title: Computer-Based Cognitive Training for Executive Functions after Stroke: A Systematic Review.
abstract: BACKGROUND
  Stroke commonly results in cognitive impairments in working memory, attention, and executive function, which may be restored with appropriate training programs. Our aim was to systematically review the evidence for computer-based cognitive training of executive dysfunctions.
  
  
  METHODS
  Studies were included if they concerned adults who had suffered stroke or other types of acquired brain injury, if the intervention was computer training of executive functions, and if the outcome was related to executive functioning. We searched in MEDLINE, PsycINFO, Web of Science, and The Cochrane Library. Study quality was evaluated based on the CONSORT Statement. Treatment effect was evaluated based on differences compared to pre-treatment and/or to a control group.
  
  
  RESULTS
  Twenty studies were included. Two were randomized controlled trials that used an active control group. The other studies included multiple baselines, a passive control group, or were uncontrolled. Improvements were observed in tasks similar to the training (near transfer) and in tasks dissimilar to the training (far transfer). However, these effects were not larger in trained than in active control groups. Two studies evaluated neural effects and found changes in both functional and structural connectivity. Most studies suffered from methodological limitations (e.g., lack of an active control group and no adjustment for multiple testing) hampering differentiation of training effects from spontaneous recovery, retest effects, and placebo effects.
  
  
  CONCLUSIONS
  The positive findings of most studies, including neural changes, warrant continuation of research in this field, but only if its methodological limitations are addressed.
authors.affiliation: Department of Psychology, Brain and Cognition, University of Amsterdam Amsterdam, Netherlands.
authors.forename: Renate M
authors.initials: RM
authors.lastname: van de Ven
authors.affiliation: Department of Psychology, Brain and Cognition, University of Amsterdam Amsterdam, Netherlands.
authors.forename: Jaap M J
authors.initials: JM
authors.lastname: Murre
authors.affiliation: Department of Psychiatry, VU University Medical Center Amsterdam, Netherlands.
authors.forename: Dick J
authors.initials: DJ
authors.lastname: Veltman
authors.affiliation: Department of Psychology, Brain and Cognition, University of AmsterdamAmsterdam, Netherlands; Department of Medical Psychology, Academic Medical Centre, University of AmsterdamNetherlands.
authors.forename: Ben A
authors.initials: BA
authors.lastname: Schmand
keywords: acquired brain injury; attention; brain training; computer-based; executive functions; restitution; retraining; working memory