Master of General Psychology, Persian Gulf University of Bushehr, Bushehr, Iran.
Clinical Psychology, Persian Gulf University of Bushehr, Bushehr, Iran.
Acta Psychol (Amst). 2024 Oct;250:104553. doi: 10.1016/j.actpsy.2024.104553. Epub 2024 Oct 28.
Traumatic brain injury (TBI) often causes persistent deficits in cognitive flexibility and information updating. Cognitive flexibility refers to the brain's ability to adjust its thinking and behavior in response to changing circumstances, whereas information updating is the process of incorporating new facts into current knowledge. Both cognitive flexibility and information updating are critical components of executive function, and their impairment can have a major influence on a person's capacity to operate independently and adjust to life's problems following a TBI. Understanding and addressing these specific cognitive processes is therefore critical in designing successful therapies for TBI patients. Previous studies have examined the effects of non-invasive brain stimulation and cognitive training separately. This study investigated the effects of combining transcranial direct current stimulation (tDCS) with computer-based cognitive training, comparing this combined intervention against a control group with no treatment, to assess improvements in two executive functions in TBI patients: cognitive flexibility and information updating. Thirty TBI patients, 2-12 weeks post-injury with impaired executive dysfunction, were randomized to an experimental or control group. The experimental group received ten 30-minute sessions over 2 weeks of anodal (A-tDCS), 2.0 mA to the prefrontal cortex while performing cognitive training tasks from the RehaCom software. The control group received no intervention during this period. Cognitive flexibility and information updating were assessed before and after the intervention period using the n-back working memory task, Wisconsin Sorting Card Test, and quantitative electroencephalography (qEEG) during eyes-closed state. Statistically significant differences in theta, alpha, beta, and gamma band power were observed between groups (p < .05, 4 < f < 6). Secondary outcomes indicated significant improvements in cognitive flexibility within Wisconsin Card Sorting Test and information updating performance within n-back task (p < .05, 7 < f < 20). The combination of tDCS and cognitive training may improve cognitive flexibility and information updating in TBI patients by enhancing plasticity and connectivity in prefrontal regions involved in these complex cognitive processes.
创伤性脑损伤（TBI）常导致认知灵活性和信息更新方面的持续缺陷。认知灵活性是指大脑根据环境变化调整思维和行为的能力，而信息更新是将新事实纳入当前知识的过程。认知灵活性和信息更新都是执行功能的关键组成部分，它们的损伤会对 TBI 患者独立运作和适应生活问题的能力产生重大影响。因此，了解和解决这些特定的认知过程对于为 TBI 患者设计成功的治疗方法至关重要。先前的研究分别研究了非侵入性脑刺激和认知训练的效果。本研究调查了经颅直流电刺激（tDCS）与基于计算机的认知训练相结合的效果，将这种联合干预与无治疗的对照组进行比较，以评估 TBI 患者两种执行功能的改善情况：认知灵活性和信息更新。30 名 TBI 患者，受伤后 2-12 周，存在执行功能障碍，随机分为实验组和对照组。实验组在 2 周内接受 10 次 30 分钟的治疗，即在前额叶皮层给予 2.0 mA 的阳极 tDCS，同时执行 RehaCom 软件中的认知训练任务。在此期间，对照组未接受任何干预。在干预前后使用 n-back 工作记忆任务、威斯康星卡片分类测试和闭眼状态下的定量脑电图（qEEG）评估认知灵活性和信息更新。观察到组间θ、α、β和γ频段功率存在统计学显著差异（p<0.05，4<f<6）。次要结果表明，威斯康星卡片分类测试中的认知灵活性和 n-back 任务中的信息更新表现有显著改善（p<0.05，7<f<20）。tDCS 和认知训练的联合使用可能通过增强涉及这些复杂认知过程的前额叶区域的可塑性和连通性来改善 TBI 患者的认知灵活性和信息更新。
