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计算机化结构化认知训练对早期阿尔茨海默病患者可行且有效:一项随机对照研究。

Computerized Structured Cognitive Training in Patients Affected by Early-Stage Alzheimer's Disease is Feasible and Effective: A Randomized Controlled Study.

作者信息

Cavallo Marco, Hunter Edyta Monika, van der Hiele Karin, Angilletta Chiara

机构信息

eCampus University, Novedrate, Como, Italy.

Department of Mental Health , Azienda Sanitaria Locale Torino 3, Collegno, Torino, Italy.

出版信息

Arch Clin Neuropsychol. 2016 Dec 1;31(8):868-876. doi: 10.1093/arclin/acw072.

Abstract

INTRODUCTION

Alzheimer's disease (AD) presents with significant neuropsychological deficits. Cognitive training in AD has recently started to demonstrate its efficacy. In this study, we implemented computerized cognitive training of a large group of early-stage AD patients, to identify its effects at a neuropsychological level and to investigate whether they were stable after 6 months.

METHOD

Overall, 80 AD patients were randomized in two groups. Patients in the experimental group used a structured rehabilitative software three times a week for 12 consecutive weeks aimed at training memory, attention, executive function and language skills, whereas patients in the control group underwent a control intervention.

RESULTS

A Repeated Measures General Linear Model considering groups' performance at the three assessment points (before training, after training and at the 6-month follow-up) showed a significant interaction effect for: digit span forward (F(2,74) = 2.785, p = 0.03) and backward (F(2,74) = 3.183, p = 0.02), two-syllable words test (F(2,74) = 3.491, p = 0.004), Rivermead Behavioural Memory Test immediate (F(2,74) = 2.877, p = 0.03) and delayed (F(2,74) = 3.783, p = 0.003), Token test (F(2,74) = 4.783, p = 0.001), and Brixton test (F(2,74) = 8.783, p < 0.001). For all of them, experimental group performed better than controls.

CONCLUSIONS

Patients in the experimental group showed a significant improvement in various neuropsychological domains, and their achievements were stable after 6 months. This study suggests an useful computerized training in AD, and should prompt further investigations about the generalizability of patients' acquired skills to more ecologically oriented tasks.

摘要

引言

阿尔茨海默病(AD)会出现显著的神经心理缺陷。AD患者的认知训练最近已开始展现出其效果。在本研究中,我们对一大群早期AD患者实施了计算机化认知训练,以确定其在神经心理层面的效果,并调查6个月后这些效果是否稳定。

方法

总体而言,80名AD患者被随机分为两组。实验组患者连续12周每周使用结构化康复软件三次,旨在训练记忆、注意力、执行功能和语言技能,而对照组患者接受对照干预。

结果

一个重复测量一般线性模型考虑了两组在三个评估点(训练前、训练后和6个月随访时)的表现,结果显示在以下方面存在显著交互效应:顺背数字广度(F(2,74) = 2.785,p = 0.03)和倒背数字广度(F(2,74) = 3.183,p = 0.02)、双音节词测试(F(2,74) = 3.491,p = 0.004)、Rivermead行为记忆测试即时回忆(F(2,74) = 2.877,p = 0.03)和延迟回忆(F(2,74) = 3.783,p = 0.003)、代币测试(F(2,74) = 4.783,p = 0.001)以及布里克斯顿测试(F(2,74) = 8.783,p < 0.001)。对于所有这些测试,实验组的表现均优于对照组。

结论

实验组患者在多个神经心理领域表现出显著改善,且其成果在6个月后保持稳定。本研究表明计算机化训练对AD患者有用,应促使进一步研究患者所获技能在更具生态导向任务中的可推广性。

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