Cognitive training and promoting a healthy lifestyle for individuals with isolated REM sleep behavior disorder: study protocol of the delayed-start randomized controlled trial CogTrAiL-RBD.

BACKGROUND: Isolated REM sleep behavior disorder (iRBD) is an early α-synucleinopathy often accompanied by incipient cognitive impairment. As executive dysfunctions predict earlier phenotypic conversion from iRBD to Parkinson's disease and Lewy body dementia, cognitive training focusing on executive functions could have disease-modifying effects for individuals with iRBD. METHODS: The study CogTrAiL-RBD investigates the short- and long-term effectiveness and the feasibility and underlying neural mechanisms of a cognitive training intervention for individuals with iRBD. The intervention consists of a 5-week digital cognitive training accompanied by a module promoting a healthy, active lifestyle. In this monocentric, single-blinded, delayed-start randomized controlled trial, the intervention's effectiveness will be evaluated compared to an initially passive control group that receives the intervention in the second, open-label phase of the study. Eighty individuals with iRBD confirmed by polysomnography will be consecutively recruited from the continuously expanding iRBD cohort at the University Hospital Cologne. The evaluation will focus on cognition and additional neuropsychological and motor variables. Furthermore, the study will examine the feasibility of the intervention, effects on physical activity assessed by accelerometry, and interrogate the intervention's neural effects using magnetic resonance imaging and polysomnography. Besides, a healthy, age-matched control group (HC) will be examined at the first assessment time point, enabling a cross-sectional comparison between individuals with iRBD and HC. DISCUSSION: This study will provide insights into whether cognitive training and psychoeducation on a healthy, active lifestyle have short- and long-term (neuro-)protective effects for individuals with iRBD. TRIAL REGISTRATION: The study was prospectively registered in the German Clinical Trial Register (DRKS00024898) on 2022-03-11, https://drks.de/search/de/trial/DRKS00024898 . PROTOCOL VERSION: V5 2023-04-24.

Stronger functional connectivity during reading contextually predictable words in slow readers.

The effect of word predictability is well-documented in terms of local brain activation, but less is known about the functional connectivity among those regions associated with processing predictable words. Evidence from eye movement studies showed that the effect is much more pronounced in slow than in fast readers, suggesting that speed-impaired readers rely more on sentence context to compensate for their difficulties with visual word recognition. The present study aimed to investigate differences in functional connectivity of fast and slow readers within core regions associated with processing predictable words. We hypothesize a stronger synchronization between higher-order language areas, such as the left middle temporal (MTG) and inferior frontal gyrus (IFG), and the left occipito-temporal cortex (OTC) in slow readers. Our results show that slow readers exhibit more functional correlations among these connections; especially between the left IFG and OTC. We interpret our results in terms of the lexical quality hypothesis which postulates a stronger involvement of semantics on orthographic processing in (speed-)impaired readers.