de Oliveira Rosa Virginia, Rosa Franco Alexandre, Abrahão Salum Júnior Giovanni, Moreira-Maia Carlos Renato, Wagner Flávia, Simioni André, de Fraga Bassotto Caroline, R Moritz Guilherme, Schaffer Aguzzoli Cristiano, Buchweitz Augusto, Schmitz Marcelo, Rubia Katya, Paim Rohde Luis Augusto
Postgraduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
ADHD Outpatient Program, Hospital de Clinicas de Porto Alegre, Department of Psychiatry, Federal University of Rio Grande do Sul, Serviço de Psiquiatria. Ramiro Barcelos, 2350. Bairro Santa Cecília, Porto Alegre, RS, CEP: 90035-903, Brazil.
Brain Imaging Behav. 2020 Oct;14(5):1933-1944. doi: 10.1007/s11682-019-00137-0.
The neurofunctional effects of Cognitive training (CT) are poorly understood. Our main objective was to assess fMRI brain activation patterns in children with ADHD who received CT as an add-on treatment to stimulant medication. We included twenty children with ADHD from a clinical trial of stimulant medication and CT (10 in medication + CT and 10 in medication + non-active training). Between-group differences were assessed in performance and in brain activation during 3 fMRI paradigms of working memory (N-back: 0-back, 1-back, 2-back, 3-back), sustained attention (Sustained Attention Task - SAT: 2 s, 5 s and 8 s delays) and inhibitory control (Go/No-Go). We found significant group x time x condition interactions in working memory (WM) and sustained attention on brain activation. In N-back, decreases were observed in the BOLD signal change from baseline to endpoint with increasing WM load in the right insula, right putamen, left thalamus and left pallidum in the CT compared to the non-active group; in SAT - increases in the BOLD signal change from baseline to endpoint with increasing delays were observed in bilateral precuneus, right insula, bilateral associative visual cortex and angular gyrus, right middle temporal, precentral, postcentral, superior frontal and middle frontal gyri in the CT compared to the non-active group. CT in ADHD was associated with changes in activation in task-relevant parietal and striato-limbic regions of sustained attention and working memory. Changes in brain activity may precede behavioral performance modifications in working memory and sustained attention, but not in inhibitory control.
认知训练(CT)的神经功能效应目前还知之甚少。我们的主要目标是评估接受CT作为兴奋剂药物辅助治疗的多动症儿童的功能磁共振成像(fMRI)脑激活模式。我们纳入了来自一项兴奋剂药物和CT临床试验的20名多动症儿童(10名接受药物+CT治疗,10名接受药物+非活性训练)。在3种功能磁共振成像工作记忆范式(N-back:0-back、1-back、2-back、3-back)、持续注意力(持续注意力任务-SAT:2秒、5秒和8秒延迟)和抑制控制(Go/No-Go)过程中,对两组之间的表现和脑激活进行了差异评估。我们发现在工作记忆(WM)和持续注意力的脑激活方面存在显著的组×时间×条件交互作用。在N-back任务中,与非活性组相比,CT组右侧脑岛、右侧壳核、左侧丘脑和左侧苍白球从基线到终点的血氧水平依赖(BOLD)信号变化随工作记忆负荷增加而降低;在SAT任务中,与非活性组相比,CT组双侧楔前叶、右侧脑岛、双侧联合视觉皮层和角回、右侧颞中回、中央前回、中央后回、额上回和额中回从基线到终点的BOLD信号变化随延迟增加而增加。多动症的CT治疗与持续注意力和工作记忆相关的顶叶及纹状体-边缘区域的激活变化有关。脑活动的变化可能先于工作记忆和持续注意力方面的行为表现改变,但在抑制控制方面并非如此。