title: Immediate neuropsychological and behavioral benefits of computerized cognitive rehabilitation in Ugandan pediatric cerebral malaria survivors.
abstract: OBJECTIVE
  Our earlier studies on Ugandan children surviving cerebral malaria showed cognitive deficits mainly in attention and memory. We now present the first study in sub-Saharan Africa to investigate the feasibility and potential benefits of computerized cognitive rehabilitation training on neuropsychological and behavioral functioning of children surviving cerebral malaria.
  
  
  METHODS
  A randomized trial in which 65 children admitted 45 months earlier with cerebral malaria were recruited at Mulago Hospital, Kampala, Uganda. For 8 weeks, 32 of the children received weekly training sessions using Captain's Log cognitive training software and the other 33 were assigned to a nontreatment condition. Pre- and postintervention assessments were completed using CogState, a computerized neuropsychological battery, measuring visuomotor processing speed, working memory, learning, attention and psychomotor speed and the Child Behavior Checklist measuring internalizing problems, externalizing problems, and total problems.
  
  
  RESULTS
  Preintervention scores were similar between both groups. Treatment effects were observed on visuospatial processing speed [group effect (standard error) 0.14 (0.03); p < .001], on a working memory and learning task [0.08 (0.02); p < .001], psychomotor speed [0.14 (0.07); p = .04], and on internalizing problems [-3.80 (1.56); p = .02] after controlling for age, sex, school grade, quality of the home environment, and weight for age z scores. Similar treatment effects were observed when no adjustments for the above covariates were made.
  
  
  CONCLUSIONS
  Computerized cognitive training long after the cerebral malaria episode has immediate benefit on some neuropsychological and behavioral functions in African children. The long-term benefit of this intervention needs to be investigated.
authors: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden. pbangirana@yahoo.com
authors: Paul
authors: P
authors: Bangirana
authors: Bruno
authors: B
authors: Giordani
authors: Chandy C
authors: CC
authors: John
authors: Connie
authors: C
authors: Page
authors: Robert O
authors: RO
authors: Opoka
authors: Michael J
authors: MJ
authors: Boivin
mesh_terms: D000704:Analysis of Variance; D002648:Child; D003072:Cognition Disorders / Q000209:etiology / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003201:Computers; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016779:Malaria, Cerebral / Q000523:psychology*; D008297:Male; D009483:Neuropsychological Tests; D012984:Software; D017741:Survivors; D013997:Time Factors; D016896:Treatment Outcome; D014454:Uganda