Individuals with mild cognitive impairment (MCI) experience cognitive difficulties and many find themselves in a transitional stage between aging and dementia, making this population a suitable target for cognitive intervention. In MCI, not all cognitive functions are impaired and preserved functions can thus be recruited to compensate for the impact of cognitive impairment. Improving cognition may have a tremendous impact on quality of life and help delay the loss of autonomy that comes with dementia. Several studies have reported evidence of cognitive benefits following cognitive intervention in individuals with MCI. Studies that relied on training memory and attentional control have provided the most consistent evidence for cognitive gains. A few studies have investigated the neurophysiological processes by which these training effects occur. More research is needed to draw clear conclusions on the type of brain processes that are engaged in cognitive training and there are insufficient findings regarding transfer to activities of daily life. Results from recent studies using new technologies such as virtual reality provide encouraging evidence of transfer effects to real-life situations.
Benjamin Boller and Sylvie Belleville
Aidan Moran, Nick Sevdalis, and Lauren Wallace
At first glance, there are certain similarities between performance in surgery and that in competitive sports. Clearly, both require exceptional gross and fine motor ability and effective concentration skills, and both are routinely performed in dynamic environments, often under time constraints. On closer inspection, however, crucial differences emerge between these skilled domains. For example, surgery does not involve directly antagonistic opponents competing for victory. Nevertheless, analogies between surgery and sport have contributed to an upsurge of research interest in the psychological processes that underlie expertise in surgical performance. Of these processes, perhaps the most frequently investigated in recent years is that of motor imagery (MI) or the cognitive simulation skill that enables us to rehearse actions in our imagination without engaging in the physical movements involved. Research on motor imagery training (MIT; also called motor imagery practice, MIP) has important theoretical and practical implications. Specifically, at a theoretical level, hundreds of experimental studies in psychology have demonstrated the efficacy of MIT/MIP in improving skill learning and skilled performance in a variety of fields such as sport and music. The most widely accepted explanation of these effects comes from “simulation theory,” which postulates that executed and imagined actions share some common neural circuits and cognitive mechanisms. Put simply, imagining a skill activates some of the brain areas and neural circuits that are involved in its actual execution. Accordingly, systematic engagement in MI appears to “prime” the brain for optimal skilled performance. At the practical level, as surgical instruction has moved largely from an apprenticeship model (the so-called see one, do one, teach one approach) to one based on simulation technology and practice (e.g., the use of virtual reality equipment), there has been a corresponding growth of interest in the potential of cognitive training techniques (e.g., MIT/MIP) to improve and augment surgical skills and performance. Although these cognitive training techniques suffer both from certain conceptual confusion (e.g., with regard to the clarity of key terms) and inadequate empirical validation, they offer considerable promise in the quest for a cost-effective supplementary training tool in surgical education. Against this background, it is important for researchers and practitioners alike to explore the cognitive psychological factors (such as motor imagery) that underlie surgical skill learning and performance.
Jeffrey J. Lockman, Nicholas E. Fears, and Emily A. Lewis
Spatial ability is manifest across different psychological domains, including perception, action, and cognition. The development of spatial understanding originates in the perception-action skills of infants. When infants act on the world, either during object manipulation or locomotion, one may begin to glean the foundations of older children’s and adults’ efforts to think, reason, and solve problems more symbolically and abstractly. Even during infancy, different actions, such as reaching and locomotion, may incur different spatial demands, requiring infants to use spatial information flexibly. In the preschool years and beyond, as symbolic skills become more developed, children’s spatial abilities become more abstract, which are reflected in their abilities to think about the layout of environments and to use maps to learn about environments. Besides differences in spatial ability as a function of developmental level, individual differences in spatial ability have also been documented as a function of gender, daily experience, and blindness. Collectively, research on individual differences in spatial development suggests that training procedures can reduce differences in spatial skill that may arise in different individuals. Finally, to understand spatial development more fully, research is needed on the neural bases of spatial development, cross-cultural differences in spatial development, and the impact of technology on spatial behavior.
Karen Z. H. Li, Halina Bruce, and Rachel Downey
Research on the interplay of cognition and mobility in old age is inherently multidisciplinary, informed by findings from life span developmental psychology, kinesiology, cognitive neuroscience, and rehabilitation sciences. Early observational work revealed strong connections between sensory and sensorimotor performance with measures of intellectual functioning. Subsequent work has revealed more specific links between measures of cognitive control and gait quality. Convergent evidence for the interdependence of cognition and mobility is seen in patient studies, wherein cognitive impairment is associated with increased frequency and risk of falling. Even in cross-sectional studies involving healthy young and older adults, the effects of aging on postural control and gait are commonly exacerbated when participants perform a motor task with a concurrent cognitive load. This motor-cognitive dual-task method assumes that cognitive and motor domains compete for common capacity, and that older adults recruit more cognitive capacity than young adults to support gait and posture. Neuroimaging techniques such as magnetic resonance imaging (MRI) have revealed associations between measures of mobility (e.g., gait velocity and postural control) and measures of brain health (e.g., gray matter volumes, cortical thickness, white matter integrity, and functional connectivity). The brain regions most often associated with aging and mobility also appear to subserve high-level cognitive functions such as executive control, attention, and working memory (e.g., dorsolateral prefrontal cortex, anterior cingulate). Portable functional neuroimaging has allowed for the examination of neural functioning during real-time walking, often in conjunction with detailed spatiotemporal measures of gait. A more recent strategy that addresses the interdependence of cognitive and motor processes in old age is cognitive remediation. Cognitive training has yielded promising improvements in balance, walking, and overall mobility status in healthy older adults, and those with age-related neurodegenerative conditions such as Parkinson’s Disease.