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认知工作记忆训练(CWMT)对患有注意缺陷多动障碍(ADHD)的青少年的疗效:一项考虑伴随药物治疗效果的对照试验。

Cognitive Working Memory Training (CWMT) in adolescents suffering from Attention-Deficit/Hyperactivity Disorder (ADHD): A controlled trial taking into account concomitant medication effects.

机构信息

University Service of Child and Adolescent Psychiatry, University Hospital of Lausanne, Switzerland.

Biomedical Imaging Center (CIBM), Department of Radiology, University Hospital of Lausanne, Switzerland.

出版信息

Psychiatry Res. 2018 Nov;269:79-85. doi: 10.1016/j.psychres.2018.07.036. Epub 2018 Jul 27.

Abstract

Although, cognitive working memory training (CWMT) has been reported to enhance working memory functioning in youths with attention-deficit/ hyperactivity disorder (ADHD), few studies take into account the concomitant effects of medication. Sixty adolescents aged from 11 to 15 years were randomly assigned to CWMT treatment, whereas medication was either continued or not introduced (no randomization performed). Results revealed beneficial effects of CWMT on the different components of working memory (WM), namely the phonological loop, the visuospatial sketchpad and the central executive. In particular, CWMT allowed participants to obtain a level of performance similar to the typically-developing adolescents for the phonological loop (i.e., forward digit span) as well as for the visuospatial sketchpad (i.e., board span). For the central executive (i.e., backward digit span) the concomitant effects of CWMT and medication allows participants to obtain the performance level of the typically-developing adolescents. Although, no transfers were observed with respect to other cognitive functions, in medicated patients with ADHD, CWMT reduced hyperactivity / impulsivity symptoms at 2-month follow-up. The present study gives evidence of the efficacy of CWMT to enhance WM performance, as well as, to reduce symptoms. The overall results highlight the usefulness of multimodal interventions.

摘要

虽然认知工作记忆训练(CWMT)已被报道可增强注意力缺陷/多动障碍(ADHD)青少年的工作记忆功能,但很少有研究考虑到药物治疗的伴随影响。60 名年龄在 11 至 15 岁的青少年被随机分配到 CWMT 治疗组,而药物治疗要么继续,要么不引入(未进行随机分组)。结果表明,CWMT 对工作记忆(WM)的不同成分(即语音回路、视空间草图和中央执行)具有有益的影响。特别是,CWMT 使参与者在语音回路(即顺背数字广度)和视空间草图(即棋盘跨度)方面获得了类似于正常发育青少年的表现水平。对于中央执行(即倒背数字广度),CWMT 和药物治疗的伴随影响使参与者能够获得正常发育青少年的表现水平。虽然在接受药物治疗的 ADHD 患者中没有观察到其他认知功能的转移,但 CWMT 在 2 个月的随访中降低了多动/冲动症状。本研究证明了 CWMT 提高 WM 表现和降低症状的疗效。总体结果强调了多模式干预的有用性。

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