REHABILITATION OF COGNITIVE SYMPTOMS IN MS

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“ 发展认知康复策略”的人， 高优先研究领域（HPRA）。本 该提案旨在研究导致受损的确切机制。 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以前发现的康复策略， 来提高这个人群的工作记忆人们早就认识到， 患有MS的人在工作记忆方面存在缺陷（定义为能够 同时在短期存储器中存储和操作信息）。 然而，我们实验室的初步研究表明，当给予足够的 处理信息的时间，MS受试者的表现与健康对照组一样好 (HCs)在最常用的工作记忆任务中， 加法测试（PASAT）。这表明MS患者可能不会受到损害， 关于工作记忆的问题！相反，他们的工作记忆缺陷 这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， 加工提高了MS在工作记忆任务上的准确性：a）除了 PASAT和B）不同程度的工作记忆困难。整体 本项目的目的是确定是否增加 信息处理时间改善MS受试者的工作记忆准确性 在不同难度的任务中。具体目标是 项目是：I）检查工作记忆障碍的假设， MS受试者是由于信息处理的速度而不是准确性 表现; 2）检查MS受试者的假设，当给予更多的时间 在处理信息时，它的表现和HC在工作记忆中的表现一样准确 3）通过使用工作记忆任务来扩展我们最初的试点研究， 不同程度的困难，从而增加了我们的普遍性， 初步调查结果。为了调查这些假设，80名受试者（40名MS和40名MS） 40 HC）将给予PASAT的变体（也称为l-back） 以及一个更难的衍生物，称为2back。在1和 2-背任务，性能的准确性将控制在50%的正确率 (by使用利用“极限法”程序的计算机算法）。这 然后允许量化信息处理时间的量 要求每个主题达到50%的准确性性能 正确.为了实现我们的目标，提高我们的试点推广， 数据，我们将评估增加信息处理时间对 在不同的工作记忆任务上的表现准确性。为了实现这一目标，所有 受试者将在4个水平上被施用Salthouse工作记忆任务， 任务难度和三种不同的信息时间 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 造成工作记忆能力不足的关键认知因素 该项目的结果将具有重大意义 用于治疗MS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 日常生活中的表现。

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.