Cogmed Working Memory Training . In contrast to what was previously assumed, we have shown that systematic training can improve working memory capacity, in both children and adults. Brain imaging studies also show that working memory training leads to increased brain activity in the prefrontal and parietal cortex. Improving working memory capacity leads to better performance on several tasks that require working memory and control of attention and it translates to increased attentiveness in everyday life. Working Memory is a key function necessary for critical cognitive tasks. Working memory is the ability to keep and manipulate information online for a brief period of time. This ability can be measured for example by testing how many digits a subject can repeat back after hearing them once (verbal working memory) or how many positions a subject can remember after seeing them once (visual working memory). In daily life we use working memory to remember plans or instructions of what to do next. But keeping information online is a very basic function that has proved to be of central importance in a wide range of cognitive tasks. Verbal working memory is necessary for comprehending long sentences; and verbal working memory capacity predicts performance on reading comprehension in the scholastic aptitude test (SAT) (Daneman and Carpenter, 1. Working memory is also important for control of attention, and to maintain task- relevant information during problem solving. Presented by: Torkel Klingberg, M.D., Ph.D., Karolinska Institute. Prepared by: Kathryn Ralph Research Coordinator Cogmed Pearson Clinical Assessment. Below please find answers to questions asked during the live webinar: 1. Feggy Ostrosky Universidad Nacional. Neuropsychological evaluation (NPE) is a testing method through which a neuropsychologist can acquire data about a subject’s cognitive, motor, behavioral, linguistic, and executive functioning. Associate Professor of Neurology; Vice Chair of Education; University of Colorado School of Medicine, Aurora, Colorado. Disclosure: Augusto A. Miravalle, MD, has disclosed the following. 4 valutazione del lobo frontale 1. Scienze e Tecniche Psicologiche I semestre – a.a. 2013-14 NEUROPSICOLOGIA CLINICA M.Sc. Program in Neurosciences. Neuropsychological tests are specifically designed tasks used to measure a psychological function known to be linked to a particular brain structure or pathway. Tests are used for research into brain function and in a clinical. CONCEPTO DE TEST El vocablo test traducido del ingles significa (prueba, investigaci. Actualmente presenta el siguiente. Research from JAMA Otolaryngology–Head & Neck Surgery — A Novel Treatment for Tinnitus and Tinnitus-Related Cognitive Difficulties Using Computer-Based Cognitive Training and D-Cycloserine. Historically, the executive functions have been seen as regulated by the prefrontal regions of the frontal lobes, but it is still a matter of ongoing debate if that really is the case. Even though articles on.More generally, working memory has been suggested to be the single most important factor in determining general intellectual ability (S. About 5. 0% of differences between individuals in non- verbal IQ can be explained by differences in working memory capacity (Conway et al., 2. More recently, it has also become clear that there is a strong link between working memory capacity and the ability to resist distractions and irrelevant information. One study used the so called “cocktail party effect”, i. Recent studies have also shown that low working memory is related to being “off- task” and daydreaming (Kane et al., 2. These psychological studies are consistent with neuroimaging studies, which have shown that subjects with higher working memory capacity are less likely to store irrelevant information (Vogel et al., 2. The prefrontal cortex is important in providing this “filtering” of irrelevant information, and subjects with higher working memory capacity have a higher prefrontal activity and are better at filtering out distractors (Mc. Nab and Klingberg, 2. When people have deficits in working memory, they are often experienced as “inattention problems”, e. In children the problem is often remembering what to do next, which makes them unable to finish an activity according to plan. In conclusion, working memory allows us to hold on to information in order to complete a task, and is especially important in any cognitively demanding environment with irrelevant distractions. Working memory deficits occur in many conditions. There is a normal variability from individual to individual in working memory capacity. In the individual, capacity can also be temporarily decreased due to stress or lack of sleep. Moreover, there is a normal decline in capacity with aging, starting around 2. Except for this normal variability, working memory capacity is also affected in a range of clinical conditions, affecting the neural systems underlying working memory. Studies on both animals and humans have shown that the prefrontal and parietal cortexes are essential for working memory performance; as is the basal ganglia, as well as correct dopaminergic transmission. When these systems are affected, working memory is impaired. Stroke affecting the frontal lobe is associated with working memory deficits, as are traumatic brain injuries (Robertson and Murre, 1. In these cases, the working memory deficits lead to attention and planning problems. Attention Deficit Hyperactivity Disorder (ADHD and ADD) is associated with disturbances of both the frontal lobe and the dopaminergic system, and is consequently also associated with working memory deficits. Learning disability is another prevalent condition, in children and in adults, which can be defined as academic