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功能连接与反应抑制:计算机化认知训练 8 周随机对照试验的二次分析

Functional Connectivity and Response Inhibition: A Secondary Analysis of an 8-Week Randomized Controlled Trial of Computerized Cognitive Training.

机构信息

Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.

Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Vancouver, British Columbia, Canada.

出版信息

J Alzheimers Dis. 2021;80(4):1525-1537. doi: 10.3233/JAD-200844.

Abstract

BACKGROUND

Evidence suggests that computerized cognitive training (CCT) can improve cognitive function in older adults, particularly executive functions. However, the underlying mechanisms by which CCT may improve executive functions are not well established.

OBJECTIVE

To determine: 1) inter-network functional connectivity correlates of changes in executive functions; and 2) the effect of CCT on these functional connectivity correlates.

METHODS

This secondary analysis included a subset of 124 adults aged 65-85 years enrolled in an 8-week randomized controlled trial of CCT. Participants were randomized to either: 1) group-based CCT 3x/week for 1 hour plus 3x/week home-based training; 2) group-based CCT preceded by brisk walking (Ex+CCT) 3x/week for 1 hour plus 3x/week home-based training; or 3) group-based balanced and toned (BAT) classes 3x/week for 1 hour (control). At baseline and trial completion, 65 of the 124 participants completed resting-state functional magnetic resonance imaging and neuropsychological tests of executive functions, specifically the Stroop Colour-Word Test and Flanker Test.

RESULTS

Improved performance on the Stroop Colour-Word Test and Flanker Test were associated with decreased correlation between the default mode network (DMN) and the fronto-parietal network (FPN) (p < 0.05). Compared with BAT, CCT alone significantly decreased correlation between the left dorsolateral prefrontal cortex and both the left and right medial temporal gyrus (-0.143, 95%CI [-0.256,-0.030], p = 0.014, and -0.123, 95%CI [-0.242,-0.004], p = 0.043, respectively).

CONCLUSION

Decreased correlation between DMN and FPN, indicating less connection between these networks, may be an underlying mechanism by which CCT improves executive functions. Future studies are needed to replicate this finding.

摘要

背景

有证据表明,计算机化认知训练(CCT)可以改善老年人的认知功能,特别是执行功能。然而,CCT 改善执行功能的潜在机制尚不清楚。

目的

确定:1)执行功能变化的网络间功能连接相关性;2)CCT 对这些功能连接相关性的影响。

方法

这项二次分析包括一项 8 周随机对照 CCT 试验中招募的 124 名 65-85 岁成年人的一个亚组。参与者被随机分配到以下三组之一:1)每周 3 次团体 CCT,每次 1 小时,外加每周 3 次家庭训练;2)每周 3 次团体 CCT 前进行快走(Ex+CCT),每次 1 小时,外加每周 3 次家庭训练;3)每周 3 次团体平衡和协调(BAT)课程,每次 1 小时(对照组)。在基线和试验结束时,124 名参与者中的 65 名完成了静息态功能磁共振成像和执行功能的神经心理学测试,特别是 Stroop 颜色-单词测试和 Flanker 测试。

结果

Stroop 颜色-单词测试和 Flanker 测试的表现改善与默认模式网络(DMN)和额顶网络(FPN)之间的相关性降低相关(p<0.05)。与 BAT 相比,单独的 CCT 显著降低了左侧背外侧前额叶皮层与左、右内侧颞叶之间的相关性(-0.143,95%CI [-0.256,-0.030],p=0.014,和-0.123,95%CI [-0.242,-0.004],p=0.043)。

结论

DMN 和 FPN 之间的相关性降低,表明这些网络之间的连接减少,这可能是 CCT 改善执行功能的潜在机制。需要进一步的研究来复制这一发现。

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