Moore Amy Lawson, Carpenter Dick M, James Randolph L, Miller Terissa Michele, Moore Jeffrey J, Disbrow Elizabeth A, Ledbetter Christina R
Department of Psychology, Gibson Institute of Cognitive Research, Colorado Springs, CO, United States.
College of Education, University of Colorado Colorado Springs, Colorado Springs, CO, United States.
Front Hum Neurosci. 2020 Jun 24;14:229. doi: 10.3389/fnhum.2020.00229. eCollection 2020.
Nearly half of all mild brain injury sufferers experience long-term cognitive impairment, so an important goal in rehabilitation is to address their multiple cognitive deficits to help them return to prior levels of functioning. Cognitive training, or the use of repeated mental exercises to enhance cognition, is one remediation method for brain injury. The primary purpose of this hypothesis-generating pilot study was to explore the statistical and clinical significance of cognitive changes and transfer of training to real-life functioning following 60 h of Brain Booster, a clinician-delivered cognitive training program, for six patients with mild traumatic brain injury (TBI) or non-traumatic acquired brain injury (ABI). The secondary purpose was to explore changes in functional connectivity and neural correlates of cognitive test gains following the training. We used a multiple case study design to document significant changes in cognitive test scores, overall IQ score, and symptom ratings; and we used magnetic resonance imaging (MRI) to explore trends in functional network connectivity and neural correlates of cognitive change. All cognitive test scores showed improvement with statistically significant changes on five of the seven measures (long-term memory, processing speed, reasoning, auditory processing, and overall IQ score). The mean change in IQ score was 20 points, from a mean of 108 to a mean of 128. Five themes emerged from the qualitative data analysis including improvements in cognition, mood, social identity, performance, and Instrumental Activities of Daily Living (IADLs). With MRI, we documented significant region-to-region changes in connectivity following cognitive training including those involving the cerebellum and cerebellar networks. We also found significant correlations between changes in IQ score and change in white matter integrity of bilateral corticospinal tracts (CST) and the left uncinate fasciculus. This study adds to the growing body of literature examining the effects of cognitive training for mild TBI and ABI, and to the collection of research on the benefits of cognitive training in general. www.ClinicalTrials.gov, identifier NCT02918994.
近一半的轻度脑损伤患者会经历长期认知障碍，因此康复的一个重要目标是解决他们的多种认知缺陷，帮助他们恢复到之前的功能水平。认知训练，即通过反复进行心理练习来增强认知，是脑损伤的一种补救方法。这项产生假设的试点研究的主要目的是探讨在为6名轻度创伤性脑损伤（TBI）或非创伤性获得性脑损伤（ABI）患者提供为期60小时的临床医生实施的认知训练项目“Brain Booster”后，认知变化的统计学和临床意义以及训练向现实生活功能的迁移。次要目的是探讨训练后功能连接性的变化以及认知测试成绩提高的神经相关性。我们采用多案例研究设计来记录认知测试分数、总体智商分数和症状评分的显著变化；并使用磁共振成像（MRI）来探索功能网络连接性的趋势以及认知变化的神经相关性。所有认知测试分数均有所改善，在七项测量中的五项（长期记忆、处理速度、推理、听觉处理和总体智商分数）上有统计学显著变化。智商分数的平均变化为20分，从平均108分提高到平均128分。定性数据分析得出五个主题，包括认知、情绪、社会认同、表现和日常生活工具性活动（IADL）方面的改善。通过MRI，我们记录了认知训练后连接性在区域间的显著变化，包括涉及小脑和小脑网络的变化。我们还发现智商分数的变化与双侧皮质脊髓束（CST）和左侧钩束白质完整性的变化之间存在显著相关性。这项研究为越来越多研究认知训练对轻度TBI和ABI影响的文献增添了内容，也为关于认知训练总体益处的研究做出了贡献。ClinicalTrials.gov网站，标识符NCT02918994。
