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      Spatial Working Memory Deficits Represent a Core Challenge for Rehabilitating Neglect

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          Abstract

          Left neglect following right hemisphere injury is a debilitating disorder that has proven extremely difficult to rehabilitate. Traditional models of neglect have focused on impaired spatial attention as the core deficit and as such, most rehabilitation methods have tried to improve attentional processes. However, many of these techniques (e.g., visual scanning training, caloric stimulation, neck muscle vibration) produce only short-lived effects, or are too uncomfortable to use as a routine treatment. More recently, many investigators have begun examining the beneficial effects of prism adaptation for the treatment of neglect. Although prism adaptation has been shown to have some beneficial effects on both overt and covert spatial attention, it does not reliably alter many of the perceptual biases evident in neglect. One of the challenges of neglect rehabilitation may lie in the heterogeneous nature of the deficits. Most notably, a number of researchers have shown that neglect patients present with severe deficits in spatial working memory (SWM) in addition to their attentional impairments. Given that SWM can be seen as a foundational cognitive mechanism, critical for a wide range of other functions, any deficit in SWM memory will undoubtedly have severe consequences. In the current review we examine the evidence for SWM deficits in neglect and propose that it constitutes a core component of the syndrome. We present preliminary data which suggest that at least one current rehabilitation method (prism adaptation) has no effect on SWM deficits in neglect. Finally, we end by reviewing recent work that examines the effectiveness of SWM training and how SWM training may prove to be a useful avenue for future rehabilitative efforts in patients with neglect.

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          Most cited references89

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          Working Memory: Theories, Models, and Controversies

          I present an account of the origins and development of the multicomponent approach to working memory, making a distinction between the overall theoretical framework, which has remained relatively stable, and the attempts to build more specific models within this framework. I follow this with a brief discussion of alternative models and their relationship to the framework. I conclude with speculations on further developments and a comment on the value of attempting to apply models and theories beyond the laboratory studies on which they are typically based.
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            Working memory, short-term memory, and general fluid intelligence: a latent-variable approach.

            A study was conducted in which 133 participants performed 11 memory tasks (some thought to reflect working memory and some thought to reflect short-term memory), 2 tests of general fluid intelligence, and the Verbal and Quantitative Scholastic Aptitude Tests. Structural equation modeling suggested that short-term and working memories reflect separate but highly related constructs and that many of the tasks used in the literature as working memory tasks reflect a common construct. Working memory shows a strong connection to fluid intelligence, but short-term memory does not. A theory of working memory capacity and general fluid intelligence is proposed: The authors argue that working memory capacity and fluid intelligence reflect the ability to keep a representation active, particularly in the face of interference and distraction. The authors also discuss the relationship of this capability to controlled attention, and the functions of the prefrontal cortex.
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              Computerized training of working memory in children with ADHD--a randomized, controlled trial.

              Deficits in executive functioning, including working memory (WM) deficits, have been suggested to be important in attention-deficit/hyperactivity disorder (ADHD). During 2002 to 2003, the authors conducted a multicenter, randomized, controlled, double-blind trial to investigate the effect of improving WM by computerized, systematic practice of WM tasks. Included in the trial were 53 children with ADHD (9 girls; 15 of 53 inattentive subtype), aged 7 to 12 years, without stimulant medication. The compliance criterion (>20 days of training) was met by 44 subjects, 42 of whom were also evaluated at follow-up 3 months later. Participants were randomly assigned to use either the treatment computer program for training WM or a comparison program. The main outcome measure was the span-board task, a visuospatial WM task that was not part of the training program. For the span-board task, there was a significant treatment effect both post-intervention and at follow-up. In addition, there were significant effects for secondary outcome tasks measuring verbal WM, response inhibition, and complex reasoning. Parent ratings showed significant reduction in symptoms of inattention and hyperactivity/impulsivity, both post-intervention and at follow-up. This study shows that WM can be improved by training in children with ADHD. This training also improved response inhibition and reasoning and resulted in a reduction of the parent-rated inattentive symptoms of ADHD.
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                Author and article information

                Journal
                Front Hum Neurosci
                Front Hum Neurosci
                Front. Hum. Neurosci.
                Frontiers in Human Neuroscience
                Frontiers Media S.A.
                1662-5161
                27 June 2013
                2013
                : 7
                : 334
                Affiliations
                [1] 1Department of Psychology, Grant MacEwan University , Edmonton, AB, Canada
                [2] 2Department of Psychology, University of Toronto , Toronto, ON, Canada
                [3] 3Department of Psychology, University of Waterloo , Waterloo, ON, Canada
                Author notes

                Edited by: Stefan Van Der Stigchel, Utrecht University, Netherlands

                Reviewed by: Rik Vandenberghe, Katholieke Universiteit Leuven, Belgium; Stefan Van Der Stigchel, Utrecht University, Netherlands; Anna Maria Berti, University of Turin, Italy

                *Correspondence: Christopher L. Striemer, Department of Psychology, Grant MacEwan University, 10700 – 104 Avenue, Edmonton, AB T5J 4S2, Canada e-mail: striemerc@ 123456macewan.ca
                Article
                10.3389/fnhum.2013.00334
                3694262
                23818880
                eb34e674-f66b-48a9-8e23-8dc463c72d23
                Copyright © 2013 Striemer, Ferber and Danckert.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in other forums, provided the original authors and source are credited and subject to any copyright notices concerning any third-party graphics etc.

                History
                : 28 February 2013
                : 14 June 2013
                Page count
                Figures: 3, Tables: 0, Equations: 0, References: 104, Pages: 11, Words: 9116
                Categories
                Neuroscience
                Hypothesis and Theory

                Neurosciences
                neglect,spatial working memory,prism adaption,rehabilitation,parietal lobe
                Neurosciences
                neglect, spatial working memory, prism adaption, rehabilitation, parietal lobe

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