title: A Randomized Controlled Trial to Evaluate if Computerized Cognitive Rehabilitation Improves Neurocognition in Ugandan Children with HIV.
abstract: Clinically stable children with HIV can have neuromotor, attention, memory, visual-spatial, and executive function impairments. We evaluated neuropsychological and behavioral benefits of computerized cognitive rehabilitation training (CCRT) in Ugandan HIV children.
  
  
  
  One hundred fifty-nine rural Ugandan children with WHO Stage I or II HIV disease (6 to 12 years; 77 boys, 82 girls; M = 8.9, SD = 1.86 years) were randomized to one of three treatment arms over a 2-month period.
  
  
  
  The CCRT arm received 24 one-hour sessions over 2 months, using Captain's Log (BrainTrain Corporation) programmed for games targeting working memory, attention, and visual-spatial analysis. These games progressed in difficulty as the child's performance improved. The second arm was a "limited CCRT" with the same games rotated randomly from simple to moderate levels of training. The third arm was a passive control group receiving no training. All children were assessed at enrollment, 2 months (immediately following CCRT), and 3 months after CCRT completion.
  
  
  
  The CCRT group had significantly greater gains through 3 months of follow-up compared to passive controls on overall Kaufman Assessment Battery for Children-second edition (KABC-II) mental processing index (p < .01), planning (p = .04), and knowledge (p = .03). The limited CCRT group performed better than controls on learning (p = .05). Both CCRT arms had significant improvements on CogState Groton maze learning (p < .01); although not on CogState attention/memory, TOVA/impulsivity, or behavior rating inventory for executive function and child behavior checklist (psychiatric behavior/symptom problems) ratings by caregiver.
  
  
  
  CCRT intervention can be effective for neurocognitive rehabilitation in children with HIV in low-resource settings, especially in children who are clinically stable on ARV treatment.
authors.affiliation: 1 Departments of Psychiatry and Neurology & Ophthalmology, Michigan State University , East Lansing, Michigan.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Boivin
authors.affiliation: 2 Department of Psychiatry, Makerere University School of Medicine , Kampala, Uganda .
authors.forename: Noeline
authors.initials: N
authors.lastname: Nakasujja
authors.affiliation: 3 Department of Statistics and Probability, Michigan State University , East Lansing, Michigan.
authors.forename: Alla
authors.initials: A
authors.lastname: Sikorskii
authors.affiliation: 4 Department of Paediatrics and Child Health, Makerere University School of Medicine , Kampala, Uganda .
authors.forename: Robert O
authors.initials: RO
authors.lastname: Opoka
authors.affiliation: 5 Departments of Psychiatry, Neurology, and Psychology, School of Nursing, University of Michigan , Ann Arbor, Michigan.
authors.forename: Bruno
authors.initials: B
authors.lastname: Giordani
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use; D002648:Child; D060825:Cognitive Dysfunction / Q000523:psychology / Q000534:rehabilitation* / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000523:psychology / Q000534:rehabilitation* / Q000821:virology; D006801:Humans; D007858:Learning / Q000502:physiology*; D008297:Male; D018782:Maze Learning / Q000502:physiology*; D009483:Neuropsychological Tests; D012424:Rural Population; D014454:Uganda; D018910:Video Games / Q000523:psychology
chemical_list: D019380:Anti-HIV Agents