认知健康：开启新潮流
《决策大脑》认知健康：开启新潮流,页面无弹窗的全文阅读!
体育锻炼的好处人尽皆知，但如何进行体育锻炼就是另一回事了。一些人会抓着厨房门做引体向上，另一些人则会去心血管健身中心。虽然引体向上或许对你有好处（当然，除非你在做引体向上时把厨房门给弄坏了），更复杂的锻炼一定会给你带来更多的好处。这就是我们会花费时间和金钱选择健身器材、私人教练和缴纳会费参加健身俱乐部的原因。
精心设计的锻炼一定是巧妙利用了人体解剖学和生理学的知识。每项训练都是为了增强某个特定的肌肉群或生理系统。根据自身的目标，你可能会选择一套全面、平衡的锻炼方法，或者集中进行某种特定的锻炼。一个大学生运动员的锻炼当然不同于他的教授所做的锻炼，前者是为全运会做准备，而后者人到中年，体重过重，为自己心血管系统的状况忧心忡忡，想通过锻炼预防心脏病。
大脑被称作“小宇宙”不无道理。在所有的生物系统中，大脑的功能和结构最复杂也最多样化。对大脑复杂性的了解为设计一套“大脑训练组”提供了良好的基础。要专门针对特定的认知功能来设计思维训练。我们中的大多数人对认知挑战的好处都有模糊的认知。和体育锻炼一样，你的思维锻炼的复杂程度也有高有低。你在星期天早上做的填字游戏或许对你有好处，你可以把它当作大脑的“引体向上”。但是，你可以做的远不止这些。
如果认知训练能够改善并强化大脑，那么有必要设计一套系统性的训练，来确保大脑的全部（至少是大部分）重要部位都能参与上述训练。在健身训练当中，重要的是以一种均衡的方式对各种不同的肌肉群进行训练。可以通过由不同的、经过精心挑选的训练组成的训练组来实现均衡。对大脑的现有了解让设计一套能对大脑各个部位进行系统性训练的“认知训练组”成为可能。如果间接的（也就是随机的）思维训练对预防痴呆症都有明显的效果，那么靶向的、科学设计的认知训练方法一定更有益。
阿尔茨海默病和其他一些原发性退行性痴呆的早期症状（如路易体痴呆症）是非常不同的。记忆力衰退和出现海马体功能障碍的迹象是大多数上述疾病的早期症状，但并非所有患者都如此。对一些患者来说，早期的衰退表现为找不到合适的词语，这与左颞叶有关；有的表现为空间定向障碍，与顶叶有关；有的是预见能力、社会判断和主动性受到影响，这些是额叶障碍的迹象。虽然总体而言，上述所有部位都容易在阿尔茨海默病中受到影响，但各自的脆弱程度是非常不同的。那么，不同个体的不同大脑结构的相对脆弱程度都取决于什么呢？
荷兰阿姆斯特丹大脑研究所的科学家米尔米兰、范·索默伦和斯瓦伯提出了一个让人惊讶的假说。他们认为，特定的大脑区域在一生中的激活有助于预防或延缓该大脑部位的退化。依据该观点，将设计作为职业或爱好的人的顶叶得到了保护，从事创作的人的颞叶得到了保护，参与复杂决策和规划的人的额叶得到了保护。
该推论的逻辑结论促人深思，让人惊讶。为了让整个大脑免受退行性疾病的影响，必须设计一套综合性认知训练法，让大脑的各个部位都参与到均衡的、科学的训练中去。系统性认知训练应当是衰老和职业生涯巅峰时期的一项重要活动，这一观念是全新的。但它是体育锻炼的一个自然的逻辑延伸。“身体健康”已经成为一个家喻户晓的名词。“认知健康”成为下一个文化潮流还有一段距离。
不出所料，在过去几年中，致力于强化认知、延缓甚至是扭转衰老带来的认知衰退的公司、网站和产品层出不穷。掀起认知强化运动的条件也越来越成熟。和所有的新概念一样，“认知健康”也有其支持者和反对者。在2007年年底的几周时间里，我收看了美国公共广播公司制作的一档节目，该节目邀请了包括迈克尔·莫山尼奇在内的顶尖神经科学家以及支持“认知健康”运动的知名作家，并宣读了刊登在一个主流报刊上的专栏文章，该文章对“认知健康”运动进行了猛烈抨击。本书无法对该运动进行更详细的回顾和评价，但是，“认知健康”现象已经来到了我们的身边，不论我们是否欢迎它（我个人是赞成这一运动的）。
将认知训练作为预防思维衰退、改善思维功能的方法仍然是一个尚未被涉及的领域。随着我们在这一引人入胜的新路上继续前行，我们将会找到评估其效果的严谨的新方法。在理想状态下，我们希望能够通过功能性神经成像技术对各种类型的认知训练对大脑生理结构产生的影响进行检测，这一点也日益成为现实。究竟有没有效果呢？效果是整体性的还是局部性的？效果取决于训练吗？这些都是21世纪需要解决的重要问题。
E. Goldberg, L. J. Gerstman, S. Mattis, J. E. Hughes, C. A. Sirio, and R. M. Bilder Jr.,“Selective effects of cholinergic treatment on verbal memory in posttraumatic amnesia,”J Clin Neuropsychol 4 (1982): 219–34.
