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1、 老年人认知训练方式及其神经机制分析 摘要：伴随老化, 老年人的认知和脑功能会表现出一定的下降趋势.尽管如此, 人类的大脑到老年期都会保有一定的可塑性, 认知训练的方式是延缓认知和脑功能衰退的有效手段.本文回顾了以往针对老年人不同类型的认知训练研究, 探讨了认知训练的理论基础 (包括放大观和补偿观) , 深入分析了老年人认知训练的神经机制, 并在此基础上指出以往研究中理论基础冲突的不足和对未来研究老年人训练任务适配性的展望.关键词：老年人; 认知训练; 大脑可塑性; 神经机制;作者简介： *尹述飞, Tel:18627838661, E-mail:;收稿日期：2018-05-14基金： 国家自
2、然科学基金青年基金 (31600904, 31700973); 湖北省教育厅人文社会科学研究项目 (18Q017); 应用实验心理北京市重点实验室资助项目;The Neural Mechanisms of Cognitive Training in Older AdultsYIN Shu-Fei CHEN Xiang-Zhan LIU Qi-Zhen DING Zhou-Zhou LI Tian YANG Wei-Ping ZHU Xin-YiDepartment of Psychology, Faculty of Education, Hubei University Beijing Key
3、 Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University Center on Aging Psychology, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of ScienceAbstract：Despite brain functions decline with age in the elderly, the brain maintains a
4、 certain degree of plasticity which can delay this process through cognitive training. Various cognitive trainings were tested in studies, including strategy training, cognitive processes based training, and multidimensional cognitive training.Recently, computerized cognitive training is becoming th
5、e focus of this area because of its universal potential of application. Previous studies have identified the effectiveness of cognitive trainings, but some vital issues remain unclear. For example, to what extent cognitive trainings can help benefit cognition of the elderly and which kind of trainin
6、g is the most beneficial to the specific cognitive ability. To better understand the effectiveness of cognitive trainings and the way they work, this paper reviewed the studies of neural mechanisms of cognitive trainings and the related theoretical models. SMRI studies find that cognitive trainings
7、can alter the structure of the brain, thus delaying or resisting the cognitive decline with age. Functional MRI studies also find that cognitive trainings help improve cognition functionally in both rest state and task-related state. Based on the perspective of compensatory and magnification, severa
8、l theory models were established to interpret these findings, including HAROLD model, CRUNCH model, Lovdens model, STAC model and Bellevilles Interactive model.Compensatory perspective focuses the individual differences within the same age range and proposes that cognitive trainings benefit the elde
9、rly with lower cognitive ability better, while magnification perspective emphasizes the differences between the youth and the elderly and puts forward that cognitive trainings magnify these differences (cognitive trainings benefit individuals with higher cognitive ability better) . At present, there
10、 is no consistent conclusion about the two perspectives, and more studies are needed to reconcile the contradiction. In addition, it is beneficial for the application of cognitive trainings in the future to use brain image techniques to examine the effectiveness of cognitive trainings, to carry more
11、 studies on computerized cognitive trainings and to adopt more rigorous experimental design is beneficial to the application of cognitive trainings in the future.Keyword：older adults; cognitive training; brain plasticity; neural mechanisms;Author： YIN Shu-Fei, Tel:18627838661.E-mail:;Received： 2018-
12、05-14Fund： supported in part by grants from The National Natural Science Foundation of China (31600904, 31700973); Humanities and Social Science Research Project of Hubei Provincial Education Department (18Q017); Beijing Key Labortory of Applied Experimental Psychology;认知能力的毕生发展过程包括发展 (获得) 和衰退 (丧失)
13、两个复杂而相互关联的动力学过程1,2.适当的干预措施, 如认知训练, 可以延缓认知功能的衰退, 并在一定程度上改善个体的认知功能.国内外相关研究发现, 通过认知训练能使老年人的认知成绩得以提高, 证明老年人的认知能力具有一定的可塑性, 这也提示认知训练等干预手段将有助于延缓老年性痴呆等神经退行性疾病的发生和发展.虽然研究证明认知训练对老年人的认知功能有一定改善作用, 但是认知功能包含多个维度的内容, 所以各研究运用的认知训练方式多样, 认知老化理论以及模型也各有特色.针对这些研究中不一致的地方, 从认知训练的神经机制角度进行探讨可能为老年人认知能力的改善和提升提供重要的理论基础.1 认知训练的
14、理论观点和假设人类大脑具有一定的灵活性和可塑性, 随着年龄的增长, 大脑受到老化的影响不只是被动地衰退 (deterioration) , 还有可能发生功能性补偿活动, 包括老年人的大脑半球非对称性减弱模式 (hemispheric asymmetry reduction in older adults, HAROLD) 和认知老化的后部向前部转换模式 (posterior-anterior shift with aging, PASA) .HAROLD表现为在进行认知操作时, 年轻人的大脑表现出明显的偏侧化激活, 而老年人则表现为明显的双侧化激活3.PASA表现为前后模式转换, 即在进行认知
15、任务时, 老年人脑的前部活动增强而后部活动减弱4.结构性成像数据显示, 伴随老化白质和灰质会出现萎缩, 特别体现在前部脑区 (外侧前额叶) 、海马和基底神经核等区域, 但枕叶是神经元损伤相对最小的部位5.这些证据说明, 老年人的大脑会使用各种补偿性策略来适应老化2,6.总体来讲, 老年人认知功能干预研究的不同, 不仅表现在训练方案上, 也表现在理论观点和对有关认知老化的主要问题的强调上2,7.大部分认知干预研究都强调的问题是, 关注认知功能的可塑性和训练效果的个体差异8.基于此, 认知理论的假设主要分为放大观和补偿观两个方面.1.1 放大观考虑到横断研究法在认知老化研究中的优势, 年龄已经成为
16、最常见的个体差异变量.早期的训练研究主要涉及不同年龄组 (年轻人和老年人) 间训练效果的比较9,10.根据放大观 (magnification perspective) , 各年龄组在认知资源或认知储备的基线水平上存在差异, 并且假定基线能力较高的被试可能获得更高的训练收益.所以, 在训练中被试间个体差异 (比如年龄) , 会随着训练而被放大8.在不使用策略和指导的训练中, 干预主要集中在练习完成一个或多个认知任务;而最初能力较高的个体拥有更多的认知资源, 只需要练习就可以表现得很好.从认知神经机制的角度来看, 这可能与个体的神经可塑性有关, 大脑的可塑性可能先于或伴随行为的可塑性而产生11.神经
