工作记忆训练对脑损伤患者认知功能的迁移效应  

Transfer effect of working memory training on cognitive function in patients with brain injury

作　　者：薛翠萍 恽晓平[2] 张黎明[1,3] 赵茹莲[1,3] 薛翠红 刘爱贤 XUE Cuiping;YUN Xiaoping;ZHANG Liming(Beijing Rehabilitation Hospital of Capital Medical University,Beijing,100144)

机构地区：[1]首都医科大学附属北京康复医院,北京市100144 [2]中国康复研究中心北京博爱医院康复评定科 [3]首都医科大学康复医学院 [4]衡水市第二人民医院

出　　处：《中国康复医学杂志》2022年第5期630-635,共6页Chinese Journal of Rehabilitation Medicine

基　　金：首都医科大学附属北京康复医院健康管理专项科研项目(2018-009);首都医科大学附属北京康复医院培养项目(2018-021);国家自然科学基金项目(81272165)。

摘　　要：目的:探讨工作记忆训练对脑损伤患者日常生活记忆、思维能力、注意力等认知功能的迁移效应。方法:将28例患有工作记忆障碍的脑损伤患者随机分为训练组(n=14)和对照组(n=14)。训练组患者参与4周的工作记忆训练,训练内容采用“工作记忆训练系统”。对照组患者未进行认知康复训练。两组患者训练前后均进行数字/空间记忆广度测试、n-back测试、威斯康星卡片分类测试、瑞文推理测试、选择反应时测验、Stroop测验、Rivermead行为记忆测试第3版等进行训练疗效及转移效应评定。分别比较两组患者训练前后差值,并对工作记忆与日常生活记忆、思维、注意等能力进行相关分析。结果:(1)训练组在所有的测试项目中较训练前均有提高(P<0.05);对照组只有数字正背较训练前有提高;(2)在Rivermead行为记忆测试第3版中训练后成绩训练组较对照组有明显提高(P<0.05);(3)在威斯康星卡片分类测验及瑞文推理测验中训练组较对照组均有提高(P<0.05);(4)在Stroop测验、选择反应时测验中训练组和对照组在训练前后均无明显差异;(5)工作记忆成绩训练前后差值与威斯康星卡片分类测验总应答数、RBMT量表分及记忆指数、瑞文推理测验得分存在相关关系,相关系数为﹣0.419—0.650,有显著性意义(P<0.05);但工作记忆与选择反应时、Stroop测验相关系数范围为﹣0.002—0.258(P>0.05)。结论:工作记忆强化训练疗效可以向日常生活记忆抽象思维推理能力迁移,提高患者日常生活记忆水平思维概括能力,但向注意力迁移作用不确切。Objective:To explore the effect of working memory training on mental ability,daily life memory and attention in patients with brain injury.Method:Totally 28 patients with working memory impairment were randomly divided into training group(n=14)and control group(n=14).The patients in the training group participated in working memory training for 4weeks,and the training content was"working memory training system".The patients in the control group did not receive cognitive rehabilitation training.Before and after the training,the patients in the two groups were tested with digit/spatial memory span test,n-back test,Wisconsin card classification test,raven reasoning test,attention selection test,Stroop and Rivermead behavioral memory test 3rd Edition test to evaluate the training effect and transfer effect.The differences between the two groups before and after training were compared,and the correlation between working memory,thinking,attention and other abilities was analyzed.Result:First,in the training group,all test items were all improved(P<0.05),in the control group,only digit back was improved.Second,in the third version of Rivermead behavioral memory test,the performance of the training group was significantly improved(P<0.05).Third,in the reasoning thinking test,Wisconsin card classification test the training group improved more than the control group.Fourth,there was no difference between two groups in the Stroop test and the attention test in the selective reaction time.Fifth,there was a correlation between the improvement of working memory and the total response of Wisconsin card classification test,RBMT scale score,memory index and raven reasoning test score The correlation coefficient was between﹣0.595and 0.650,which was statistically significant(P<0.05),but the correlation coefficients of working memory and attention reaction time,Stroop test were between﹣0.002 and 0.258(P>0.05).Conclusion:The effect of working memory intensive training can be migrated to daily life memory the abstract thinking and

关 键 词：工作记忆训练 脑损伤 迁移效应 认知功能 

分 类 号：R651[医药卫生—外科学] R493[医药卫生—临床医学]