Aim

To evaluate the combined effect of compensation therapy and functional training on working memory (WM) in patients with acquired injury and chronic cognitive deficits by investigating the dose-response relationship and specificity of transfer effects.

Research design

Double-blind randomized controlled trial.

Methods

All patients underwent 4 weeks of compensation therapy in a day-care setting. In addition, they received either 20 sessions of computer-based WM training (n = 11) or attention training (n = 9). Transfer effects on cognition and their functional relevance in daily life were assessed before treatment, after 2 weeks (10 additional training sessions), and after 4 weeks (20 additional training sessions) of therapy.

Results

The combined treatment led to significant improvements in WM performance, verbal memory, and self-reported changes in daily life. The amount of training was identified to modulate efficacy: Significant improvements showed only in the later training phase. We observed no differences between the two training schemes (WM vs. attentional training).

Conclusions

Even in the chronic phase after brain lesion WM performance can be enhanced by the combination of compensation therapy and computerized cognitive training when applied intensely; both a more general attention and a specific WM training regimen are effective.

中文翻译：

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高低强度神经心理治疗对获得性脑损伤患者工作记忆的影响。

目标

通过研究剂量效应关系和转移效应的特异性，评估补偿疗法和功能训练对获得性损伤和慢性认知缺陷患者工作记忆（WM）的综合作用。

研究设计

双盲随机对照试验。

方法

在日托环境中，所有患者均接受了4周的补偿治疗。此外，他们还接受了20场基于计算机的WM培训（n = 11）或注意培训（n = 9）。在治疗前，治疗2周后（额外的10个培训课程）和治疗4周后（20个额外的培训课程）评估转移对认知的影响及其在日常生活中的功能相关性。

结果

结合治疗可以显着改善WM的表现，口头记忆和自我报告的日常生活变化。确定了训练量以调节功效：只有在以后的训练阶段才显示出明显的改善。我们观察到两种训练方案（WM与注意力训练）之间没有差异。

结论

即使在脑损伤后的慢性期，强烈应用补偿疗法和计算机认知训练相结合，也可以提高WM的表现；更普遍的关注和特定的WM培训方案都是有效的。