Effects of an app-based sensorimotor training in promoting neuroplasticity and neuropsychological functioning in frailty: A randomized controlled trial

Florian Beier; Martin Löffler; Frauke Nees; Robin Bekrater-Bodmann; Stefano Silvoni; Simon Desch; Annette Löffler; Lucrezia Hausner; Lutz Frölich; Herta Flor

doi:10.1016/j.archger.2023.105202

Effects of an app-based sensorimotor training in promoting neuroplasticity and neuropsychological functioning in frailty: A randomized controlled trial

Arch Gerontol Geriatr. 2023 Dec:115:105202. doi: 10.1016/j.archger.2023.105202. Epub 2023 Sep 17.

Authors

Affiliations

¹ Medical Faculty Mannheim, Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Heidelberg University, Square J5, Mannheim 68159, Germany. Electronic address: florian.beier@zi-mannheim.de.
² Medical Faculty Mannheim, Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Heidelberg University, Square J5, Mannheim 68159, Germany; Department of Experimental Psychology, Clinical Psychology, Heinrich Heine University Düsseldorf, Germany; Integrative Spinal Research Group, Department of Chiropractic Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
³ Medical Faculty Mannheim, Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Heidelberg University, Square J5, Mannheim 68159, Germany; Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany.
⁴ Medical Faculty Mannheim, Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Heidelberg University, Square J5, Mannheim 68159, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany.
⁵ Medical Faculty Mannheim, Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Heidelberg University, Square J5, Mannheim 68159, Germany.
⁶ Medical Faculty Mannheim, Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Heidelberg University, Square J5, Mannheim 68159, Germany; Department of Experimental Psychology, Clinical Psychology, Heinrich Heine University Düsseldorf, Germany.
⁷ Medical Faculty Mannheim, Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Heidelberg University, Square J5, Mannheim 68159, Germany; Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
⁸ Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
⁹ Medical Faculty Mannheim, Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Heidelberg University, Square J5, Mannheim 68159, Germany; Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany.

PMID: 37776754
DOI: 10.1016/j.archger.2023.105202

Abstract

Background: Loss of sensorimotor stimulation and maladaptive plastic changes of the brain may play a major role in problematic aging phenomena such as frailty. However, it is not clear if interventions specifically targeting neuroplasticity can reverse or slow the development of frailty.

Objectives: We compared the effect of a tablet-based neuroplasticity-oriented sensorimotor training (experimental group, EG) and a tablet-based relaxation training (control group, CG) on frailty and sensorimotor brain function.

Methods: Interventions consisted of daily 30 min sessions distributed over 90 days. Assessments took place at baseline, after 60 days, and after 90 days. A total of N = 48 frail older adults (EG: n = 24; CG: n = 24) were assigned to the two groups and reassessed after 60 days. Primary outcomes included frailty phenotype (FP) and frailty index (FI). Sensorimotor brain activity was evaluated using functional magnetic resonance imaging and single-pulse transcranial magnetic stimulation.

Results: After 60 days of training, both groups showed a reduction in the number of FP criteria (p < 0.001) with a trend towards a significant time-by-group interaction (p = 0.058) indicating a stronger reduction of frailty in the EG (p < 0.001) compared to the CG (p = 0.039). In addition, pain was significantly reduced in the EG but not the CG. No significant effects were found for measures of brain function.

Discussion: We provided initial evidence that a neuroplasticity-oriented sensorimotor training could be beneficial in counteracting frailty as well as chronic pain. Further studies are needed to determine the potentially underlying neuroplastic mechanisms and the influence of plasticity-related biomarkers as well as their clinical significance.

Trial registration: ClinicalTrials.gov NCT03666039 (registered 11 September 2018).

Keywords: Aging; Frailty; Neuroplasticity; Sensorimotor functioning; Training app.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Brain
Frail Elderly / psychology
Frailty*
Humans
Mobile Applications*
Neuronal Plasticity

Associated data

ClinicalTrials.gov/NCT03666039