S. A. Areosa and F. Sherriff, “Memantine for dementia,” Cochrane Database Syst Rev 3(2003): CD003154.
V. M. Polyakov, L. I. Moskovichyute, and E. G. Simernitskaya, “Neuropsychological analysis of the role in brain functional organization in man,” in Modern Problems in Neurobiology, ed. (Tbilisi: 1986), 329–30; O. A. Krotkova, T. A. Karaseva, and L. I. Moskovichyute, “Lateralization features of the dynamics of higher mental functions following endonasal glutamic acid electrophoresis,” Zh Vopr Neirokhir Im N N Burdenko,no. 3 (1982): 48–52; N. K. Korsakova and L. I. Moskovichyute, Subcortical Structures and Psychological Processes (Moscow: Moscow University Publishing House, 1985);L. I. Moskovitchyute, M. Mimura, and M. Albert, “Selective effect of dopamine on apraxia,”presented at the AAN Annual Meeting, May 1–7, 1994, Washington, D.C.
B. H. Dobkin and R. Hanlon, “Dopamine agonist treatment of anterograde amnesia from a mediobasal forebrain injury,” Ann Neurol 33 (1993): 313–6.
D. E. Hobson, E. Pourcher, and W. R. Martin, “Ropinirole and pramipexole, the new agonists,” Can J Neurol Sci 26 (1999; Suppl 2): S27–33.
E. D. Ross and R. M. Stewart, “Akinetic mutism from hypothalamic damage: successful treatment with dopamine agonists,” Neurology 31 (1981): 1435–39; B. H. Dobkin and R. Hanlon, “Dopamine agonist treatment of antegrade amnesia from a mediobasal forebrain injury,” Ann Neurol 33 (1993): 313–6.
M. F. Kraus and P. Maki, “The combined use of amantadine and L-dopa/carbidopa in the treatment of chronic brain injury,” Brain Inj 11 (1997): 455–60; M. F. Kraus and P. M. Maki,“Effect of amantadine hydrochloride on symptoms of frontal lobe dysfunction in brain injury: case studies and review,” J Neuropsychiatry Clin Neurosci 9 (1997): 222–30.
J.Wolper, Schizophrenia could be treated with fewer side effects. eFluxMedia. Retrieved August 30, 2008, from http://ef iuxmedia/news_Schizophrenia_Could_Be_Treated_with_Fewer_Side_Effects_08288.html (2007).
M. J. Farah, J. Illes, R. Cook-Deegan, H. Gardner, E. Kandel, P. King, E. Parens,B. Sahakian, and P. R. Wolpe, “Neurocognitive enhancement: what can we do and what should we do?” Nat Rev Neurosci 5 (2004): 421–5.
Memory Pharmaceuticals, About Us: Scientific Advisory Board. Retrieved August 30, 2008,from http://memorypharma/a_advisoryboard.html (2008).
B. Sahakian and S. Morein-Zamir, “Professor’s little helper,” Nature 450 (2007):1157–9.
M. E. Rettmann, J. L. Prince, and S. M. Resnick, “Analysis of sulcal shape changes associated with aging,” Human Brain Mapping Conference, New York, NY, June 18–23,2003, #929
S. N. Burke and C. A. Barnes, “Neural plasticity in the ageing brain,” Nat Rev Neurosci 7(2006): 30–40.
M. Ballmaier, M. Kumar, V. Elderkin-Thompson, et al., “Cortical abnormalities in elderly depressed patients,” Human Brain Mapping Conference, New York, NY, June 18–23, 2003,#735; S. Grieve, R. Clark, and E. Gordon, “Brain volume and regional tissue distribution in 193 normal subjects using structural MRI: the effect of gender, handedness and age,”Human Brain Mapping Conference, New York, NY, June 18–23, 2003, #1203; D. Rex and A. Toga, “Age, gender, and handedness inf iuences on relative tissue volumes in the human brain,” Human Brain Mapping Conference, New York, NY, June 18–23, 2003, #930;Y. Taki, R. Goto, et al. (2003). Voxel based morphometry of age-related structural change of gray matter for each decade in normal male subjects,” Human Brain Mapping Conference,New York, NY, June 18–23, 2003, #1228.
