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基于可塑性的认知康复对慢性创伤性脑损伤静息态功能连接的影响:一项初步研究。

The effects of plasticity-based cognitive rehabilitation on resting-state functional connectivity in chronic traumatic brain injury: A pilot study.

机构信息

Traumatic Brain Injury and Concussion Center, Department of Neurology, University of Utah, Salt Lake City, UT, USA.

Department of Psychology, Brigham Young University, Provo, UT, USA.

出版信息

NeuroRehabilitation. 2022;51(1):133-150. doi: 10.3233/NRE-210264.

Abstract

BACKGROUND

Traumatic brain injury (TBI) often results in chronic impairments to cognitive function, and these may be related to disrupted functional connectivity (FC) of the brain at rest.

OBJECTIVE

To investigate changes in default mode network (DMN) FC in adults with chronic TBI following 40 hours of auditory processing speed training.

METHODS

Eleven adults with chronic TBI underwent 40-hours of auditory processing speed training over 13-weeks and seven adults with chronic TBI were assigned to a non-intervention control group. For all participants, resting-state FC and cognitive and self-reported function were measured at baseline and at a follow-up visit 13-weeks later.

RESULTS

No significant group differences in cognitive function or resting-state FC were observed at baseline. Following training, the intervention group demonstrated objective and subjective improvements on cognitive measures with moderate-to-large effect sizes. Repeated measures ANCOVAs revealed significant (p < 0.001) group×time interactions, suggesting training-related changes in DMN FC, and semipartial correlations demonstrated that these were associated with changes in cognitive functioning.

CONCLUSIONS

Changes in the FC between the DMN and other resting-state networks involved in the maintenance and manipulation of internal information, attention, and sensorimotor functioning may be facilitated through consistent participation in plasticity-based auditory processing speed training in adults with chronic TBI.

摘要

背景

创伤性脑损伤(TBI)常导致认知功能的慢性损伤,这可能与大脑静息状态下功能连接(FC)的中断有关。

目的

研究成人慢性 TBI 患者在接受 40 小时听觉处理速度训练后,其默认模式网络(DMN)FC 的变化。

方法

11 名慢性 TBI 成人接受了为期 13 周、共 40 小时的听觉处理速度训练,另外 7 名慢性 TBI 成人被分配到非干预对照组。所有参与者在基线和 13 周后的随访中都进行了静息状态 FC 以及认知和自我报告功能的测量。

结果

基线时,两组在认知功能或静息状态 FC 上均无显著差异。经过训练,干预组在认知测量上表现出客观和主观的改善,具有中到大的效应量。重复测量方差分析显示出显著的(p < 0.001)组×时间交互作用,表明 DMN FC 发生了与训练相关的变化,而偏相关分析表明这些变化与认知功能的变化有关。

结论

通过在慢性 TBI 成人中持续参与基于可塑性的听觉处理速度训练,DMN 与其他与内部信息、注意力和感觉运动功能的维持和操作相关的静息状态网络之间的 FC 变化可能得到促进。

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