Cognitive Gains from Gist Reasoning Training in Adolescents with Chronic-Stage Traumatic Brain Injury
Cognitive Gains from Gist Reasoning Training in Adolescents with Chronic-Stage Traumatic Brain Injury
复制标题
患有慢性阶段创伤性脑损伤的青少年通过要点推理训练获得认知收益
作者：
Lori G. Cook;S. Chapman;A. Elliott;N. Evenson;Kami Vinton
患有创伤性脑损伤 (TBI) 的青少年通常表现出对先前获得的技能恢复良好。然而，高阶和后来出现的认知功能常常受到损害，并与学术和社会/行为领域的不良结果相关。很少有对照试验可以测试慢性恢复阶段认知治疗的有效性。目前的试点研究比较了两种形式的认知训练，即要点推理（自上而下）与死记硬背学习（自下而上）对 20 名 TBI 后 6 个月或更长时间的青少年（12-20 岁）抽象意义、回忆事实和利用核心执行功能（即工作记忆、抑制）能力的影响。参与者在 1 个月内完成了 8 次 45 分钟的课程。训练后，主旨推理组（n = 10）在抽象含义和事实回忆能力方面表现出显着提高。该小组还对未经训练的工作记忆和抑制执行功能表现出显着的概括。记忆训练组（n = 10）在抽象意义的能力或其他未经训练的专门执行功能方面未能表现出显着的进步，尽管事实回忆的改善接近显着性。这些初步结果表明，对于处于 TBI 慢性阶段的青少年来说，利用自上而下的推理方法进行相对短期的训练（6 小时）比自下而上的死记硬背学习方法更有效地提高高阶认知能力。这些发现需要在更大规模的研究中得到重复；尽管如此，初步数据表明，传统的认知干预计划需要扩展到后期的培训机会。慢性阶段的高阶认知训练可能有助于提高患有 TBI 的青少年的认知表现水平。
Adolescents with traumatic brain injury (TBI) typically demonstrate good recovery of previously acquired skills. However, higher-order and later emergent cognitive functions are often impaired and linked to poor outcomes in academic and social/behavioral domains. Few control trials exist that test cognitive treatment effectiveness at chronic recovery stages. The current pilot study compared the effects of two forms of cognitive training, gist reasoning (top-down) versus rote memory learning (bottom-up), on ability to abstract meanings, recall facts, and utilize core executive functions (i.e., working memory, inhibition) in 20 adolescents (ages 12–20) who were 6 months or longer post-TBI. Participants completed eight 45-min sessions over 1 month. After training, the gist reasoning group (n = 10) exhibited significant improvement in ability to abstract meanings and increased fact recall. This group also showed significant generalizations to untrained executive functions of working memory and inhibition. The memory training group (n = 10) failed to show significant gains in ability to abstract meaning or on other untrained specialized executive functions, although improved fact recall approached significance. These preliminary results suggest that relatively short-term training (6 h) utilizing a top-down reasoning approach is more effective than a bottom-up rote learning approach in achieving gains in higher-order cognitive abilities in adolescents at chronic stages of TBI. These findings need to be replicated in a larger study; nonetheless, the preliminary data suggest that traditional cognitive intervention schedules need to extend to later-stage training opportunities. Chronic-stage, higher-order cognitive trainings may serve to elevate levels of cognitive performance in adolescents with TBI.
DOI：
10.1073/pnas.0402680101
发表时间：
2004-05-25
影响因子：
11.1
作者：
Gogtay, N;Giedd, JN;Thompson, PM
通讯作者：
Thompson, PM
严重创伤性脑损伤儿童的自我调节能力：自然行为的初步调查。
影响因子：
2
作者：
Cook,LoriG;Chapman,SandraB;Levin,HarveyS
通讯作者：
Levin,HarveyS