E.Goldberg, The Wisdom Paradox: How Your Mind Can Grow Stronger as Your Brain Grows Older (New York: Gotham Books, 2005).
E.Goldberg, The Wisdom Paradox: How Your Mind Can Grow Stronger as Your Brain Grows Older (New York: Gotham Books, 2005).
M. E. Rettmann, J. L. Prince, and S. M. Resnick, “Analysis of sulcal shape changes associated with aging, Human Brain Mapping Conference, New York, NY, June 18–23,2003, #929.
S. Grieve, R. Clark, and E. Gordon, “Brain volume and regional tissue distribution in 193 normal subjects using structural MRI: the effect of gender, handedness and age, Human Brain Mapping Conference, New York, NY, June 18–23, 2003, #1203.
L. A. Leigland, L. E. Schulz, and J. S. Janowsky, “Age-related changes in emotional memory,” Neurobiol Aging 25 (2004): 1117–24.
Y. Taki, R. Goto, et al., “Voxel based morphometry of age-related structural change of gray matter for each decade in normal male subjects,” Human Brain Mapping Conference,New York, NY, June 18–23, 2003, #1228.
M. Ballmaier, M. Kumar, V. Elderkin-Thompson, et al., “Cortical abnormalities in elderly depressed patients,” Human Brain Mapping Conference, New York, NY, June 18–23, 2003.#735.
S. Ramon y Cajal, “Textura del sistema nervioso del hombre y de los vertebrados” (Aragon,Spain: Gobierno de Aragon, Departamento de Educacion y Cultura, 2002).
S. A. Goldman and F. Nottebohm, “Neuronal production, migration, and differentiation in a vocal control nucleus of the adult female canary brain,” Proc Natl Acad Sci USA 80(1983): 2390–4.
J. Altman, “Are new neurons formed in the brains of adult mammals?” Science 135 (1962):1127–8.
E. Gould, P. Tanapat, B. S. McEwen, G. Flugge, and E. Fuchs, “Proliferation of granule cell precursors in the dentate gyrus of adult monkeys is diminished by stress,” Proc Natl Acad Sci USA 95 (1998): 3168–71.
E. Gould, A. J. Reeves, M. S. Graziano, and C. G. Gross, “Neurogenesis in the neocortex of adult primates,” Science 286(5439) (1999): 548–52.
P. S. Eriksson, E. Perf ilieva, T. Bjork-Eriksson, A. M. Alborn, C. Nordborg, D. A. Peterson,et al., “Neurogenesis in the adult human hippocampus,” Nat Med 4 (1998): 1313–7.
A. Sahay and R. Hen, “Adult hippocampal neurogenesis in depression,” Nat Neurosci 10(2007): 1110–5.
E. Gould, “How widespread is adult neurogenesis in mammals?” Nat Rev Neurosci 8(2007): 481–8.
E. Gould, “How widespread is adult neurogenesis in mammals?” Nat Rev Neurosci 8(2007): 481–8.
E. Gould, “How widespread is adult neurogenesis in mammals?” Nat Rev Neurosci 8(2007): 481–8.
R. Katzman, R. Terry, R. DeTeresa, T. Brown, P. Davies, P. Fuld, X. Renbing, and A. Peck,“Clinical, pathological, and neurochemical changes in dementia: a subgroup with preserved mental status and numerous neocortical plaques,” Ann Neurol 23 (1988): 138–44.
J. E. Brody, “Mental reserves keep brains agile,” New York Times (December 11, 2007): F7.
R. Katzman, “Education and the prevalence of dementia and Alzheimer’s disease,”Neurology 43 (1993): 13–20.
M. S. Albert, K. Jones, C. R. Savage, L. Berkman, T. Seeman, D. Blazer, and J. W. Rowe,“Predictors of cognitive change in older persons: MacArthur studies of successful aging,”Psychol Aging 10 (1995): 578–89.
D. A. Snowdon, S. J. Kemper, J. A. Mortimer, L. H. Greiner, D. R. Wekstein, and W. R. Markesbery, “Linguistic ability in early life and cognitive function and Alzheimer’s disease in late life: f indings from the Nun Study [see comments],” JAMA 275 (1996):528–32.
D. A. Snowdon, S. J. Kemper, J. A. Mortimer, L. H. Greiner, D. R. Wekstein, and W. R. Markesbery, “Linguistic ability in early life and cognitive function and Alzheimer’s disease in late life: f indings from the Nun Study [see comments],” JAMA 275 (1996):528–32.
E. A. Maguire, D. G. Gadian, I. S. Johnsrude, C. D. Good, J. Ashburner, R. S. Frakowiak,and C. D. Frith, “Navigation-related structural change in the hippocampi of taxi drivers,”Proc Natl Acad Sci USA 97 (2000): 4398–4403.
