CCN, Dept. of Psychology and Communication, Aalborg University, 9220 Aalborg, Denmark.
CNRU, CFIN, MindLab, Aarhus University, Denmark.
Brain. 2017 Apr 1;140(4):1100-1106. doi: 10.1093/brain/awx001.
Working memory impairment is prevalent in brain injured patients across lesion aetiologies and severities. Unfortunately, rehabilitation efforts for this impairment have hitherto yielded small or no effects. Here we show in a randomized actively controlled trial that working memory performance can be effectively restored by suggesting to hypnotized patients that they have regained their pre-injury level of working memory functioning. Following four 1-h sessions, 27 patients had a medium-sized improvement relative to 22 active controls (Bayes factors of 342 and 37.5 on the two aggregate outcome measures) and a very large improvement relative to 19 passive controls (Bayes factor = 1.7 × 1013). This was a long-term effect as revealed by no deterioration following a 6.7 week no-contact period (Bayes factors = 7.1 and 1.3 in favour of no change). To control for participant-specific effects, the active control group was crossed over to the working memory suggestion and showed superior improvement. By the end of the study, both groups reached a performance level at or above the healthy population mean with standardized mean differences between 1.55 and 2.03 relative to the passive control group. We conclude that, if framed correctly, hypnotic suggestion can effectively improve working memory following acquired brain injury. The speed and consistency with which this improvement occurred, indicate that there may be a residual capacity for normal information processing in the injured brain.
工作记忆损伤在各种病因和严重程度的脑损伤患者中都很常见。不幸的是，迄今为止，针对这种损伤的康复努力收效甚微。在这里，我们在一项随机对照试验中表明，通过向催眠患者暗示他们已经恢复了受伤前的工作记忆功能，可以有效地恢复工作记忆表现。在进行了四次 1 小时的治疗后，27 名患者相对于 22 名主动对照组（在两个综合结果测量中贝叶斯因子为 342 和 37.5）和 19 名被动对照组（贝叶斯因子 = 1.7×1013）有中等程度的改善。这是一种长期效应，因为在 6.7 周无接触期后没有恶化（贝叶斯因子分别为 7.1 和 1.3，表明没有变化）。为了控制参与者特定的影响，将主动对照组交叉到工作记忆暗示组，结果显示出更好的改善。在研究结束时，两组的表现水平都达到或高于健康人群的平均值，与被动对照组相比，标准化均数差为 1.55 至 2.03。我们得出结论，如果框架正确，催眠暗示可以有效地改善后天性脑损伤后的工作记忆。这种改善的速度和一致性表明，受伤大脑中可能存在正常信息处理的剩余能力。
