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正念干预对轻度认知障碍导致与注意力相关的改善和神经可塑性变化:9 个月随机对照试验的结果。

Mindfulness intervention for mild cognitive impairment led to attention-related improvements and neuroplastic changes: Results from a 9-month randomized control trial.

机构信息

Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Department of Psychiatry, Sengkang General Hospital, Singhealth Duke-Nus Academic Medical Centre, Singapore.

出版信息

J Psychiatr Res. 2021 Mar;135:203-211. doi: 10.1016/j.jpsychires.2021.01.032. Epub 2021 Jan 21.

DOI:10.1016/j.jpsychires.2021.01.032
PMID:33497874
Abstract

Mindfulness-based interventions can enhance cognitive abilities among older adults, thereby effectively delaying cognitive decline. These cognitive enhancements are theorized to accompany neuroplastic changes in the brain. However, this mindfulness-associated neuroplasticity has yet to be documented adequately. A randomized controlled trial was carried out among participants with mild cognitive impairment (MCI) to examine the effects of a mindfulness-based intervention on various cognitive outcomes and cortical thickness (CT) in the context of age-related cognitive impairment. Participants were assigned to a mindfulness awareness program (MAP)(n = 27) and an active control condition - health education program (n = 27). In both, they attended weekly sessions for three months and subsequently, monthly sessions for six months. Cognitive assessments and structural scans were carried out across three time-points. Whole brain analyses on CT were carried out and were supplemented with region of interest-based analyses. ROI values and cognitive outcomes were analyzed with mixed MANOVAs and followed up with univariate ANOVAs. Nine-month MAP-associated gains in working memory span and divided attention, along with an increased CT in the right frontal pole and decreased CT in the left anterior cingulate were observed. Three-month MAP-associated CT increase was observed in the left inferior temporal gyrus but did not sustain thereafter. MAP led to significant cognitive gains and various CT changes. Most of these neurobehavioral changes, may require sustained effort across nine months, albeit at a reduced intensity. MAP can remediate certain cognitive impairments and engender neuroplastic effects even among those with MCI.

摘要

正念干预可以增强老年人的认知能力,从而有效延缓认知能力下降。这些认知增强被认为伴随着大脑的神经可塑性变化。然而,这种与正念相关的神经可塑性尚未得到充分记录。一项针对轻度认知障碍(MCI)患者的随机对照试验,旨在研究正念干预对与年龄相关的认知障碍背景下各种认知结果和皮质厚度(CT)的影响。参与者被分配到正念意识计划(MAP)(n=27)和积极对照组-健康教育计划(n=27)。在这两个组中,他们每周参加一次为期三个月的课程,然后每月参加一次为期六个月的课程。在三个时间点进行认知评估和结构扫描。对 CT 进行全脑分析,并辅以基于感兴趣区域的分析。使用混合 MANOVAs 分析 ROI 值和认知结果,并进行单变量 ANOVA 随访。观察到 9 个月的 MAP 相关工作记忆跨度和注意力分散的增加,以及右侧额极 CT 的增加和左侧前扣带 CT 的减少。还观察到 3 个月的 MAP 相关左颞下回 CT 增加,但此后并未持续。MAP 导致显著的认知收益和各种 CT 变化。这些神经行为变化中的大多数,可能需要 9 个月的持续努力,尽管强度降低。MAP 甚至可以在 MCI 患者中纠正某些认知障碍并产生神经可塑性效应。

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