Recla Monica, Molteni Erika, Manfredi Valentina, Arrigoni Filippo, Nordio Andrea, Galbiati Susanna, Pastore Valentina, Modat Marc, Strazzer Sandra
Neurophysiatric Department, Neuropsychological and Cognitive-behavioral Service, Scientific Institute, I.R.C.C.S. Eugenio Medea, 23842 Bosisio Parini, Italy.
School of Biomedical Engineering & Imaging Sciences, and Centre for Medical Engineering, King's College, SE1 7EU London, UK.
Brain Sci. 2020 Jul 7;10(7):430. doi: 10.3390/brainsci10070430.
(1) Background: Memory deficits are common sequelae of pediatric Acquired Brain Injury (ABI). Only methods for non-focused cognitive remediation are available to the pediatric field. The aims of this feasibility trial are the description, implementation, and test of an intensive program specific to the training and re-adaptation of memory function in children, called Intensive Memory-Focused Training Program (IM-FTP); (2) Methods: Eleven children and adolescents with ABI (mean age at injury = 12.2 years, brain tumor survivors excluded) were clinically assessed and rehabilitated over 1-month through IM-FTP, including physio-kinesis/occupational, speech, and neuropsychology treatments. Each patient received a psychometric evaluation and a brain functional MRI at enrollment and at discharge. Ten pediatric controls with ABI (mean age at injury = 13.8 years) were clinically assessed, and rehabilitated through a standard program; (3) Results: After treatment, both groups had marked improvement in both immediate and delayed recall. IM-FTP was associated with better learning of semantically related and unrelated words, and larger improvement in immediate recall in prose memory. Imaging showed functional modification in the left frontal inferior cortex; (4) Conclusions: We described an age-independent reproducible multidisciplinary memory-focused rehabilitation protocol, which can be adapted to single patients while preserving inter-subject comparability, and is applicable up to a few months after injury. IM-FTP will now be employed in a powered clinical trial.
(1) 背景：记忆缺陷是小儿获得性脑损伤（ABI）常见的后遗症。小儿领域目前仅有非针对性认知康复方法。本可行性试验的目的是描述、实施并测试一项针对儿童记忆功能训练和重新适应的强化计划，即强化记忆聚焦训练计划（IM - FTP）；(2) 方法：11名患有ABI的儿童和青少年（受伤时平均年龄 = 12.2岁，排除脑肿瘤幸存者）接受了临床评估，并通过IM - FTP进行了为期1个月的康复治疗，包括物理运动/职业、言语和神经心理学治疗。每位患者在入组时和出院时均接受了心理测量评估和脑功能磁共振成像检查。10名患有ABI的儿科对照患者（受伤时平均年龄 = 13.8岁）接受了临床评估，并通过标准计划进行了康复治疗；(3) 结果：治疗后，两组在即时回忆和延迟回忆方面均有显著改善。IM - FTP与更好地学习语义相关和不相关单词以及散文记忆中即时回忆的更大改善相关。影像学显示左额叶下回有功能改变；(4) 结论：我们描述了一种与年龄无关的可重复的多学科记忆聚焦康复方案，该方案可根据个体患者进行调整，同时保持个体间的可比性，并且在受伤后几个月内均可应用。IM - FTP现在将用于一项有足够样本量的临床试验。
