# Medial prefrontal activation as a neural predictor of cognitive training gains in older adults with amnestic mild cognitive impairment: exploratory evidence

## TL;DR

This study explores how brain activity in the prefrontal cortex during cognitive training can predict cognitive improvements in older adults with early memory issues.

## Contribution

The study identifies medial prefrontal activation during attentional training as a novel predictor of cognitive gains in individuals with amnestic mild cognitive impairment.

## Key findings

- Greater left medial prefrontal activation during attentional training was linked to better cognitive outcomes in aMCI patients.
- Only attentional training showed significant associations between prefrontal activation and cognitive improvement.
- Prefrontal activation patterns during training can predict cognitive gains, suggesting potential for personalized training programs.

## Abstract

Not all individuals benefit equally from cognitive training, making it essential to identify neural markers that can predict individual responsiveness, particularly among those at the early stages of cognitive impairment.

This study investigated whether prefrontal activation measured by functional near-infrared spectroscopy (fNIRS) during three categories of training tasks (attentional, imagery, and associative) predicts cognitive gains in older adults. Twenty-two older adults with amnestic mild cognitive impairment (aMCI) completed a 12-week digital-device–based cognitive training program comprising 12 tasks (6 attentional, 3 imagery, 3 associative). Prefrontal activation was recorded via fNIRS during each task. Cognitive improvement was assessed using the Alzheimer's Disease Assessment Scale–Cognitive Subscale at baseline and 3 months (n = 22).

Among the three task categories, only attentional training was associated with prefrontal activation patterns that significantly predicted cognitive improvement at 3 months. Specifically, greater activation in the left mPFC during attentional training was negatively associated with ADAS-Cog scores (β = –.443, p = 0.039), indicating that individuals with higher activation exhibited greater cognitive improvement.

The findings suggest that increased medial prefrontal activation during attentional training reflects compensatory engagement and task-related control processes, which in turn predict larger cognitive gains in individuals with aMCI. These results indicate that neural activation measured during training can serve as a reliable predictor of subsequent cognitive gains, offering a potential foundation for designing personalized and adaptive educational programs.