Background: Cognitive training may enhance cognition and support brain health during aging, but few trials have evaluated readily accessible chatbot-based programs with neuroimaging outcomes. Objective: This study aimed to evaluate the effects of a chatbot-based cognitive training program on white matter microstructural organization and cognition in cognitively unimpaired older adults. Methods: In a single-blind randomized controlled trial, 72 cognitively unimpaired older adults were assigned to chatbot-based cognitive training (30 min/day, 5 days/week for 12 weeks; n=37) or a no-intervention control (n=35). Diffusion tensor imaging at baseline and 12 weeks quantified fractional anisotropy (FA) in predefined white matter tracts, and cognition was assessed with the Cambridge Neuropsychological Test Automated Battery. Results: Groups were comparable at baseline. After 12 weeks, the training group showed significantly less FA reduction than controls in the bilateral tapetum and right posterior thalamic radiation, surviving false discovery rate control (P

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Background: Training visual processing skills, a domain implicated in sport performance and injury risk, could reduce injuries among youth athletes. The useful field of view (UFOV) cognitive training program improves visual processing efficiency. While UFOV training has been extensively studied in aging populations and yields significant cognitive and functional benefits, it has yet to be examined in adolescents. Objective: The aim of this study is to preliminarily assess the #feasibility and acceptability of UFOV training in youth and report on the magnitude of change in visual processing efficiency from pre- to posttraining. Methods: Six adolescent athletes (aged 14‐18 years) completed a 5-week adaptive, online, remote UFOV training program. The UFOV training program has a gamelike interface and increases in difficulty as participants accurately identify and locate targets that are rapidly displayed in the center and at the periphery of their screen amid distractors. Participants were assigned a total training dose of 250 levels across 5 weeks, with 5 scheduled sessions per week, each lasting approximately 25 minutes (equating to approximately 10.42 hours of assigned training time). Individuals met remotely with research staff weekly to receive coaching. We examined #feasibility by calculating overall dose adherence (percentage of assigned levels completed) and regimen adherence (percentage of scheduled training sessions completed). Average overall acceptability, program #usability, adoptability, and perceived benefit were calculated using responses to a posttraining survey, where item-level responses ranged from 1 to 7 on a Likert scale (responses greater than 4 reflected a view more positive than neutral toward the program). Participants completed the Double Decision Assessment pre- and posttraining to quantify the magnitude of change in visual processing efficiency. Results: In this pilot cohort, we observed strong dose (mean 95.33%, SD 11.43%) and regimen (mean 90.67%, SD 12.56%) adherence. Participants’ responses to the acceptability survey suggested positive views of the program overall (mean 5.47, SD 0.4) and in terms of #usability (mean 5.69, SD 0.43), perceived benefit (mean 5.36, SD 0.69), and adoptability (mean 5.17, SD 0.61). All participants demonstrated improved visual processing efficiency from pre- to posttraining (mean difference of 168.67, SD 112.05 ms; Cohen =1.51). Conclusions: Though preliminary, results suggest that UFOV training may be feasible and acceptable for adolescent athletes. All participants in this pilot study demonstrated improvements in visual processing efficiency after completing 5 weeks of training. Further research is needed to investigate the #feasibility of implementing this training in other contexts, such as without research team support or in a group setting. Future work should also evaluate the extent to which UFOV training improves visual processing more than an active control intervention and whether visual processing improvements transfer to untrained skills to reduce the risk of sport-related injury.

Background: Repetitive transcranial magnetic stimulation induces neural plasticity, which may be maximized via adjunctive interventions. Objective: This study aimed to examine the feasibility and acceptability of interleaving computerized cognitive training (CCT) with accelerated intermittent theta burst (iTBS) repetitive transcranial magnetic stimulation in 2 open-label phase I trials of amnestic mild cognitive impairment (aMCI; NCT04503096) and poststroke mild cognitive impairment (psMCI; NCT04655963). Methods: Participants (aMCI: n=21; and psMCI: n=14) received 24 sessions of accelerated iTBS over 3 days (8 sessions per day). During the 10‐ to 15-minute intervals between iTBS sessions, participants engaged in CCT via the BrainHQ platform. During the 4-week follow-up period, participants were asked to complete 20 minutes daily of BrainHQ. Both studies offered identical compensation for daily practice, but the aMCI group received weekly reminders, whereas the psMCI group did not. Study-specific questionnaires assessed BrainHQ acceptability (administered post-treatment and at follow-up). Results: During in-laboratory treatment, the groups completed similar amounts of BrainHQ (aMCI: median 107, IQR 92-121 min; and psMCI: median 111, IQR 93-137 min; =.51). However, engagement differed during the unmonitored follow-up (aMCI: median 450, IQR 167-581 min,; and psMCI: median 142, IQR 0-477 min); practice time increased in the aMCI group but decreased in the psMCI group over the 4 weeks (=.001). Both groups generally rated BrainHQ positively at both time points in terms of their experience with the platform, exercises, and perceived benefit for their mood and functioning. Conclusions: Combined treatment with CCT and accelerated iTBS is feasible and acceptable in people with mild cognitive impairment. Standardized dosing of CCT is feasibly achieved when interleaved with iTBS sessions and completed in-laboratory, but ecological adherence to CCT in an unmonitored, self-directed context likely requires additional supports and may be influenced by patient characteristics. Trial Registration: ClinicalTrials.gov NCT04503096; https://clinicaltrials.gov/study/NCT04503096 and NCT04655963; https://clinicaltrials.gov/study/NCT04655963