Computer-aided cognitive rehabilitation improves cognitive performances and induces brain functional connectivity changes in relapsing remitting multiple sclerosis patients: an exploratory study
Computer-aided cognitive rehabilitation improves cognitive performances and induces brain functional connectivity changes in relapsing remitting multiple sclerosis patients: an exploratory study
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DOI：
10.1007/s00415-014-7528-z
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发表时间：
2015-01-01
影响因子：
6
通讯作者：
Tedeschi, G.
中科院分区：
文献类型：
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作者：
Bonavita, S.;Sacco, R.;Tedeschi, G.
为了更好地了解短期基于计算机的认知康复 (cCR) 对认知障碍复发缓解 (RR) 多发性硬化症 (MS) 患者的认知表现和默认模式网络 (DMN) 内在功能连接 (FC) 的影响。 18 名认知受损的 RRMS 患者通过 Rao 短暂可重复电池和静息态功能磁共振成像进行神经心理学评估，以评估短期（8 周，每周两次）cCR 前后的 DMN FC。对照组由 14 名认知受损的 RRMS 患者组成，他们被分配接受非特异性认知训练 (aCT)，并接受相同的研究方案。还测试了 DMN 和认知表现之间的相关性。 cCR 后，以下测试有显着改善：SDMT (p < 0.01)、PASAT 3aEuro(3) (p < 0.00)、PASAT 2aEuro(3) (p < 0.03)、SRT-D (p < 0.02) 和 10/36 SPART-D (p < 0.04)；后扣带皮层 (PCC) 和双侧下顶叶皮层 (IPC) 的 DMN FC 显着增加。 cCR 后，Stroop 色词干扰测试与 PCC 中的 FC 之间出现显着负相关。 aCT 后，对照组在 FC 或神经心理学测试中均未显示出任何显着影响。比较基线时以及 cCR 或 aCT 后获得的数据时，两组的脑体积和病变负荷没有发现显着差异。在认知受损的 RRMS 患者中，cCR 可以改善认知表现（即处理速度以及视觉和语言持续记忆），并增加 DMN 的 PCC 和 IPC 中的 FC。这项探索性研究表明，cCR 可能会诱导适应性皮层重组，有利于更好的认知表现，从而从建立认知或大脑储备的总体角度加强认知锻炼的价值。
To better understand the effects of short-term computer-based cognitive rehabilitation (cCR) on cognitive performances and default mode network (DMN) intrinsic functional connectivity (FC) in cognitively impaired relapsing remitting (RR) multiple sclerosis (MS) patients. Eighteen cognitively impaired RRMS patients underwent neuropsychological evaluation by the Rao's brief repeatable battery and resting-state functional magnetic resonance imaging to evaluate FC of the DMN before and after a short-term (8 weeks, twice a week) cCR. A control group of 14 cognitively impaired RRMS patients was assigned to an aspecific cognitive training (aCT), and underwent the same study protocol. Correlations between DMN and cognitive performances were also tested. After cCR, there was a significant improvement of the following tests: SDMT (p < 0.01), PASAT 3aEuro(3) (p < 0.00), PASAT 2aEuro(3) (p < 0.03), SRT-D (p < 0.02), and 10/36 SPART-D (p < 0.04); as well as a significant increase of the FC of the DMN in the posterior cingulate cortex (PCC) and bilateral inferior parietal cortex (IPC). After cCR, a significant negative correlation between Stroop Color-Word Interference Test and FC in the PCC emerged. After aCT, the control group did not show any significant effect either on FC or neuropsychological tests. No significant differences were found in brain volumes and lesion load in both groups when comparing data acquired at baseline and after cCR or aCT. In cognitively impaired RRMS patients, cCR improves cognitive performances (i.e., processing speed and visual and verbal sustained memory), and increases FC in the PCC and IPC of the DMN. This exploratory study suggests that cCR may induce adaptive cortical reorganization favoring better cognitive performances, thus strengthening the value of cognitive exercise in the general perspective of building either cognitive or brain reserve.