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7 周认知训练对非痴呆型血管性认知障碍患者的影响(Cog-VACCINE 研究):一项随机对照试验。

The effects of 7-week cognitive training in patients with vascular cognitive impairment, no dementia (the Cog-VACCINE study): A randomized controlled trial.

机构信息

Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, Beijing, China; Key Laboratory of Neurodegenerative Diseases, Ministry of Education of the People's Republic of China, Beijing, China.

Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, Beijing, China; Key Laboratory of Neurodegenerative Diseases, Ministry of Education of the People's Republic of China, Beijing, China.

出版信息

Alzheimers Dement. 2019 May;15(5):605-614. doi: 10.1016/j.jalz.2019.01.009. Epub 2019 Mar 17.

Abstract

INTRODUCTION

Evidence for the efficacy of cognitive training in patients with subcortical vascular cognitive impairment no dementia is still lacking.

METHODS

A randomized, active controlled design using multidomain, adaptive, computerized cognitive training for 30 minutes, 5 days/week for 7 weeks. Assessments included global cognitive function and executive function (primary outcomes) and brain functional connectivity and structural changes (secondary outcomes).

RESULTS

Sixty patients were randomized across three medical centers in Beijing. At the end of the intervention, the cognitive training group showed significant improvement in Montreal Cognitive Assessment relative to the active control group (P = .013) and significantly increased functional connectivity between the left dorsolateral prefrontal cortex and medial prefrontal cortex, which was significantly correlated with Montreal Cognitive Assessment change (P = .017).

DISCUSSION

Computerized cognitive training significantly improved global cognitive function, which was supported by the improved brain plasticity. Incorporation of biomarkers should be implemented in cognitive training trials.

摘要

简介

对于皮质下血管性认知障碍但无痴呆的患者,认知训练的疗效证据仍然缺乏。

方法

采用随机、活性对照设计,使用多领域、适应性、计算机化认知训练,每次 30 分钟,每周 5 天,共 7 周。评估包括总体认知功能和执行功能(主要结局)以及脑功能连接和结构变化(次要结局)。

结果

60 名患者在北京的三个医学中心被随机分配。干预结束时,与活性对照组相比,认知训练组在蒙特利尔认知评估方面的表现有显著改善(P=0.013),并且左背外侧前额叶皮层和内侧前额叶皮层之间的功能连接显著增加,这与蒙特利尔认知评估的变化显著相关(P=0.017)。

讨论

计算机化认知训练显著改善了整体认知功能,这得到了大脑可塑性改善的支持。认知训练试验应纳入生物标志物。

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