コンピューターを用い個人の能力と興味にテーラーメイドしたワーキングメモリ訓練の効果─保続性の反応が改善された統合失調症患者の例

Effects of computer-based working memory training which is tailor-made for personal ability and interest: Improvement of perseveration in a patient with schizophrenia

要旨：日常生活場面を取り入れ，個人の興味・関心に配慮したワーキングメモリ課題を開発し，保続性の反応を呈する統合失調症患者に実施した．その結果，保続性の反応が改善し，BACS-Jのワーキングメモリ，運動機能，遂行機能の改善を認めた．また，意欲や活力，心の健康の改善が得られた．これらの結果は2回目介入時に再現性を認めた．本課題は，実生活の一場面をモデルに，思考・計画・判断・意思決定をするという特徴をもち，個人の興味・関心や遂行能力にテーラーメイドできる．興味・関心に配慮することは，課題に対する注意集中，記憶，思考，選択のしやすさに繋がり，潜在能力を喚起し，認知機能や意欲の改善に寄与することが示唆された．

　We developed a computer-based working memory training paradigm, in which a patient can simulate everyday life events. We introduced this task to a patient with schizophrenia who exhibited perseverated responses. Upon introducing the training task, the patient's perseverated responses were markedly reduced and working memory, motor responses, and Tower of London performances in BACS-J were also improved, along with the patient's motivation and mental condition. One year after introducing the task, we repeated the task and almost the same effects were observed. In the present training task, we can adjust both the task materials and difficulty based on each patient's interest and capability. These task features may provide positive effects in the patient's mental condition and contribute to improved cognitive and motivational capacity.