Neural bases of cognitive rehabilitation for brain injury

脑损伤认知康复的神经基础

• 批准号: 8007477
• 负责人: MARK D'ESPOSITO
• 金额: --
• 依托单位: VA NORTHERN CALIFORNIA HEALTH CARE SYS
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-02-01 至 2015-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8007477
• 关键词: Address; Attention; Automobile Driving; Base of the Brain; Behavior; Behavioral; Biological Markers; Brain; Brain Injuries; Chronic; Clinical; Cognition; Cognitive; Complex; Computer Assisted; Computers; Cues; Development; Educational Intervention; Effectiveness; Exercise; Foundations; Functional Magnetic Resonance Imaging; Functional disorder; Goals; Individual; Intervention; Lead; Learning; Life; Measurement; Measures; Memory; Modeling; Neurocognitive; Neurosciences; Patient Education; Patients; Performance; Problem Solving; Process; Protocols documentation; Psychophysiology; Randomized Controlled Trials; Regulation; Relative (related person); Research; Short-Term Memory; Structure; Testing; Time; Training; Work; abstracting; base; behavior measurement; cognitive function; cognitive rehabilitation; design; disability; distraction; effective intervention; follow-up; functional disability; improved; information processing; intervention effect; mind control; neuromechanism; novel; programs; relating to nervous system; response; selective attention; success; theories; therapy design; tool

DESCRIPTION (provided by applicant): Project Summary/Abstract Some of the most common and disabling consequences of brain injury are deficits in cognition. In particular, disruption of attentional regulation reduces the efficiency and effectiveness of functions including learning, memory, problem-solving and goal management, leading to significant functional disability. Despite the importance of these problems, few effective interventions are available. The long-term goal of this research program is to develop and test novel neuroscience-based interventions for improving cognitive functioning. In order to achieve this goal, an important intermediate step is to understand the mechanisms that support treatment success, when they do occur. However, such mechanisms of cognitive improvement are currently poorly understood. The overall goal of this proposal is to elucidate mechanisms through which attention may be improved for patients with brain injury. Attention regulation occurs at a number of possible levels to control brain functioning, from guiding attention towards selected information from the 'top-down' based on explicit goals, to the most basic driving and sustaining of cognitive activity from the 'bottom-up.' The proposed projects will determine the neural and behavioral effects of interventions designed to train different levels of attentional control, in randomized controlled studies for individuals with brain injury. Aim 1. To determine the neural, neurocognitive and functional effects of a theory-driven, strategy-based intervention that trains goal-oriented attention with intensive application through accomplishment of personally relevant projects. Hypothesis: Participation in the experimental intervention will enhance functioning in complex 'real-life' settings, relative to an educational intervention matched for time and attention. Aim 2. To determine the neural, neurocognitive and functional effects of a computer-assisted game-based protocol designed to intensively train the target process of re-direction of selective attention when distracted. Hypothesis: Participation in the experimental intervention will result in improvements in attention and working memory (reflecting protection from distraction), relative to a comparison intervention matched for time and computer usage. Aim 3. To determine the neural, neurocognitive and functional effects of a computer-assisted training task that targets basic tonic and phasic attention functions. Hypothesis: Participation in the experimental intervention improves sustained attention, relative to a comparison intervention matched for time and computer usage. Each study will also investigate to what extent effects transfer to higher and lower levels of function and domains of cognitive functioning that are not explicitly trained; to what extent neural measures help to explain variability in behavioral effects; and to what extent effects are maintained at 6 months follow-up. Conclusions. By applying three different intervention approaches we will be able to systematically determine effects at multiple levels at which attention regulates brain functioning. This information will help build a neuroscience foundation for the development of novel interventions to improve cognitive functioning with potentially wide-ranging impacts for individuals with brain injury. PUBLIC HEALTH RELEVANCE: Project Narrative/Relevance Statement: Some of the most common and disabling consequences of brain injury are deficits in cognition. In particular, disruption of attentional regulation reduces the efficiency and effectiveness of functions including learning, memory, problem-solving and goal management, leading to significant functional disability. Despite the importance of these problems, few effective interventions are available. The long-term goal of this research program is to develop and test novel neuroscience-based interventions for improving cognitive functioning. In order to achieve this goal, an important intermediate step is to understand the mechanisms that support treatment success, when they do occur. The overall goal of this proposal is to elucidate mechanisms through which attention may be improved for patients with brain injury. This information will help build a neuroscience foundation for the development of novel interventions to improve cognitive functioning with potentially wide-ranging impacts for individuals with brain injury.

描述(由申请人提供)： 项目摘要/摘要脑损伤的一些最常见和致残的后果是认知障碍。特别是，注意力调节的中断会降低学习、记忆、解决问题和目标管理等功能的效率和有效性，导致严重的功能障碍。尽管这些问题很重要，但有效的干预措施寥寥无几。这项研究计划的长期目标是开发和测试基于神经科学的新干预措施，以改善认知功能。为了实现这一目标，一个重要的中间步骤是了解支持治疗成功的机制，当它们确实发生时。然而，这种认知改善的机制目前还知之甚少。这项建议的总体目标是阐明改善脑损伤患者注意力的机制。注意力调节发生在许多可能的水平上，以控制大脑功能，从根据明确目标自上而下地将注意力引导到选定的信息，到自下而上地驱动和维持最基本的认知活动。拟议的项目将在针对脑损伤患者的随机对照研究中，确定旨在训练不同水平注意力控制的干预措施的神经和行为影响。目的1.通过完成与个人相关的项目，确定以理论为导向、以策略为基础的干预训练目标导向注意力和强化应用的神经、神经认知和功能效应。假设：与时间和注意力相匹配的教育干预相比，参与实验干预将增强复杂的“现实生活”环境中的功能。目的2.确定一种计算机辅助游戏协议的神经、神经认知和功能效应，该协议旨在集中训练分散注意力时选择性注意的目标重定向过程。假设：与时间和电脑使用相匹配的对照干预相比，参与实验干预将导致注意力和工作记忆的改善(反映出对分心的保护)。目的3.确定计算机辅助训练任务对神经、神经认知和功能的影响，该任务的目标是基本的紧张性和相位性注意功能。假设：与时间和电脑使用相匹配的对比干预相比，参与实验干预可以提高持续注意力。每项研究还将调查影响在多大程度上转移到没有明确训练的更高和更低水平的功能和认知功能领域；神经测量在多大程度上有助于解释行为影响的可变性；以及在6个月的随访中影响保持在多大程度上。结论。通过应用三种不同的干预方法，我们将能够系统地确定注意力在多个水平上调节大脑功能的效果。这些信息将有助于为开发新的干预措施建立神经科学基础，以改善认知功能，并对脑损伤患者产生潜在的广泛影响。 公共卫生相关性： 项目叙述/相关陈述：脑损伤最常见和最严重的后果是认知障碍。特别是，注意力调节的中断会降低学习、记忆、解决问题和目标管理等功能的效率和有效性，导致严重的功能障碍。尽管这些问题很重要，但有效的干预措施寥寥无几。这项研究计划的长期目标是开发和测试基于神经科学的新干预措施，以改善认知功能。为了实现这一目标，一个重要的中间步骤是了解支持治疗成功的机制，当它们确实发生时。这项建议的总体目标是阐明改善脑损伤患者注意力的机制。这些信息将有助于为开发新的干预措施建立神经科学基础，以改善认知功能，并对脑损伤患者产生潜在的广泛影响。