REHABILITATION OF COGNITIVE SYMPTOMS IN MS

多发性硬化症认知症状的康复

• 批准号: 6194160
• 负责人: John DeLuca
• 金额: $ 17.21万
• 依托单位: KESSLER FOUNDATION, INC.
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-01 至 2003-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6194160
• 关键词: clinical research; human subject; memory disorders; multiple sclerosis; neural information processing; rehabilitation; short term memory

DESCRIPTION: (Adapted from the Investigator's Abstract): In March 1993, the National Advisory Board on Medical Rehabilitation Research identified "the development of cognitive rehabilitation strategies" in persons with neurological disorders as a high priority research area (HPRA). The present proposal is designed to study the precise mechanism responsible for impaired working memory performance in patients with multiple sclerosis (MS), and to more closely test a rehabilitation strategy previously found by our laboratory to improve working memory in this population. It has long been recognized that persons with MS have deficits in working memory (defined as the ability to simultaneously store and manipulate information in short-term storage). However, preliminary work from our laboratory has shown that, when given enough time to process information, MS subjects perform as well as healthy controls (HCs) on the most commonly used working memory task, the Paced Auditory Serial Addition Test (PASAT). This suggests that persons with MS may not be impaired with regard to working memory at all! Rather, their working memory deficits appear to be primarily attributable to impaired information processing speed. What is still not known, however, is whether increased time for information processing improves MS accuracy on working memory tasks: a) other than the PASAT and b) with varied levels of working memory difficulty. The OVERALL OBJECTIVE of this project is to determine whether increasing the amount of information processing time improves working memory accuracy in MS subjects across tasks with different levels of difficulty. The SPECIFIC AIMS of this project are to: I ) examine the hypothesis that working memory impairment among MS subjects is due to speed of information processing and not accuracy of performance; 2) examine the hypothesis that MS subjects, when given more time to process information, will perform as accurately as HCs on working memory tasks; And 3) extend our initial pilot study by using working memory tasks at various levels of difficulty, thereby increasing the generalizability of our preliminary findings. To investigate these hypotheses, 80 subjects (40 MS and 40 HC) will be administered a variant of the PASAT (also known as the l-back) as well as a more difficult derivative, known as the 2back. In both the 1- and 2-back tasks, accuracy of performance will be controlled at 50 percent correct (by using a computer algorithm utilizing a "method of limits" procedure). This then allows for the quantification of the amount of information processing time required for each subject to achieve accuracy performance of 50 percent correct. To address our aim of increasing the generalizability of our pilot data, we will assess the impact of increased information processing time on performance accuracy on a different working memory task. To achieve this, all subjects will be administered the Salthouse working memory task at 4 levels of task difficulty and with three different amounts of time for information processing (12 different permutations in all). By performing these experiments, we will be able to determine whether increased information processing time is the key cognitive element responsible for deficient working memory performance in patients with MS. Results of this project will have significant implications for the treatment of memory disorders in persons with MS. If our hypotheses are supported, then our data will lay the foundation for intervention strategies geared toward increasing information processing efficiency to improve memory performance in everyday life.

描述：（改编自研究者摘要）：1993 年 3 月， 国家医疗康复研究咨询委员会确定了“ 认知康复策略的制定” 神经系统疾病作为高度优先研究领域（HPRA）。现在的 该提案旨在研究导致受损的精确机制 多发性硬化症 (MS) 患者的工作记忆表现 更仔细地测试我们实验室之前发现的康复策略 改善这一人群的工作记忆。人们很早就认识到 患有多发性硬化症的人存在工作记忆缺陷（定义为工作记忆的能力） 同时存储和操作短期存储中的信息）。 然而，我们实验室的初步工作表明，当给予足够的 处理信息的时间，多发性硬化症受试者的表现与健康对照组一样好 （HC）关于最常用的工作记忆任务，节奏听觉序列 加法测试（PASAT）。这表明多发性硬化症患者可能不会受到损害 关于工作记忆！相反，他们的工作记忆缺陷 似乎主要归因于信息处理速度受损。 然而，目前尚不清楚的是，获取信息的时间是否会增加 处理提高了 MS 在工作记忆任务上的准确性：a) 除了 PASAT 和 b) 具有不同程度的工作记忆难度。整体 该项目的目的是确定是否增加 信息处理时间提高了多发性硬化症受试者的工作记忆准确性 跨越不同难度级别的任务。本次活动的具体目标 项目的目的是： I ) 检验以下假设：工作记忆受损 MS 科目是由于信息处理的速度而不是准确性 表现; 2) 检查假设，当给予多发性硬化症受试者更多的时间时 处理信息，将像 HC 一样准确地处理工作记忆 任务； 3）通过使用工作记忆任务来扩展我们最初的试点研究 不同级别的难度，从而增加我们的普遍性 初步调查结果。为了研究这些假设，80 名受试者（40 名 MS 和 40 HC）将接受 PASAT 的变体（也称为 l-back） 以及一个更难的衍生品，称为 2back。在 1- 和 2背任务，表演准确率将控制在50%正确率 （通过使用利用“限制方法”程序的计算机算法）。这 然后允许量化信息处理时间量 每个科目需要达到 50% 的准确率 正确的。为了实现提高试点的普遍性的目标 数据，我们将评估增加信息处理时间对 不同工作记忆任务的性能准确性。为了实现这一目标，所有 受试者将接受 4 个级别的 Salthouse 工作记忆任务 任务难度和三种不同的信息时间量 处理（总共 12 种不同的排列）。通过进行这些实验， 我们将能够确定增加的信息处理时间是否是 导致工作记忆表现不足的关键认知元素 多发性硬化症患者。该项目的结果将产生重大影响 用于治疗多发性硬化症患者的记忆障碍。如果我们的假设是 支持，那么我们的数据将为干预策略奠定基础 旨在提高信息处理效率以改善记忆力 日常生活中的表现。