OBJECTIVE Youth with sickle cell disease (SCD) are at risk for neurocognitive deficits including problems with working memory (WM), but few interventions to improve functioning exist. This study sought to determine the feasibility and efficacy of home-based, digital WM training on short-term memory and WM, behavioral outcomes, and academic fluency using a parallel group randomized controlled trial design. METHODS 47 children (7-16 years) with SCD and short-term memory or WM difficulties were randomized to Cogmed Working Memory Training at home on a tablet device (N = 24) or to a standard care Waitlist group (N = 23) that used Cogmed after the waiting period. Primary outcomes assessed in clinic included performance on verbal and nonverbal short-term memory and WM tasks. Secondary outcomes included parent-rated executive functioning and tests of math and reading fluency. RESULTS In the evaluable sample, the Cogmed group (N = 21) showed greater improvement in visual WM compared with the Waitlist group (N = 22; p = .03, d = 0.70 [CI95 = 0.08, 1.31]). When examining a combined sample of participants, those who completed ≥10 training sessions exhibited significant improvements in verbal short-term memory, visual WM, and math fluency. Adherence to Cogmed was lower than expected (M = 9.07 sessions, SD = 7.77), with 19 participants (41%) completing at least 10 sessions. Conclusions: Visual WM, an ability commonly affected by SCD, is modifiable with cognitive training. Benefits extended to verbal short-term memory and math fluency when patients completed a sufficient training dose. Additional research is needed to identify ideal candidates for training and determine whether training gains are sustainable and generalize to real-world outcomes.

中文翻译：

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小儿镰状细胞病工作记忆训练的随机对照试验。

目的患有镰状细胞病（SCD）的青年处于神经认知缺陷的风险中，包括工作记忆（WM）问题，但是很少有改善功能的干预措施。这项研究旨在使用并行分组的随机对照试验设计来确定基于家庭的数字WM短期记忆和WM训练，行为结果和学术流利度的可行性和有效性。方法将47名SCD，短期记忆或WM困难的儿童（7-16岁）随机分配到在家中使用平板设备进行Cogmed工作记忆训练（N = 24）或标准护理候补名单组（N = 23），在等待期过后使用Cogmed。临床评估的主要结局包括口头和非语言短期记忆和WM任务的表现。次要结果包括父母评估的执行功能以及数学和阅读流利程度的测试。结果在可评估的样本中，Cogmed组（N = 21）的视觉WM较等待列表组（N = 22; p = .03，d = 0.70 [CI95 = 0.08，1.31]）有更大的改善。当检查参与者的组合样本时，完成≥10次培训的参与者在言语短期记忆，视觉WM和数学流利性方面均表现出显着改善。对Cogmed的依从性低于预期（M = 9.07，SD = 7.77），有19名参与者（41％）完成了至少10节。结论：视觉WM，一种通常受SCD影响的能力，可以通过认知训练来改变。当患者完成足够的训练剂量后，其益处将扩展到口头短期记忆和数学流利性。