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：

---

小儿镰状细胞病工作记忆训练的随机对照试验

目标 患有镰状细胞病 (SCD) 的青年面临神经认知缺陷的风险，包括工作记忆 (WM) 问题，但几乎没有改善功能的干预措施。本研究旨在使用平行组随机对照试验设计确定基于家庭的数字 WM 培训在短期记忆和 WM、行为结果和学术流利度方面的可行性和有效性。方法 47 名 SCD 和短期记忆或 WM 困难的儿童（7-16 岁）被随机分配到在家使用平板设备进行 Cogmed 工作记忆训练（N = 24）或标准护理候补名单组（N = 23）等待期后使用 Cogmed。临床评估的主要结果包括语言和非语言短期记忆和 WM 任务的表现。次要结果包括父母评定的执行功能以及数学和阅读流畅性的测试。结果 在可评估的样本中，Cogmed 组（N = 21）与 Waitlist 组（N = 22；p = .03，d = 0.70 [CI95 = 0.08，1.31]）相比，视觉 WM 的改善更大。在检查参与者的组合样本时，完成≥10 次培训的参与者在口头短期记忆、视觉 WM 和数学流畅度方面表现出显着改善。对 Cogmed 的依从性低于预期（M = 9.07 次，SD = 7.77），19 名参与者（41%）完成了至少 10 次。结论：视觉 WM 是一种通常受 SCD 影响的能力，可通过认知训练进行修改。当患者完成足够的训练剂量时，益处扩展到口头短期记忆和数学流畅性。