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Behavioral and neuronal substrates of serious game‐based computerized cognitive training in cognitive decline related to Alzheimer's Disease
Esther Brill, Alexa Frederike Holfelder, Michael Falkner, Christine R. Krebs, Anna‐Katharine Brem, Stefan Klöppel. Alzheimer s & Dementia, 2025-12-01
Topic: Amyloid, tau and blood-test diagnosis
Significant improvement over time was observed in aggregated domain specific composite scores of episodic and semantic memory and spatial abilities. However, there was no significant interaction between groups and timepoints. Adherence to the training protocol was consistently high across timepoints and groups (4.87 sessions per week). Voxel-based morphometry revealed no significant changes in grey matter volume following CCT, nor did amyloid levels moderate its effectiveness. Significant cognitive and subjective improvements were observed after long-term training. This RCT indicates no specific advantages of a three-month CCT intervention on cognitive or biological outcomes. However, the consistently high adherence rates observed in this study highlight the importance of designing interventions that align with personal relevance and individual values, particularly in subjects with SCD and MCI who demonstrated high motivation to engage in healthy aging behaviors. Further, positive effects were observed subjectively and after long-term CCT, warranting the inclusion of CCT in multicomponent interventions.
Key findings
- Significant improvement over time was observed in aggregated domain specific composite scores of episodic and semantic memory and spatial abilities.
- However, there was no significant interaction between groups and timepoints.
- Adherence to the training protocol was consistently high across timepoints and groups (4.87 sessions per week).
- Voxel-based morphometry revealed no significant changes in grey matter volume following CCT, nor did amyloid levels moderate its effectiveness.
- Significant cognitive and subjective improvements were observed after long-term training.
Why it matters
This randomized controlled trial found no significant interaction between groups and timepoints for computerized cognitive training, no significant changes in grey matter volume, and no moderating effect of amyloid levels, though cognitive and subjective improvements were seen over time. It concludes there were no specific advantages of the three-month intervention on cognitive or biological outcomes, while noting high adherence and suggesting inclusion of cognitive training in multicomponent interventions.
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Study details
- Study designlongitudinal study
- Participants155
- Evidence strengthHigh
How this study scored 49/100
Published in a peer-reviewed journal, and it is a longitudinal study following the same people over time. Scored zero for effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer s & Dementia) |
| Journal's citation record | 2 / 4 | Alzheimer s & Dementia: journal h-index 228 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A longitudinal study following the same people over time |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 2 / 4 | 155 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 0 / 6 | Cited 0.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Stefan Klöppel: h-index 67 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | King's College London: institution h-index 1,348 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41447190) |
| Free to read | 2 / 2 | Free to read |
| Total | 49 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1002/alz70857_102105
- PubMed: 41447190
- Original source →
- Free full text: Alzheimer s & Dementia →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Brill, E., Holfelder, A. F., Falkner, M., Krebs, C. R., Brem, A., & Klöppel, S. (2025). Behavioral and neuronal substrates of serious game‐based computerized cognitive training in cognitive decline related to Alzheimer's Disease. Alzheimer s & Dementia. https://doi.org/10.1002/alz70857_102105
Vancouver
Brill E, Holfelder AF, Falkner M, Krebs CR, Brem A, Klöppel S. Behavioral and neuronal substrates of serious game‐based computerized cognitive training in cognitive decline related to Alzheimer's Disease. Alzheimer s & Dementia. 2025. doi:10.1002/alz70857_102105. PMID: 41447190.
BibTeX
@article{brill2025-41447190,
author = {Brill, Esther and Holfelder, Alexa Frederike and Falkner, Michael and Krebs, Christine R. and Brem, Anna‐Katharine and Klöppel, Stefan},
title = {{Behavioral and neuronal substrates of serious game‐based computerized cognitive training in cognitive decline related to Alzheimer's Disease}},
journal = {Alzheimer s \& Dementia},
year = {2025},
doi = {10.1002/alz70857_102105},
pmid = {41447190},
url = {https://doi.org/10.1002/alz70857_102105}
}
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