The effects of an online piano training programme, PIANO-Cog, on cognition and brain microstructure in healthy older adults.
| ISRCTN | ISRCTN11023869 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN11023869 |
- Submission date
- 13/11/2024
- Registration date
- 13/11/2024
- Last edited
- 13/11/2024
- Recruitment status
- No longer recruiting
- Overall study status
- Ongoing
- Condition category
- Mental and Behavioural Disorders
Plain English summary of protocol
Background and study aims
As we age, our cognitive abilities can decline. Research suggests that activities combining sensory and motor skills, like musical training, might help improve cognitive functions in older adults. This study aims to test a self-guided piano training program called PIANO-Cog, which participants can do at home. The goal is to see if this program is acceptable to participants and if a larger study would be feasible.
Who can participate?
Cognitively healthy volunteers over the age of 50, with little-to-no musical training, can take part in this study.
What does the study involve?
Participants will undergo 2 hours of cognitive testing and a 30-minute MRI scan before and after an 8-week intervention period. They will be randomly assigned to either the piano training group or a control group. The piano group will receive a 30-minute training video each week and are asked to practice for 30 minutes, 5 days a week. The control group will continue their usual activities and avoid any musical or cognitive training during the study.
What are the possible benefits and risks of participating?
Participants may not directly benefit from the study. Those in the piano training group will receive a keyboard for 8 weeks, but it must be returned after the study. Control group participants will get the piano training videos after the study ends. There are small risks associated with MRI scanning, such as discomfort in confined spaces and the need to remain still. Cognitive testing can be tiring, but breaks will be provided as needed.
Where is the study run from?
Cardiff University Brain Research Imaging Centre (CUBRIC), Maindy Road, Cardiff (UK)
When is the study starting and how long is it expected to run for?
March 2023 to July 2025
Who is funding the study?
School of Psychology, Cardiff University (UK)
Who is the main contact?
Fionnuala Rogers (RogersF2@cardiff.ac.uk)
Contact information
Public, Scientific, Principal Investigator
CUBRIC
Cardiff
CF24 4HQ
United Kingdom
 ORCID ID |
0000-0002-1001-7653 |
|---|---|
| Phone | +44 (0)29 2087 0365 |
| RogersF2@cardiff.ac.uk |
Study information
| Study design | Two-arm single-blinded randomized controlled trial (pilot feasibility study) |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Randomised controlled trial |
| Study setting(s) | Home, University/medical school/dental school |
| Study type | Prevention, Quality of life |
| Participant information sheet | 46395 PIS Piano MRI Study v3 14.06.24.pdf |
| Scientific title | The effects of Piano Instruction for Adult Novices as Online Cognitive intervention (PIANO-Cog) on executive function, fluid intelligence and white and grey matter microstructure compared to passive control in healthy older adults |
| Study acronym | PIANO-Cog |
| Study objectives | Our primary hypotheses are: 1. PIANO-Cog will be a feasible online cognitive training intervention for healthy non-musicians over the age of 50 years old. 2. A future fully-powered RCT into the effects of 8-weeks of home-based PIANO-Cog training compared to no-training control will be feasible. Our secondary hypotheses are that, in healthy non-musicians (>50 years), 8 weeks of piano training will: 1. Lead to improvements in processing speed, response inhibition and attention switching as measured by digit-symbol substitution test, a Stroop test, Go/No-go test and verbal fluency category switching tasks 2. Lead to grey and white matter microstructural changes in auditory, motor and somatosensory networks measured using DTI and metrics from the biophysical models, NODDI and SANDI. Specifically, we expect to see an increase in soma density and soma size metrics from SANDI model and increased orientation dispersion and intracellular density metrics from the NODDI model following piano training compared to the control group. 3. Underlying microstructural changes will be associated with changes in processing speed (digit-symbol task) and EF (N-back, Stroop and Go/No-go tasks). |
| Ethics approval(s) |
Approved 20/06/2024, School of Psychology Research Ethics Committee, Cardiff University (70 Park Place, Cardiff, CF10 3AT, United Kingdom; +44(0)29 208 70707; psychethics@cardiff.ac.uk), ref: EC.23.05.16.6801GRA |
| Health condition(s) or problem(s) studied | Age-related cognitive decline and neurodegeneration. |
| Intervention | Cognitively healthy non-musicians over 50 years will be recruited and screened for cognitive impairment and < 4 years music experience. They will be assigned to either self-guided piano training or a passive control for 8 weeks. Piano training consists of video-guided tutorials which can be carried out in participant's homes. Cognitive assessments and diffusion MRI will take place before and after the intervention period. The groups will be stratified by sex and by two age categories: 50-65 years and >65 years. Pseudo-random numbers will be used to generate randomised group allocation per stratum using R version 4.41, and implemented by the lead researcher. Neither participants nor the researcher conducting baseline testing will be informed of group allocation until after baseline testing is completed, as the algorithm determining group allocation will take place only at the end of testing. |
| Intervention type | Behavioural |
