| 其他摘要 | The prefrontal cortex (PFC) is a critical region in the human brain. It modulatesmany cognitive functions, including executive functions (EFs), memory, attention anddecision-making. Meanwhile, PFC is also an important brain region that compensatesfor the structural and functional decline of other brain regions with increasing age, andplays a very important role in maintaining the normal cognitive function and activitiesof daily living in the elderly. However, the age-dependent decline in the structure andfunction of the PFC limits its compensatory function, leading to cognitive decline anddifficulties in daily life in old adults. Previous studies have shown that human PFCretains lifelong plasticity, therefore it is of great significance to explore targeted trainingof PFC in old adults. Previous studies have found that EFs training and video gametraining can effectively alleviate the volume atrophy of the PFC and the decline ofprocessing efficiency with age. In the present study, we developed a gamified executivefunction training system based on the plasticity of the PFC and trained the older adultswith the aim of ameliorating the structure and function of the PFC and improvingcognitive functions in the older adults.This paper contains three studies. In Study One, we designed three gamificationtasks, namely inhibition, switching, and working memory, and conducted the threegamification tasks and a battery of cognitive tests in 108 healthy older adults, aims toverify the reliability and validity of these gamification tasks. The results showed thatthe three gamification tasks have high internal consistency reliability and a goodconstruct validity as well as criterion-related validity, suggesting that the threegamification tasks could be used as effective tool to assess EFs for older adults. In StudyTwo, we further explored the functional activation of PFC in young and older adultswhen conducting the three gamification EFs tasks. The results showed that during theinhibition game, the right ventrolateral prefrontal cortex (VLPFC) of older adults wasactivated significantly; during the switching game playing, the left VLPFC of older was activated significantly; during the working memory game playing, the bilateral VLPFCand DLPFC of older adults were activated significantly. All these results reflected theeffectiveness of the game design on the neural level, these results proved theeffectiveness of the design of gamified EFs tasks based on brain activation. Moreover,we also found significant functional activation differences between older and youngadults when performing different gamification tasks. Compared to older adults, youngadults activated stronger in bilateral VLPFC and DLPFC during inhibition game, andin left ACC during the switching game. Compared to young adults, older adultsactivated stronger in the left DLPFC and bilateral VLPFC during the working memorygame. These results show that at the level of brain activation, gamified EFs tasks has ahigh sensitivity to aging.In Study Three, based on the gamification EFs tasks of Study One, we furtherdeveloped gamified EFs training system and exergame EFs training system, and trainedolder adults through these two intervention techniques to investigate and compare thetraining effects on cognition, PFC structure and function of older adults. A total of 114older adults were recruited and randomly assigned to the EFs cognitive game traininggroup (referred to as the game training group), the EFs exergame training group(referred to as the exergame training group) and the control group. Baseline cognitiveassessments and MRI scans were conducted. The two training group received 24 1-hourtraining sessions in 12 weeks, twice a week, while the control group maintained thenormal lifestyle during the training. After the training, cognitive assessments and MRIscans were conducted again for partiticipants in all three groups. The results showedthat compared with pre-test, older participants in the two training group significantlyenhanced their inhibition, switching, working memory as well as episodic memory, andcould reach similar level as young adults. After training, older adults in the gametraining group increased the gray matter volume in left DLPFC while decreased in theleft VLPFC, older adults in the exergame training group increased the gray mattervolume in the left ACC and bialteral VLPFC, suggesting older adults in both traininggroups improved the PFC volume. After training, the PFC function of the the twotraining group was also improved but in different way, among which the game traininggroup increased the neural efficiency, which led to decreased functional activation inright VLPFC during the inhibition game and in the left ACC during the workingmemory game; the exergame training group increased the neural resourecs and led toincreased functional activation in the right DLPFC and left DLPFC/ACC during theinhibition game.In conclusion, the present study proved the current custom-designed PFCplasticity-based gamification EFs assessment and training system can not onlyeffectively assess the EFs of older adults, but also improve the PFC plasticity andenhance cognitive function for older adults. Through this study, it can be found thatgamified cognitive tasks developed based on cognitive neuroscience theory can providean interesting, convenient and low-cost assessment and training tool for the older adults,helping them to better understand their cognitive abilities and conduct targeted training.In addition, the present study also compared the differences in the training effects ofcognitive game and exergame training on older adults, and revealed the different neuralmechanisms behind these two intervention techniques, and provided evience for furtherunderstanding of the two training ways and helping the older adults choose suitabletraining approaches. |
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