Department of Psychology, Faculty of Health Sciences, Camilo José Cela University, Madrid, Spain.
Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology (Technical University of Madrid and Complutense University of Madrid), Madrid, Spain.
Neuropsychol Rehabil. 2021 Jul;31(6):983-1001. doi: 10.1080/09602011.2020.1751663. Epub 2020 Apr 23.
Previous research has identified a critical role of executive function and memory in self-awareness, a metacognitive capacity often impaired in acquired brain injury. Through this observational study, we aimed to explore the effect of cognitive rehabilitation on the predictive value of these variables, as also whether any of them can predict the level of self-awareness once the cognitive rehabilitation is completed. 69 patients underwent a neuropsychological assessment, including self-awareness, at admission to and discharge from a cognitive rehabilitation process. Regression analysis was performed at these two moments and a third one was conducted to evaluate whether any of the variables at admission predicted the level of self-awareness at discharge. Verbal fluency was found to be the best predictor of self-awareness, both at admission and discharge. In addition, inhibition and cognitive flexibility, as well as episodic memory, appeared as significant predictors of post-rehabilitation self-awareness. Finally, verbal fluency was revealed as the unique pre-rehabilitation predictor of subsequent level of self-awareness following rehabilitation. While post-acute self-awareness is predicted by non-specific executive measures, the cognitive improvement putatively induced by neuropsychological rehabilitation reveals the contribution of more specific executive and memory functions. Importantly, pre-rehabilitation verbal fluency scores predicted the level of self-awareness after cognitive rehabilitation.
先前的研究已经确定了执行功能和记忆在自我意识中的关键作用，而自我意识是一种元认知能力，在获得性脑损伤中经常受损。通过这项观察性研究，我们旨在探讨认知康复对这些变量的预测价值的影响，以及它们中的任何一个是否可以预测认知康复完成后的自我意识水平。69 名患者在认知康复过程的入院时和出院时接受了神经心理学评估，包括自我意识评估。在这两个时间点进行了回归分析，并进行了第三个分析，以评估入院时的任何变量是否可以预测出院时的自我意识水平。在入院和出院时，言语流畅性是自我意识的最佳预测指标。此外，抑制和认知灵活性以及情景记忆也表现为康复后自我意识的重要预测指标。最后，言语流畅性被揭示为康复后自我意识后续水平的唯一康复前预测指标。虽然急性后自我意识是由非特异性执行措施预测的，但神经心理学康复所带来的认知改善揭示了更具体的执行和记忆功能的贡献。重要的是，康复前的言语流畅性评分可以预测认知康复后的自我意识水平。
