Abstract
This case study examined the effects of auditory working memory (WM) training on neuroplastic changes in stroke survivors and how such effects might be influenced by self-perceived stress. Two participants with a history of stroke participated in the study. One of them had a higher level of self-perceived stress. Both participants underwent a course of auditory WM training and completed baseline and post-training assessments such as self-perceived stress, performance satisfaction questionnaires, behavioral task performance, and functional magnetic resonance imaging. They were trained on a computerized auditory WM task (n-back) 5 days a week for 6 weeks, for a total of 20 h. Participant 1 had high levels of perceived stress, both pre- and post-training, and showed improvement on the satisfaction aspect of functional engagement only. Participant 2 had lower levels of perceived stress and demonstrated improvements on all performance tasks. Neuroimaging results showed evidence of improved neural efficiency on the trained task for participant 2. The results shed light on the need to evaluate psychological influences, e.g., stress, when studying the neuroplastic changes in people with stroke. However, the case design approach and other factors that might have positively influenced outcomes mean that these results must be interpreted with a great deal of caution. Future studies using a larger sample are recommended to verify the findings.
Highlights
Working memory (WM) is considered one of the most important cognitive components for stroke rehabilitation (Cicerone et al, 2011)
During training, participant 1 showed a gradual decline in hit rate and response speed in all of the n-back tasks over the 6-week period
Our results show different patterns of neuroplastic changes in two participants with different levels of self-perceived stress
Summary
Working memory (WM) is considered one of the most important cognitive components for stroke rehabilitation (Cicerone et al, 2011). The participants had difficulty with WM as indicated by a score of 3 or above on WM items of the Cognitive Failure Questionnaire (Broadbent et al, 1982) They were not receiving any other therapies during the time of experiment and were fitted for fMRI. Participant 1 was 37-year-old man and suffered a mild stroke involving the right middle cerebral artery (MCA) 2 years before the study. He had completed a bachelor degree in a local college and was working full time in a private company as a secretary He was single, lived alone, and had no documented history of any other neurological or psychiatric conditions. He reported memory deficits that were noticeable during work and social interaction with colleagues
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