Spencer-Smith Megan, Klingberg Torkel
Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden; School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia.
Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden.
PLoS One. 2015 Mar 20;10(3):e0119522. doi: 10.1371/journal.pone.0119522. eCollection 2015.
Many common disorders across the lifespan feature impaired working memory (WM). Reported benefits of a WM training program include improving inattention in daily life, but this has not been evaluated in a meta-analysis. This study aimed to evaluate whether one WM training method has benefits for inattention in daily life by conducting a systematic review and meta-analysis.
We searched Medline and PsycINFO, relevant journals and contacted authors for studies with an intervention and control group reporting post-training estimates of inattention in daily life. To reduce the influence of different WM training methods on the findings, the review was restricted to trials evaluating the Cogmed method. A meta-analysis calculated the pooled standardised difference in means (SMD) between intervention and control groups.
A total of 622 studies were identified and 12 studies with 13 group comparisons met inclusion criteria. The meta-analysis showed a significant training effect on inattention in daily life, SMD=-0.47, 95% CI -0.65, -0.29, p<.00001. Subgroup analyses showed this significant effect was observed in groups of children and adults as well as users with and without ADHD, and in studies using control groups that were active and non-adaptive, wait-list and passive as well as studies using specific or general measures. Seven of the studies reported follow-up assessment and a meta-analysis showed persisting training benefits for inattention in daily life, SMD=-0.33, 95% CI -0.57 -0.09, p=.006. Additional meta-analyses confirmed improvements after training on visuospatial WM, SMD=0.66, 95% CI 0.43, 0.89, p<.00001, and verbal WM tasks, SMD=0.40, 95% CI 0.18, 0.62, p=.0004.
Benefits of a WM training program generalise to improvements in everyday functioning. Initial evidence shows that the Cogmed method has significant benefits for inattention in daily life with a clinically relevant effect size.
许多贯穿一生的常见疾病都存在工作记忆（WM）受损的情况。据报道，WM训练计划的益处包括改善日常生活中的注意力不集中，但尚未在荟萃分析中对此进行评估。本研究旨在通过进行系统评价和荟萃分析，评估一种WM训练方法对日常生活中注意力不集中是否有益。
我们检索了Medline和PsycINFO、相关期刊，并联系作者获取有干预组和对照组且报告了训练后日常生活中注意力不集中评估结果的研究。为减少不同WM训练方法对研究结果的影响，该评价仅限于评估Cogmed方法的试验。荟萃分析计算了干预组和对照组之间合并的标准化均值差异（SMD）。
共识别出622项研究，12项研究（包含13组比较）符合纳入标准。荟萃分析显示，对日常生活中的注意力不集中有显著的训练效果，SMD=-0.47，95%置信区间为-0.65至-0.29，p<0.00001。亚组分析表明，在儿童和成人组以及患有和未患有注意力缺陷多动障碍（ADHD）的使用者中，以及在使用积极和非适应性对照组、等待名单和被动对照组的研究中，以及在使用特定或一般测量方法的研究中，均观察到了这种显著效果。其中7项研究报告了随访评估，荟萃分析显示，对日常生活中注意力不集中的训练益处持续存在，SMD=-0.33，95%置信区间为-0.57至-0.09，p=0.006。额外的荟萃分析证实，训练后视觉空间WM有改善，SMD=0.66，95%置信区间为0.43至0.89，p<0.00001；言语WM任务也有改善，SMD=0.40，95%置信区间为0.18至0.62，p=0.0004。
WM训练计划的益处可推广至日常功能的改善。初步证据表明，Cogmed方法对日常生活中的注意力不集中有显著益处，且具有临床相关的效应量。
