Deficits in working memory (WM) functions represent one of the main causes of limited participation in daily life and impaired recovery after brain injury. Based on promising research in clinically healthy individuals, which suggest that repetitive training may improve WM performance and other related cognitive functions, this thesis aimed at exploring the potential and limits of WM training in clinical populations. Existing research on WM training and relevant neuropsychological outcomes were examined with a special focus on individuals with acquired brain injury by means of a meta-analysis (study I). The findings indicated relevant impact of WM training on both behavioral performance and disease-related symptom reduction. To determine the primary outcome variable for the evaluation studies, the Corsi Block-Tapping Task was reviewed (study II). Due to the lack of an appropriate theory-based intervention tailored for the needs of individuals with low WM capacity, the program 'WOME' was developed (study III). Three randomized, double-blind, placebo-controlled trials were carried out to evaluate the efficacy of the new intervention and to provide valuable recommendations for its application in clinical practice (study IV, V and VI). Significant improvements in the trained tasks, moderate to large transfer effects in overall WM performance, and related benefits in daily life were demonstrated. The effects were short-termed with very limited evidence supporting transfer to other cognitive functions. In accordance with the results of the meta-analysis (study I), the number of sessions was identified as an important modulator of efficacy by comparing different training intensities and training tasks. The specific content, in contrast, seemed to be less relevant. Mediation analyses revealed that inter-individual differences influence the successful application of the intervention, in particular initial WM capacity. Implications for clinical application and WM training research are discussed.:1. Introduction
1.1. Definition of the working memory system
1.2. Functional neuroanatomy of working memory
1.3. Functional relevance of working memory
1.4. Training of working memory functions
1.5. Objectives of the current thesis
2. Experimental work
2.1. Study I: Can impaired working memory functioning be improved by training? A meta-analysis with a special focus on brain injured patients
2.2. Study II: „Was misst eigentlich die Blockspanne?“ — Der Gold-Standard im Fokus.
2.3. Study III: WOME working memory training — A new intervention for individuals with low WM capacity
2.4. Study IV: WOME: Theory-based working memory training — A placebo-controlled, double-blind evaluation in older adults
2.5. Study V: Effects of working memory training in patients with acquired brain injury: a double-blind randomized controlled trial.
2.6. Study VI: The effect of high vs. low intensity neuropsychological treatment on working memory in patients with acquired brain injury.
3. General discussion
3.1. Summary of the empirical findings
3.2. Implications for clinical practice
3.2.1. Benefits and limits of working memory training
3.2.2. The importance of training dose and its practical implementation
3.2.3. The influence of inter-individual differences on training efficacy
3.3. Implications for working memory training research
3.4. Critical comments and directions for future research
3.5. Conclusion
4. References
5. Summary
6. Zusammenfassung
Appendices
List of abbreviations
List of Tables
List of Figures
Supplemental material
Curriculum vitae
List of publications
Selbstständigkeitserklärung
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:74241 |
| Date | 26 March 2021 |
| Creators | Weicker, Juliane |
| Contributors | Exner, Cornelia, Schubert, Torsten, Universität Leipzig |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:doctoralThesis, info:eu-repo/semantics/doctoralThesis, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | https://doi.org/10.1080/02699052.2020.1773536, https://doi.org/10.3389/fnagi.2018.00247, https://doi.org/10.1024/1016-264X/a000194, https://doi.org/10.1037/neu0000227 |
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