Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.
Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China.
CNS Neurosci Ther. 2024 Jun;30(6):e14779. doi: 10.1111/cns.14779.
Previous neuroimaging studies of vascular cognitive impairment, no dementia (VCIND), have reported functional alterations, but far less is known about the effects of cognitive training on functional connectivity (FC) of intrinsic connectivity networks (ICNs) and how they relate to intervention-related cognitive improvement. This study provides comprehensive research on the changes in intra- and inter-brain functional networks in patients with VCIND who received computerized cognitive training, with a focus on the underlying mechanisms and potential therapeutic strategies.
We prospectively collected 60 patients with VCIND who were randomly divided into the training group (N = 30) receiving computerized cognitive training and the control group (N = 30) receiving fixed cognitive training. Functional MRI scans and cognitive assessments were performed at baseline, at the 7-week training, and at the 6-month follow-up. Utilizing templates for ICNs, the study employed a linear mixed model to compare intra- and inter-network FC changes between the two groups. Pearson correlation was applied to calculate the relationship between FC and cognitive function.
We found significantly decreased intra-network FC within the default mode network (DMN) following computerized cognitive training at Month 6 (p = 0.034), suggesting a potential loss of functional specialization. Computerized training led to increased functional coupling between the DMN and sensorimotor network (SMN) (p = 0.01) and between the language network (LN) and executive control network (ECN) at Month 6 (p < 0.001), indicating compensatory network adaptations in patients with VCIND. Notably, the intra-LN exhibited enhanced functional specialization after computerized cognitive training (p = 0.049), with significant FC increases among LN regions, which correlated with improvements in neuropsychological measures (p < 0.05), emphasizing the targeted impact of computerized cognitive training on language abilities.
This study provides insights into neuroplasticity and adaptive changes resulting from cognitive training in patients with VCIND, with implications for potential therapeutic strategies.
先前关于血管性认知障碍但无痴呆（VCIND）的神经影像学研究报告了功能改变，但对于认知训练对固有连接网络（ICN）的功能连接（FC）的影响以及它们与干预相关的认知改善之间的关系知之甚少。本研究全面研究了接受计算机化认知训练的 VCIND 患者的脑内和脑间功能网络变化，重点探讨了潜在的机制和潜在的治疗策略。
我们前瞻性地收集了 60 名 VCIND 患者，他们被随机分为训练组（N=30）接受计算机化认知训练和对照组（N=30）接受固定认知训练。在基线、7 周训练和 6 个月随访时进行功能磁共振成像扫描和认知评估。利用 ICN 模板，采用线性混合模型比较两组之间的内网络和外网络 FC 变化。采用 Pearson 相关分析计算 FC 与认知功能的关系。
我们发现，计算机化认知训练 6 个月后，默认模式网络（DMN）内网络 FC 显著降低（p=0.034），提示功能专业化可能丧失。计算机化训练导致 DMN 与感觉运动网络（SMN）之间（p=0.01）和语言网络（LN）与执行控制网络（ECN）之间的功能耦合增加（p<0.001），表明 VCIND 患者的代偿性网络适应。值得注意的是，计算机化认知训练后，LN 内网络的功能专业化增强（p=0.049），LN 区域之间的 FC 显著增加，与神经心理学测量的改善相关（p<0.05），强调了计算机化认知训练对语言能力的靶向影响。
本研究提供了 VCIND 患者认知训练引起的神经可塑性和适应性变化的见解，对潜在的治疗策略具有启示意义。
Zotero 插件
