A preliminary study of the effects of working memory training on brain function.
A preliminary study of the effects of working memory training on brain function.
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DOI：
10.1007/s11682-015-9416-2
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发表时间：
2016-06
影响因子：
3.2
通讯作者：
Pearlson GD
中科院分区：
文献类型：
--
作者：
Stevens MC;Gaynor A;Bessette KL;Pearlson GD
工作记忆 (WM) 训练可提高注意力缺陷/多动障碍 (ADHD) 中的 WM 能力，但其对非认知 ADHD 障碍的疗效一直存在激烈争议。这项初步研究的目的是描述与 WM 训练相关的 ADHD 大脑功能变化，并观察它们是否与临床改善相关。我们使用常用方法 (CogmedTM) 对 18 名被诊断患有 DSM-IV 联合亚型 ADHD 的青少年进行了 25 次 WM 训练前后的检查，其中使用了非语言 Sternberg WM fMRI 任务、神经心理学测试以及参与者和家长对 ADHD 症状严重程度和相关功能障碍的报告。与 18 名非 ADHD 对照参与者相比，全脑 SPM8 分析发现了 ADHD 激活缺陷，然后测试了 WM 训练后受损的 ADHD 额顶脑激活是否会增加。事后测试检查了神经变化与神经认知或临床改善之间的关系。正如预测的那样，WM 训练提高了 WM 表现、ADHD 临床功能以及几个额叶、顶叶和颞叶区域与 WM 相关的 ADHD 大脑活动。在所有编码、维护和检索 Sternberg 任务阶段都观察到左下额沟区域活动增加。 ADHD 症状严重程度的改善通常与已知参与 WM 相关执行处理的大脑区域的激活增益呈正相关；不同症状类型的改善具有不同的神经相关性。 WM 训练改变了非模态 WM 额顶回路和执行过程特定 WM 大脑区域的反应性。对于寻求在正在进行的 ADHD WM 训练开发工作中优化临床反应的研究人员来说，后者可能代表了一个有前途的、相对未经探索的治疗目标。
Working memory (WM) training improves WM ability in Attention-Deficit/Hyperactivity Disorder (ADHD), but its efficacy for non-cognitive ADHD impairments ADHD has been sharply debated. The purpose of this preliminary study was to characterize WM training-related changes in ADHD brain function and see if they were linked to clinical improvement. We examined 18 adolescents diagnosed with DSM-IV Combined-subtype ADHD before and after 25 sessions of WM training using a frequently employed approach (CogmedTM) using a nonverbal Sternberg WM fMRI task, neuropsychological tests, and participant- and parent-reports of ADHD symptom severity and associated functional impairment. Whole brain SPM8 analyses identified ADHD activation deficits compared to 18 non-ADHD control participants, then tested whether impaired ADHD frontoparietal brain activation would increase following WM training. Post hoc tests examined the relationships between neural changes and neurocognitive or clinical improvements. As predicted, WM training increased WM performance, ADHD clinical functioning, and WM-related ADHD brain activity in several frontal, parietal and temporal lobe regions. Increased left inferior frontal sulcus region activity was seen in all Encoding, Maintenance, and Retrieval Sternberg task phases. ADHD symptom severity improvements were most often positively correlated with activation gains in brain regions known to be engaged for WM-related executive processing; improvement of different symptom types had different neural correlates. The responsiveness of both amodal WM frontoparietal circuits and executive process-specific WM brain regions was altered by WM training. The latter might represent a promising, relatively unexplored treatment target for researchers seeking to optimize clinical response in ongoing ADHD WM training development efforts.