REHABILITATION OF COGNITIVE SYMPTOMS IN MS

描述：(改编自《调查员摘要》)：1993年3月， 国家医疗康复研究咨询委员会确定了 认知康复策略的发展 神经疾病作为一个高度优先的研究领域(HPRA)。现在 该提案旨在研究损伤的确切机制 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 以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有工作记忆缺陷(定义为 同时在短期存储器中存储和操作信息)。 然而，我们实验室的初步工作表明，当给予足够的 处理信息的时间，多发性硬化症患者的表现与健康对照组一样好 (HCS)关于最常用的工作记忆任务--起搏听觉序列 加法测验(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 似乎主要是由于信息处理速度减慢。 然而，目前尚不清楚的是，是否增加了获取信息的时间 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困难。整体而言 该项目的目标是确定是否增加 信息处理时间提高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。这样做的具体目的是 项目是：i)检查工作记忆损伤的假设 MS主题是由于信息处理的速度，而不是由于 表现；2)检验假设，当给予MS受试者更多时间时 要处理信息，将在工作内存上执行与HCS一样准确的操作 任务；以及3)通过使用工作记忆任务来扩展我们最初的试点研究 不同程度的难度，从而增加我们的 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)将实施PASAT的变体(也称为L-BACK) 以及一种更难的衍生品，被称为2back。在1-和 2-Back任务，性能的准确率将控制在50%正确 (通过使用计算机算法，利用“极限方法”程序)。这 然后允许对信息处理时间量进行量化 每个对象需要达到50%的准确率性能 对，是这样。为了实现我们的目标，增加我们的飞行员的普适性 数据，我们将评估信息处理时间增加对 在不同的工作记忆任务上的表现准确性。为了实现这一点，所有人 受试者将在4个水平上被执行Salhouse工作记忆任务 任务难度和三种不同的信息量 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 工作记忆表现不佳的关键认知因素 在多发性硬化症患者中，该项目的结果将具有重大意义 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 面向提高信息处理效率以改善内存 在日常生活中的表现。

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.