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Neuroimaging and Neuropsychological Outcomes Following Clinician-Delivered Cognitive Training for Six Patients With Mild Brain Injury: A Multiple Case Study
Frontiers in Human Neuroscience ( IF 2.9 ) Pub Date : 2020-06-24 , DOI: 10.3389/fnhum.2020.00229
Amy Lawson Moore 1 , Dick M Carpenter 2 , Randolph L James 3 , Terissa Michele Miller 1 , Jeffrey J Moore 4 , Elizabeth A Disbrow 5, 6 , Christina R Ledbetter 6, 7
Affiliation  

Nearly half of all mild brain injury sufferers experience long-term cognitive impairment, so an important goal in rehabilitation is to address their multiple cognitive deficits to help them return to prior levels of functioning. Cognitive training, or the use of repeated mental exercises to enhance cognition, is one remediation method for brain injury. The primary purpose of this hypothesis-generating pilot study was to explore the statistical and clinical significance of cognitive changes and transfer of training to real-life functioning following 60 h of Brain Booster, a clinician-delivered cognitive training program, for six patients with mild traumatic brain injury (TBI) or non-traumatic acquired brain injury (ABI). The secondary purpose was to explore changes in functional connectivity and neural correlates of cognitive test gains following the training. We used a multiple case study design to document significant changes in cognitive test scores, overall IQ score, and symptom ratings; and we used magnetic resonance imaging (MRI) to explore trends in functional network connectivity and neural correlates of cognitive change. All cognitive test scores showed improvement with statistically significant changes on five of the seven measures (long-term memory, processing speed, reasoning, auditory processing, and overall IQ score). The mean change in IQ score was 20 points, from a mean of 108 to a mean of 128. Five themes emerged from the qualitative data analysis including improvements in cognition, mood, social identity, performance, and Instrumental Activities of Daily Living (IADLs). With MRI, we documented significant region-to-region changes in connectivity following cognitive training including those involving the cerebellum and cerebellar networks. We also found significant correlations between changes in IQ score and change in white matter integrity of bilateral corticospinal tracts (CST) and the left uncinate fasciculus. This study adds to the growing body of literature examining the effects of cognitive training for mild TBI and ABI, and to the collection of research on the benefits of cognitive training in general. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT02918994.

中文翻译:

临床医生对 6 名轻度脑损伤患者进行认知训练后的神经影像学和神经心理学结果:一个多案例研究

近一半的轻度脑损伤患者会经历长期认知障碍,因此康复的一个重要目标是解决他们的多种认知缺陷,帮助他们恢复到先前的功能水平。认知训练,或使用反复的心理锻炼来增强认知能力,是一种治疗脑损伤的方法。这项产生假设的试点研究的主要目的是探索认知变化的统计和临床意义,以及在 60 小时的大脑助推器(一种临床医生提供的认知训练计划)后将训练转移到现实生活中,对六名轻度创伤性脑损伤 (TBI) 或非创伤性获得性脑损伤 (ABI)。次要目的是探索训练后认知测试增益的功能连接和神经相关性的变化。我们使用多案例研究设计来记录认知测试分数、整体智商分数和症状评分的显着变化;我们使用磁共振成像 (MRI) 来探索功能网络连接和认知变化的神经相关性的趋势。所有认知测试分数都显示出改善,七项措施中的五项(长期记忆、处理速度、推理、听觉处理和整体智商得分)有统计学意义的变化。智商得分的平均变化为 20 分,从平均 108 分到平均 128 分。定性数据分析中出现了五个主题,包括认知、情绪、社会认同、表现、和工具性日常生活活动 (IADL)。通过 MRI,我们记录了认知训练后连接性的显着区域间变化,包括那些涉及小脑和小脑网络的变化。我们还发现 IQ 评分的变化与双侧皮质脊髓束 (CST) 和左钩状束的白质完整性变化之间存在显着相关性。这项研究增加了越来越多的文献,研究了认知训练对轻度 TBI 和 ABI 的影响,以及关于认知训练总体益处的研究集合。临床试验注册:www.ClinicalTrials.gov,标识符 NCT02918994。我们记录了认知训练后区域间连通性的显着变化,包括涉及小脑和小脑网络的变化。我们还发现 IQ 评分的变化与双侧皮质脊髓束 (CST) 和左钩状束的白质完整性变化之间存在显着相关性。这项研究增加了越来越多的文献,研究了认知训练对轻度 TBI 和 ABI 的影响,以及关于认知训练总体益处的研究集合。临床试验注册:www.ClinicalTrials.gov,标识符 NCT02918994。我们记录了认知训练后区域间连通性的显着变化,包括涉及小脑和小脑网络的变化。我们还发现 IQ 评分的变化与双侧皮质脊髓束 (CST) 和左钩状束的白质完整性变化之间存在显着相关性。这项研究增加了越来越多的文献,研究了认知训练对轻度 TBI 和 ABI 的影响,以及关于认知训练总体益处的研究集合。临床试验注册:www.ClinicalTrials.gov,标识符 NCT02918994。这项研究增加了越来越多的文献,研究了认知训练对轻度 TBI 和 ABI 的影响,以及关于认知训练总体益处的研究集合。临床试验注册:www.ClinicalTrials.gov,标识符 NCT02918994。这项研究增加了越来越多的文献,研究了认知训练对轻度 TBI 和 ABI 的影响,以及关于认知训练总体益处的研究集合。临床试验注册:www.ClinicalTrials.gov,标识符 NCT02918994。
更新日期:2020-06-24
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