Positive effects of a computerised working memory and executive function training on sentence comprehension in aphasia

Abstract

Aphasia, the language disorder following brain damage, is frequently accompanied by deficits of working memory (WM) and executive functions (EFs). Recent studies suggest that WM, together with certain EFs, can play a role in sentence comprehension in individuals with aphasia (IWA), and that WM can be enhanced with intensive practice. Our aim was to investigate whether a combined WM and EF training improves the understanding of spoken sentences in IWA. We used a pre-post-test case control design. Three individuals with chronic aphasia practised an adaptive training task (a modified n-back task) three to four times a week for a month. Their performance was assessed before and after the training on outcome measures related to WM and spoken sentence comprehension. One participant showed significant improvement on the training task, another showed a tendency for improvement, and both of them improved significantly in spoken sentence comprehension. The third participant did not improve on the training task, however, she showed improvement on one measure of spoken sentence comprehension. Compared to controls, two individuals improved at least in one condition of the WM outcome measures. Thus, our results suggest that a combined WM and EF training can be beneficial for IWA.

Short-Term and Working Memory Treatments for Improving Sentence Comprehension in Aphasia: A Review and a Replication Study

“…Although improvements in sentence comprehension were noted in two of the three persons reported by Zakariás and colleagues, 16 one person did not improve. This person's progress in the n -back tasks was not as good as the progress reported for the other two persons.…”

“…Although the present article focused on far transfer effects of STM/WM training on sentence comprehension, we should highlight that treatments did not result in near transfer effects of training on all STM/WM measures across all persons, even in treatments that used STM/WM measures that were very closely related to the treatments tasks. 10 16 Although in some cases authors provided thorough discussion of the expected mechanisms of change, 14 the choice of near transfer measures may not have been the most appropriate. For example, Harris and colleagues assessed repetition of nonwords and words in a nonserial manner, although both treatments focused on serial recall.…”

“…Unlike the previous treatments that trained STM, the treatment described by Zakariás et al trained WM. 16 It used the n -back task, a WM task that has been used to measure WM capacity in aphasia. 3 17 There were two related n -back versions, a standard one and one with “lures” (i.e., distractors).…”

Time reference in nonfluent and fluent aphasia: a cross-linguistic test of the PAst DIscourse LInking Hypothesis

“…To date only the effects of cognitive training on sentence comprehension have been explored, with promising results (e.g., Salis, 2012;Zakariás, Keresztes, Marton, & Wartenburger, 2016). Future research should investigate the impact of cognitive training on verb-related morphosyntactic/morphosemantic production with a focus on time reference.…”

Working memory treatment in aphasia: A theoretical and quantitative review

“…Zakarias, Keresztes, Marton, and Wartenburger (2016) used N-back tasks to train storage and processing components of WM in three patients with chronic aphasia. The N-back tasks were classical N-back tasks using letter stimuli; task difficulty increased progressively, by varying the distance between targets (N-1, N-2, N-3) and by including lures (letters identical to the target but occurring at a non-target position) or not.…”