Working memory : development, disorders and training
Author: Westerberg, Helena
Date: 2004-05-14
Location: Skandiasalen, Astrid Lindgrens Barnsjukhus
Time: 13.00
Department: Institutionen för kvinnors och barns hälsa / Department of Women's and Children's Health
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Thesis (704.1Kb)
Abstract
Working memory (WM) is the ability to keep information online during a short period of time. Brain regions underlying WM functioning are found in the frontal and parietal cortices. It is largely unknown to what extent the neural substrates underlying WM are susceptible to training induced change. Here we investigate the development of WM capacity, if improvement by training is possible and explore the neuronal correlates for training induced change.
In Study I we used functional magnetic resonance imaging (fMRI) to investigate the neural correlates of the developmental change in WM capacity during childhood. We found that during performance of a visuo-spatial working memory test (VSWM), there was a significantly higher activity in the superior frontal and intraparietal cortex in subjects with higher capacity. Thus, the development of these areas may underlie the development of VSWM during childhood.
In Study II we used the VSWM test in children with and without ADHD and found that the test differentiated between these groups (P<.01). This supports the hypothesis that the WM deficit is a core deficit in ADHD. We proceeded by investigating if it was possible to improve WM capacity by training on WM tasks and secondly, if training effects would generalize to other cognitive tasks and areas of behaviour. These hypotheses were tested by designing a computerized program for WM training which was implemented in children with ADHD in two consecutive studies.
In Study III (N=14), we saw significant improvements in the treatment group as compared to the control group on the trained WM task (P < .001), on the non-trained WM tests (span-board P < .001, and digit span P < .001), as well as on other non-trained tasks; Stroop (P < .01), Raven (P < .001).
In Study IV the effects on the cognitive tests were replicated at a significance level of .01, with a randomized, double-blind, placebo-controlled multi-center design (N=44). In this study we also found generalisation of training effects to the behavioural level as evaluated by parents and teachers (inattention (P < .01) and parentrated hyperactivity/impulsivity (P < .05).
In Study V we investigated if stroke patients with significant WM deficits also could benefit from training. Participants suffering stroke one to three years earlier gained significant improvements in WM capacity (digit span p < .005, span board P < .05, and PASAT P < .00 1), and attention (RUFF 2&7 p < .005), as well as on cognitive symptoms in daily life, as measured by a self rating questionnaire (P < .005).
Study VI was undertaken to explore the neuronal correlates of WM improvement. Healthy young adults underwent fMRI before and after WM training. Task specific increases in brain activity were found in prefrontal and parietal cortices. These regions are known to underlie WM functioning.
Summary: WM shows a prolonged developmental course in humans. WM deficits are prominent in ADHD and following brain injury. However, WM can be improved by training and the treatment effect also generalizes to other cognitive tasks. The increase in WM capacity during childhood as well as after training is associated with increased brain activity in the prefrontal and parietal cortex.
In Study I we used functional magnetic resonance imaging (fMRI) to investigate the neural correlates of the developmental change in WM capacity during childhood. We found that during performance of a visuo-spatial working memory test (VSWM), there was a significantly higher activity in the superior frontal and intraparietal cortex in subjects with higher capacity. Thus, the development of these areas may underlie the development of VSWM during childhood.
In Study II we used the VSWM test in children with and without ADHD and found that the test differentiated between these groups (P<.01). This supports the hypothesis that the WM deficit is a core deficit in ADHD. We proceeded by investigating if it was possible to improve WM capacity by training on WM tasks and secondly, if training effects would generalize to other cognitive tasks and areas of behaviour. These hypotheses were tested by designing a computerized program for WM training which was implemented in children with ADHD in two consecutive studies.
In Study III (N=14), we saw significant improvements in the treatment group as compared to the control group on the trained WM task (P < .001), on the non-trained WM tests (span-board P < .001, and digit span P < .001), as well as on other non-trained tasks; Stroop (P < .01), Raven (P < .001).
