The effect of high vs. low intensity neuropsychological treatment on working memory in patients with acquired brain injury

ABSTRACT

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.

KEYWORDS:

• Cognitive rehabilitation
• brain injury
• plasticity
• working memory training
• dose-response relationship

Declaration of interest

The authors declare that there is no conflict of interest. Hasomed GmbH, the company that distributes the cognitive training software ‘RehaCom’ evaluated in the present study, provided the interventions free of charge for the purposes of this research. From 03/2017 to 02/2019 as well as since 03/2020, Juliane Weicker is employed at Hasomed GmbH in the context of a new research project. The company was not involved in protocol designing, data analyses or interpretation of the results. The company did not read or approve the manuscript before submission.

Supplemental material

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

This work was supported by the FAZIT Stiftung; Max-Planck-Gesellschaft.