Therapeutic efficacy of computerized cognitive remediation therapy on cognitive function, inflammatory biomarkers, and brain structure in patients with amnestic mild cognitive impairment and Alzheimer's disease: A randomized controlled trial.

Cognitive and behavioral impairments in Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI) represent significant neuropsychiatric challenges. This randomized controlled trial evaluated a 6-month computerized cognitive remediation therapy (CCRT) as a non-pharmacological intervention. Fifty-seven participants (32 aMCI, 25 mild AD) were assigned to CCRT or standard care. Outcomes included cognitive function (MMSE, MoCA), daily living activities (ADL), anxiety/depression (HAMA, HAMD-17), serum high-sensitivity C-reactive protein (Hs-CRP), and longitudinal brain MRI analyzed via voxel-based morphometry (VBM). Compared to controls, the CCRT group showed significant improvements in global cognition (ΔMMSE: +2.12 vs. -1.93, p < 0.001), daily functioning, and anxiety scores. A notable reduction in systemic inflammation (ΔHs-CRP, p < 0.01) was also observed. VBM revealed progressive gray matter atrophy in temporal and parahippocampal regions across both groups, yet cognitive gains in the CCRT cohort occurred independently of structural decline. CCRT effectively enhances cognitive-behavioral outcomes and modulates inflammatory activity in AD-spectrum patients, despite ongoing neurodegeneration. These findings support its integration as a neuropsychiatric intervention aimed at preserving function and promoting neural compensation in dementia care.