Spreij Lauriane A, Visser-Meily Johanna M A, van Heugten Caroline M, Nijboer Tanja C W
Department of Experimental Psychology, Helmholtz Institute, Utrecht University Utrecht, Netherlands.
Brain Center Rudolf Magnus, Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht, and De Hoogstraat Rehabilitation Utrecht, Netherlands.
Front Hum Neurosci. 2014 Dec 16;8:993. doi: 10.3389/fnhum.2014.00993. eCollection 2014.
Acquired Brain Injury (ABI) frequently results in memory impairment causing significant disabilities in daily life and is therefore a critical target for cognitive rehabilitation. Current understanding of brain plasticity has led to novel insights in remediation-oriented approaches for the rehabilitation of memory deficits. We will describe 3 of these approaches that have emerged in the last decade: Virtual Reality (VR) training, Computer-Based Cognitive Retraining (CBCR) and Non-Invasive Brain Stimulation (NBS) and evaluate its effectiveness.
A systematic literature search was completed in regard to studies evaluating interventions aiming to improve the memory function after ABI. Information concerning study content and reported effectiveness were extracted. Quality of the studies and methods were evaluated.
A total of 786 studies were identified, 15 studies met the inclusion criteria. Three of those studies represent the VR technique, 7 studies represent CBCR and 5 studies NBS. All 3 studies found a significant improvement of the memory function after VR-based training, however these studies are considered preliminary. All 7 studies have shown that CBCR can be effective in improving memory function in patients suffering from ABI. Four studies of the 5 did not find significant improvement of the memory function after the use of NBS in ABI patients.
On the basis of this review, CBCR is considered the most promising novel approach of the last decade because of the positive results in improving memory function post ABI. The number of studies representing VR were limited and the methodological quality low, therefore the results should be considered preliminary. The studies representing NBS did not detect evidence for the use of NBS in improving memory function.
获得性脑损伤(ABI)常导致记忆障碍,给日常生活带来严重残疾,因此是认知康复的关键目标。目前对大脑可塑性的理解为记忆缺陷康复的以补救为导向的方法带来了新的见解。我们将描述过去十年中出现的三种此类方法:虚拟现实(VR)训练、基于计算机的认知再训练(CBCR)和非侵入性脑刺激(NBS),并评估其有效性。
针对评估旨在改善ABI后记忆功能的干预措施的研究进行了系统的文献检索。提取了有关研究内容和报告有效性的信息。对研究的质量和方法进行了评估。
共识别出786项研究,15项研究符合纳入标准。其中3项研究代表VR技术,7项研究代表CBCR,5项研究代表NBS。所有3项研究均发现基于VR的训练后记忆功能有显著改善,但这些研究被认为是初步的。所有7项研究均表明CBCR可有效改善ABI患者的记忆功能。5项研究中的4项未发现ABI患者使用NBS后记忆功能有显著改善。
基于本综述,由于CBCR在改善ABI后记忆功能方面取得了积极成果,因此被认为是过去十年中最有前景的新方法。代表VR的研究数量有限且方法学质量较低,因此结果应被视为初步的。代表NBS的研究未发现使用NBS改善记忆功能的证据。