following neonatal critical illness

Objective To test the immediate and long-term effectiveness of Cogmed Working-Memory Training (CWMT) following ECMO and/or CDH.
Design A nationwide randomized controlled trial assessing neuropsychological outcome immediately and one year post-CWMT, conducted between October 2014-June 2017. Researchers involved in the follow-up assessments were blinded to group allocation.
Setting Erasmus MC-Sophia Children’s Hospital, Rotterdam and Radboud University Medical Center, Nijmegen, the Netherlands.
Patients Eligible participants were neonatal ECMO and/or CDH survivors (8-12 years) with an IQ ≥ 80 and a z-score ≤ -1.5 on at least one (working)memory test at first assessment.
Interventions CWMT, comprising 25 sessions of 45 minutes for five consecutive weeks at home.
Measurements and Main Results Participants were randomized to CWMT (n = 19) or no intervention (n = 24) (two dropped out after T0). Verbal working-memory (estimated coefficient = 0.87; p = .002) and visuospatial working-memory (estimated coefficient = 0.96, p = .003) had significantly improved in the CWMT group at T1, but was similar between groups at T2 (verbal, p = .902; visuospatial, p = .416). Improvements were found at T2 on long-term visuospatial memory following CWMT (estimated coefficient = 0.95, p = .003). Greater improvements in this domain at T2 following CWMT were associated with better self-rated school functioning (r = .541, p = .031) and parent-rated attention (r = .672, p = .006).
Conclusions Working-memory improvements after CWMT disappeared one year post-training in neonatal ECMO and/or CDH survivors. Gains in visuospatial memory persisted one year post-intervention. CWMT may be beneficial for survivors with visuospatial memory deficits.