Multidomain Computerized Cognitive Training Enhances Memory Network Connectivity and Grey Matter in CHD Patients with MCI

Patients with coronary heart disease (CHD) frequently develop mild cognitive impairment (MCI), which is associated with detrimental alterations in memory-related brain networks. Current interventions often fall short in directly addressing these neural deficits. While computerized cognitive training (CCT) holds promise for enhancing cognition through neuroplasticity, it has been unclear whether multidomain adaptive CCT can induce specific structural and functional plasticity within memory circuits in this vulnerable population, and if these neural changes correlate with improved cognitive and cardiovascular outcomes.

This secondary analysis of a multicenter, randomized trial enrolled 185 participants with CHD and MCI. Patients were randomized to receive either multidomain adaptive CCT or basic CCT as an active control. The intervention lasted 12 weeks. At baseline and post-intervention, participants underwent multimodal MRI to assess functional connectivity (FC) of the Parietal Memory Network (PMN) and Context Association Network (CAN), grey matter volume, and structural connectivity of key regions. Cognitive testing and blood pressure measurements were also performed to evaluate associations with neural changes.

Multidomain adaptive CCT significantly improved several hypothesis-driven outcomes. Within-memory network FC increased significantly in the left CAN (p=0.045), right CAN (p=0.031), and left PMN (p=0.028). Right PMN whole-brain connectivity also saw a significant increase (p=0.010). Exploratory analyses further revealed that training-induced FC increased between PMN/CAN and multiple other brain networks (pFDR < 0.05).