difficulties that are not due to inadequate opportunity to learn, general intelligence, nor to physical/emotional disorders, but to basic disorders in specific psychological processes. It has been shown that learning disability can be directly linked to deficits in working memory (Gathercole and Pickering, 2. ADHD is a widespread and serious disorder with a key WM component. ADHD is a disorder which includes severe problems of attention, impulsivity and hyperactivity. ADHD affects 3- 5% of children between 6- 1. When children with ADHD grow older, the hyperactivity decreases, but problems of inattention, which often lead to academic and occupational failure, remain in the majority of cases. ADHD has a strong genetic component, with heritability estimated around 7. Deficits in working memory are thought to be of central importance in explaining many cognitive and behavioral problems in ADHD (Barkley, 1. Castellanos and Tannock, 2. Rapport et al. A meta- analysis of 4. Martinussen et al., 2. WM deficits in ADHD, and also showed that the deficits are most pronounced in the visuo- spatial domain. Can working memory be improved? Torkel Klingberg, MD Ph. D, has conducted research at Karolinska Institutet for several years concerning the neural basis of working memory and working memory deficits in children. Working memory capacity has generally been held to be a fixed property of the individual. However, Klingberg, Helena Westerberg, Ph. D., and others at the Department for Neuropediatrics at Astrid Lind. These methods are influenced by animal research on mechanisms for training induced plasticity (Buonomano and Merzenich, 1. Development was conducted in collaboration with Jonas Beckeman and David Skoglund, professional game developers who helped solve technical issues and helped make the training more rewarding. The training consists of a specific set of working memory tasks that are performed on a computer, where the difficulty level is adjusted according to a specific algorithm. The users complete a fixed number of trials every day, taking about 3. This is done for five days a week over five weeks. During training, performance results are saved and can be used for later analysis. The program is called Cogmed RM, and has been developed by Cogmed Systems AB. Figure 2 shows how performance increases gradually during training. The first training study with ADHD: promising results. A first double- blind, placebo- controlled study of the clinical effect of the training included children with ADHD aged 7- 1. Klingberg et al., 2. Two groups were compared: a treatment group and a comparison group. Children in the treatment group practiced working memory tasks where the difficulty level was adjusted to closely match the working memory capacity of the child. This procedure was hypothesized to optimize the training effect. In the comparison condition, the same tasks were used but the working memory load, i. By having two similar versions we intended to control as much as possible for non- specific effects of the training procedure, and specifically estimate the effect of improvement of working memory. Both groups were evaluated with neuropsychological tasks before and after training. When the results from the two groups were compared, we could show that the treatment group had improved significantly more than the comparison group on working memory tasks. Moreover, they had also improved on a task measuring response inhibition, which is something children with ADHD have serious problems with. Somewhat unexpectedly, the children in the treatment group had also improved on a reasoning task known to have a high correlation with IQ. The second training study with ADHD: confirmation in a multi- center trial. A main shortcoming of the first study was the low number of subjects (N = 7 in both the treatment and in the comparison group). Moreover, ratings of ADHD symptoms were not performed; only one clinical center was involved and there was no follow- up measure. A second study was therefore conducted at four clinical sites in Sweden, evaluating the effects of training working memory tasks in a randomized, double- blind, controlled design (Klingberg et al., 2. In the multi- center study we compared two similar versions of the same training program, exactly as in the first study. Executive functions (working memory, response inhibition and reasoning) were measured and ADHD symptoms were rated by parents and teachers before, directly after, and 3 months after training. The results were very clear. There was a significant treatment effect for non- trained tasks measuring visuo- spatial and verbal working memory, response inhibition and complex reasoning. Three months after the intervention, on average more than 9. Parent ratings showed significant reduction in symptoms of inattention and hyperactivity/impulsivity, both post- intervention and at follow- up. Combined ratings from teachers and parents showed significant reduction of symptoms related to inattention post- intervention (1 SD reduction in scores, 0. SD at follow- up). These results thus confirmed the findings from the first study. Moreover, they showed that the very symptoms that define ADHD decreased (Klingberg et al., 2. Replication of findings by idependent research groups. In 2. 00. 9 Joni Holmes and Susan Gathercole, at York University, UK, published a study of the effect on Cogmed RM in children with low working memory (Holmes et al., 2. A novel aspect of this study was to include children based on their working memory performance, rather than ADHD diagnosis. From 3. 50 children those children scoring below 1. Cogmed RM), or the control group (receiving a low- intensity version of the computer program).
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