DOI: 10.1002/alz.076961 ISSN: 1552-5260

An 8‐week program of computerized cognitive training with exercise impacts cortical grey matter in older adults: Secondary findings of a randomized controlled trial

Ryan G Stein, Lisanne F Brinke, Nárlon Cássio Boa Sorte Silva, Todd C Handy, Ging‐Yuek Robin Hsiung, Teresa Liu‐Ambrose
  • Psychiatry and Mental health
  • Cellular and Molecular Neuroscience
  • Geriatrics and Gerontology
  • Neurology (clinical)
  • Developmental Neuroscience
  • Health Policy
  • Epidemiology



The world’s population is aging and thus, it is important that we find strategies to reduce the rate of age‐related cognitive decline. Lifestyle interventions can play an important role in delaying the onset of cognitive decline. Evidence shows both computerized cognitive training (CCT) or exercise can improve cognitive function. However, the effect of CCT on cortical structure is not well understood. This study examines the effect of 8‐weeks of CCT, with or without a preceding exercise bout, on cortical structure in community‐dwelling older adults.


Structural magnetic resonance imaging (MRI) data acquired from an 8‐week, 3‐arm, proof of concept randomized controlled trial was used. Participants (N = 125) aged 65 – 85 were randomized (1:1:1) to either 8 weeks of 3x/week: 1) Balance and Toned (BAT; active control); 2) CCT; or 3) Exercise + CCT (Ex‐CCT). Measurement occurred at baseline and trial completion (i.e., 8‐weeks). Fifty‐three participants with baseline and trial completion MRI data were included in this analysis. Freesurfer was used to assess BAT vs. CCT, BAT vs. Ex‐CCT, and CCT vs. Ex‐CCT differences in cortical thickness and volume at trial completion, adjusting for age, sex, and Montreal Cognitive Assessment (MoCA) score.


At trial completion, CCT vs. BAT decreased left rostral middle frontal gyrus volume (cluster size = 553.51 mm2, cluster‐wise p = .027) and left superior temporal gyrus thickness (cluster size = 525.58 mm2, cluster‐wise p = .039). Ex‐CCT vs. BAT increased cortical thickness in the left (cluster size = 900.23 mm2, cluster‐wise p = .001) and right (cluster size = 681.95 mm2, cluster‐wise p = .020) superior parietal gyri. Finally, Ex‐CCT vs. CCT increased left cuneus thickness (cluster size = 1062.12 mm2, cluster‐wise p < .001) as well as right post central gyrus thickness (cluster size = 714.85 mm2, cluster‐wise p = .005) and volume (cluster size = 1030.08 mm2, cluster‐wise p < .001).


Eight weeks of CCT with exercise is of sufficient duration to induce structural change in the brain. Moreover, exercise may enhance the effect of CCT on cortical grey matter structure vs. CCT alone.

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