| Primary outcome measure | 1. Recruitment rate = 100 x (number of participants who provided consent / number of participants eligible) % 2. Retention rate = 100 x (number of participants who complete follow-up testing / number of participants who provided consent) 3. Adherence rate (frequency) = 100 x (number of days’ practice logged / 40 days) % 4. Adherence rate (duration) = 100 x (number of minutes practice logged / (40 days x 30 minutes average session duration = 1,200 minutes) % 5. Acceptability of the intervention is assessed using an evaluation survey consisting of 27 x 6-point Likert scale items on how participants perceived the quality, difficulty level and content of the training. Four qualitative questions are also included to ask participants for their individual feedback. |
| Secondary outcome measures | 1. Processing speed measured as the number of correct responses within 90 seconds on the symbol-digit test from the WAIS-III. 2. Inhibitory control for motor responses measured as the rate of correct responses and latencies on the Go/No-go test. 3. Inhibitory control for distractor information measured as the number of correct responses and latencies on a computerised Stroop task for congruent versus incongruent trials. 4. Working memory capacity measured as the number of correct responses on the digit span task (forward and backward conditions) from the WAIS-III. 5. Updating of working memory measured as the error rates on the N-back. 6. Visual attention and attention-switching measured by completion times on the Trail-Making Task Parts A and B respectively. 7. Verbal fluency measured by the number of correct responses provided on the letter, category and category-switching subtests of the D-KEFS verbal fluency test. 8. Verbal memory measured as the total number of words recalled on the California Verbal Learning Test - II. 9. Musical abilities measured as score from the micro-PROMS which assess a participant's ability to detect changes in samples of music. 10. Piano performance measured as the number of correct notes and timing accuracy measured whilst playing 5-finger scales using a MIDI-keyboard and Reaper, compared with a reference. 11. Changes in grey matter microstructure assessed by the soma size and soma density metrics from the Soma And Neurite Density Imaging (SANDI) model which will be applied to multi-shell high angular resolution diffusion imaging data (msHARDI) collected using ultra-high gradients of the Siemens Connectom. 12. Changes in white matter microstructure assessed using the Neurite Orientation Dispersion and Density Imaging (NODDI) model which provides the isotropic signal fraction (ISOSF) as an estimate of free water, intracellular signal fraction as an estimate of axon density, and the orientation dispersion index (ODI) as an estimate of axon orientation and dispersion. |
| Overall study start date | 01/03/2023 |
| Completion date | 30/07/2025 |
Eligibility
| Participant type(s) | Healthy volunteer |
|---|---|
| Age group | Senior |
| Lower age limit | 50 Years |
| Sex | Both |
| Target number of participants | 50 |
| Key inclusion criteria | 1. >50 years old 2. Fluent English speakers 3. Have normal/corrected-to-normal vision and hearing 4. Have less than 4 years of formal musical or dance training 5. Are not involved in any musical activities 6. Have no neurological or psychiatric history that could affect learning (e.g., dementia, stroke or traumatic brain injury, depression requiring hospitalisation) 7. No self-reported difficulty with hand movement 8. No self-reported learning disabilities |
| Key exclusion criteria | 1. Impaired hearing or vision 2. Neurological diagnosis 3. Current involvement in other cognitive training or musical activities (e.g., choir singing, dance or exercise to music classes) 4. More than 4 years of formal music or dance lessons 5. Currently taking psycho-reactive medications which affect memory performance 6. Participants with MRI contra-indications (e.g., pacemakers, stents, cochlear implants, or other metal in the body such as metallic plates, screws or clips) will not be scanned, but will still be eligible for training and cognitive and motor testing |
| Date of first enrolment | 15/08/2024 |
| Date of final enrolment | 01/06/2025 |
Locations
Countries of recruitment
- United Kingdom
- Wales
Study participating centre
Cardiff
CF24 4HQ
United Kingdom
Sponsor information
University/education
CUBRIC, Maindy Road
Cardiff
CF24 4HQ
Wales
United Kingdom
| Phone | +44 29 2087 0365 |
|---|---|
| cubric@cardiff.ac.uk | |
| Website | http://www.cardiff.ac.uk/ |
"ROR" |
https://ror.org/03kk7td41 |
Funders
Funder type
University/education
Private sector organisation / Universities (academic only)
- Location
- United Kingdom
Results and Publications
| Intention to publish date | 01/10/2025 |
|---|---|
| Individual participant data (IPD) Intention to share | Yes |
| IPD sharing plan summary | Stored in publicly available repository |
| Publication and dissemination plan | This work is undertaken as part of a PhD project and is intended to be published in academic journals and presented at conferences. The aim of this research is to demonstrate the cognitive and neural benefits of musical training in later adulthood, in the hope of contributing to a body of literature demonstrating a need for public health funding for musical training to help reduce dementia-related costs, prolong independence and quality of life. |
| IPD sharing plan | The datasets generated during and/or analysed during the current study will be stored in a publicly available repository. Cognitive and MRI data will be made openly available on OSF. |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Participant information sheet | version 3 | 14/06/2024 | 13/11/2024 | No | Yes |
Additional files
Editorial Notes
13/11/2024: Trial's existence confirmed by School of Psychology Research Ethics Committee, Cardiff University.