In Study IV the effects on the cognitive tests were replicated at a significance level of .01, with a randomized, double-blind, placebo-controlled multi-center design (N=44). In this study we also found generalisation of training effects to the behavioural level as evaluated by parents and teachers (inattention (P < .01) and parentrated hyperactivity/impulsivity (P < .05).
In Study V we investigated if stroke patients with significant WM deficits also could benefit from training. Participants suffering stroke one to three years earlier gained significant improvements in WM capacity (digit span p < .005, span board P < .05, and PASAT P < .00 1), and attention (RUFF 2&7 p < .005), as well as on cognitive symptoms in daily life, as measured by a self rating questionnaire (P < .005).
Study VI was undertaken to explore the neuronal correlates of WM improvement. Healthy young adults underwent fMRI before and after WM training. Task specific increases in brain activity were found in prefrontal and parietal cortices. These regions are known to underlie WM functioning.
Summary: WM shows a prolonged developmental course in humans. WM deficits are prominent in ADHD and following brain injury. However, WM can be improved by training and the treatment effect also generalizes to other cognitive tasks. The increase in WM capacity during childhood as well as after training is associated with increased brain activity in the prefrontal and parietal cortex.
List of papers:
I. Klingberg T, Forssberg H, Westerberg H (2002). Increased brain activity in frontal and parietal cortex underlies the development of visuospatial working memory capacity during childhood. J Cogn Neurosci. 14(1): 1-10.
Pubmed
II. Westerberg H, Hirvikoski T, Forssberg H, Klingberg T (2004). Visuo-spatial working memory span: a sensitive measure of cognitive deficits in children with ADHD. Child Neuropsychology. [Accepted]
View record in Web of Science®
III. Klingberg T, Forssberg H, Westerberg H (2002). Training of working memory in children with ADHD. J Clin Exp Neuropsychol. 24(6): 781-91.
Pubmed
IV. Klingberg T, Fernell E, Olesen P, Johnson M, Gustafsson P, Dahlstrom K, Gillberg CG, Forssberg H, Westerberg H (2004). Computerized training of working memory in children with Attention-Deficit/Hyperavtivity Disorder - a controlled, randomized, double-blind, trial. [Submitted]
View record in Web of Science®
V. Westerberg H, Jacobaeus H, Hirvikoski T, Clevberger P, Ostensson ML, Bartfai A, Klingberg T (2004). Computerized working memory training - a method cognitive rehabilitation after stroke. [Submitted]
VI. Olesen PJ, Westerberg H, Klingberg T (2004). Increased prefrontal and parietal activity after training of working memory. Nat Neurosci. 7(1): 75-9. Epub 2003 Dec 14.
Pubmed
I. Klingberg T, Forssberg H, Westerberg H (2002). Increased brain activity in frontal and parietal cortex underlies the development of visuospatial working memory capacity during childhood. J Cogn Neurosci. 14(1): 1-10.
Pubmed
II. Westerberg H, Hirvikoski T, Forssberg H, Klingberg T (2004). Visuo-spatial working memory span: a sensitive measure of cognitive deficits in children with ADHD. Child Neuropsychology. [Accepted]
View record in Web of Science®
III. Klingberg T, Forssberg H, Westerberg H (2002). Training of working memory in children with ADHD. J Clin Exp Neuropsychol. 24(6): 781-91.
Pubmed
IV. Klingberg T, Fernell E, Olesen P, Johnson M, Gustafsson P, Dahlstrom K, Gillberg CG, Forssberg H, Westerberg H (2004). Computerized training of working memory in children with Attention-Deficit/Hyperavtivity Disorder - a controlled, randomized, double-blind, trial. [Submitted]
View record in Web of Science®
V. Westerberg H, Jacobaeus H, Hirvikoski T, Clevberger P, Ostensson ML, Bartfai A, Klingberg T (2004). Computerized working memory training - a method cognitive rehabilitation after stroke. [Submitted]
VI. Olesen PJ, Westerberg H, Klingberg T (2004). Increased prefrontal and parietal activity after training of working memory. Nat Neurosci. 7(1): 75-9. Epub 2003 Dec 14.
Pubmed
Issue date: 2004-04-23
Rights:
Publication year: 2004
ISBN: 91-7349-881-5
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