B. L. McNaughton, “Associative pattern competition in hippocampal circuits: new evidence and new questions,” Brain Res Rev 16 (1991): 202–4; B. L. McNaughton and R. G. M Morris, “Hippocampal synaptic enhancement and information storage,” Trends Neurosci 10 (1987): 408–15.
D. W. Green, J. Crinion, and C. J. Price, “Exploring cross-linguistic vocabulary effects on brain structures using voxel-based morphometry,” Bilingualism: Language and Cognition 10 (2007): 189–99.
P. Schneider, M. Scherg, H. G. Dosch, H. J. Specht, A. Gutschalk, and A. Rupp, “Morphology of Heschl’s gyrus ref iects enhanced activation in the auditory cortex of musicians,” Nat Neurosci 5 (2002): 688–94.
D. Golden, “Building a better brain,” Life (July 1994), 62–70.
A.Damasio, Descartes’ Error: Emotion, Reason, and the Human Brain (New York:Putnam Publishing Group,1994); A.Damasio, The Feeling of What Happens: Body and Emotion in the Making of Consciousness (New York: Harcourt Brace, 1999).
J. W. Rowe and R. L. Kahn, Successful Aging (New York: Pantheon, 1998).
R. Katzman, “The prevalence and malignancy of Alzheimer’s disease: a major killer,” Arch Neurol 33 (1976): 217.
A. Newell and H. A. Simon, Human Problem Solving (Englewood Cliffs, NJ: Prentice-Hall,1972); H. A. Simon, P. Langley, G. Bradshaw, and J. Zykow, Scientific Discovery: Exploration of the Creative Process (Cambridge, MA: MIT Press, 1987).
R. J. Hamm, M. D. Temple, D. M. O’Dell, B. R. Pike, and B. G. Lyeth, “Exposure to environmental complexity promotes recovery of cognitive function after traumatic brain injury,”J Neurotrauma 13 (1996): 41–7.
B. Kolb, Brain Plasticity and Behavior (Mahwah, NJ: Lawrence Erlbaum Associates,1995).
W. D. Heiss, J. Kessler, R. Mielke, B. Szelies, and K. Herholtz, “Long-term effects of phosphatidylserine, pyritinol, and cognitive training in Alzheimer’s disease: a neuropsychological, EEG, and PET investigation,” Dementia 5 (1994): 88–98.
G. Kempermann, H. G. Kuhn, and F. H. Gage, “More hippocampal neurons in adult mice living in an enriched environment,” Nature 386(6624) (1997): 493–5.
G. Kempermann, H. G. Kuhn, and F. H. Gage, “More hippocampal neurons in adult mice living in an enriched environment,” Nature 386(6624) (1997): 493–5.
G. Kempermann, H. G. Kuhn, and F. H. Gage, “More hippocampal neurons in adult mice living in an enriched environment,” Nature 386(6624) (1997): 493–5.
F. Dellu, W. Mayo, M. Valee, M. Le Moaz, and H. Simon, “Facilitation of cognitive performance in aged rats by past experience depends on the type of information processing involved: a combined cross-sectional and longitudinal study,” Neurobiol Learn Mem 67(1997): 121–8.
N. Milgram, E. Head, S. Zicker, C. Ikeda-Douglas, H. Murphey, B. Muggenburg, et al.,“Learning ability in aged beagle dogs is preserved by behavioral enrichment and dietary fortif ication: a two-year longitudinal study,” Neurobiol Aging 26 (2005): 77–90.
K. W. Schaie and S. L. Willis, “Can decline in adult intellectual functioning be reversed?”Dev Psychol 22 (1986): 223.
S. L. Willis, S. L. Tennstedt, M. Marsiske, K. Ball, J. Elias, K. M. Koepke, et al., “Longterm effects of cognitive training on everyday functional outcomes in older adults,” JAMA 296 (2006): 2805–14.
H. W. Mahncke, B. B. Connor, J. Appelman, O. N. Ahsanuddin, J. L. Hardy, R. A. Wood,et al., “Memory enhancement in healthy older adults using a brain plasticity-based training program: a randomized, controlled study,” Proc Natl Acad Sci USA 103 (2006):12523–8.
W. D. Heiss, J. Kessler, R. Mielke, B. Szelies, and K. Herholz, “Long-term effects of phosphatidylserine, pyritinol, and cognitive training in Alzheimer’s disease: a neuropsychological, EEG, and PET investigation,” Dementia 5 (1994): 88–98.
M. Mirmiran, E. J. van Someren, and D. F. Swaab, “Is brain plasticity preserved during aging and in Alzheimer’s disease?” Behav Brain Res 78 (1996): 43–8.
S. Aamodt and S. Wang, “Exercise on the brain,” New York Times (November 8, 2007):A33.