Effects of computerized cognitive training as add-on treatment to stimulants in ADHD: a pilot fMRI study
Effects of computerized cognitive training as add-on treatment to stimulants in ADHD: a pilot fMRI study
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DOI：
10.1007/s11682-019-00137-0
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发表时间：
2020-10-01
影响因子：
3.2
通讯作者：
Paim Rohde, Luis Augusto
中科院分区：
文献类型：
--
作者：
de Oliveira Rosa, Virginia;Rosa Franco, Alexandre;Paim Rohde, Luis Augusto
认知训练（CT）对神经功能的影响知之甚少。我们的主要目的是评估接受CT作为兴奋剂药物治疗的ADHD儿童的fMRI脑激活模式。我们纳入了20名来自兴奋剂药物和CT临床试验的ADHD儿童（10名药物+CT和10名药物+非主动训练）。在工作记忆（N-back：0-back，1-back，2-back，3-back），持续注意（持续注意任务-SAT：2 s，5 s和8 s延迟）和抑制控制（Go/No-Go）的3种fMRI范式期间，评估组间的表现和大脑激活差异。我们发现显着的组x时间x条件的相互作用，在工作记忆（WM）和持续的注意力对大脑激活。在N-back中，与非活动组相比，在CT中观察到从基线到终点的BOLD信号变化随着右丘脑、右壳核、左丘脑和左苍白球中WM负荷的增加而减少;在SAT中-在双侧楔前叶、右侧海马、双侧联合视觉皮层和角回中观察到BOLD信号从基线到终点的变化增加，右侧颞中回、中央前回、中央后回、额上级回和额中回的CT值与非活动组相比。ADHD患者的CT与持续注意力和工作记忆的任务相关顶叶和纹状体边缘区的激活变化相关。大脑活动的变化可能先于工作记忆和持续注意力的行为表现改变，但不是在抑制控制。
The neurofunctional effects of Cognitive training (CT) are poorly understood. Our main objective was to assess fMRI brain activation patterns in children with ADHD who received CT as an add-on treatment to stimulant medication. We included twenty children with ADHD from a clinical trial of stimulant medication and CT (10 in medication + CT and 10 in medication + non-active training). Between-group differences were assessed in performance and in brain activation during 3 fMRI paradigms of working memory (N-back: 0-back, 1-back, 2-back, 3-back), sustained attention (Sustained Attention Task - SAT: 2 s, 5 s and 8 s delays) and inhibitory control (Go/No-Go). We found significant group x time x condition interactions in working memory (WM) and sustained attention on brain activation. In N-back, decreases were observed in the BOLD signal change from baseline to endpoint with increasing WM load in the right insula, right putamen, left thalamus and left pallidum in the CT compared to the non-active group; in SAT - increases in the BOLD signal change from baseline to endpoint with increasing delays were observed in bilateral precuneus, right insula, bilateral associative visual cortex and angular gyrus, right middle temporal, precentral, postcentral, superior frontal and middle frontal gyri in the CT compared to the non-active group. CT in ADHD was associated with changes in activation in task-relevant parietal and striato-limbic regions of sustained attention and working memory. Changes in brain activity may precede behavioral performance modifications in working memory and sustained attention, but not in inhibitory control.