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Can impaired working memory functioning be improved by training? A meta-analysis with a special focus on brain injured patients.
Open accessAbstract
OBJECTIVE: Deficits in working memory (WM) are commonly observed after brain injuries and cause severe impairments in patients' everyday life. It is still under debate if training can enhance or rehabilitate WM in case of malfunction. The current meta-analysis investigates this issue from a clinical point of view. It addresses under which conditions and for which target group WM training may be justifiable. METHOD: Relevant WM training studies were identified by searching electronic literature databases with a comprehensive search term. In total, 103 studies, which added up to 112 independent group comparisons (N = 6,113 participants), were included in the analysis. RESULTS: Overall, WM training caused a moderate and long-lasting improvement in untrained WM tasks. Moreover, improvement of WM functioning led to sustainable better evaluation of everyday life functioning, however, effect sizes were small. Concerning transfer effects on other cognitive domains, long-lasting improvements with small effect sizes were observed in cognitive control and reasoning/intelligence. In contrast, small immediate, but no long-term effects were found for attention and long-term memory. Studies with brain injured patients demonstrated long-lasting improvements in WM functions with moderate to large effect sizes. A main moderator variable of intervention efficacy is the number of training sessions applied. CONCLUSION: WM training produces long-lasting beneficial effects which are strongly pronounced in patients with acquired brain injuries. This finding supports the application of WM training in clinical settings. To determine optimal training conditions, future studies must systematically investigate the characteristics of interventions as they are at present inevitably confounded.
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“Given previous reports, we also tested whether training WM might transfer to measures of episodic memory, especially those that serve as proxy for everyday memory functions and problem solving (Cantarella, Borella, Carretti, Kliegel, & de Beni, 2017; Weicker et al., 2016).”
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“, coming regularly to the lab for the training sessions)— recent meta-analyses did not find differences in training or transfer effects depending on the type of control group to which the training group is compared (Karbach and Verhaeghen 2014; Soveri et al. 2017; Weicker et al. 2016).”
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“For example, some studies suggest that only active control groups should be used and that using untreated controls is futile (Melby-Lervåg et al., 2016), while others discovered no significant difference between active and passive control groups (Schwaighofer et al., 2015; Weicker et al., 2016).”
BackgroundEditorial Special Topic: Enhancing Brain and Cognition Through Cognitive Training
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“…is to include only WM training programmes (i.e., Melby-Lervåg et al., 2016; Pappa et al., 2020; Schwaighofer et al., 2015; Soveri et al., 2017; Weicker et al., 2016)—that is, training programmes based on tasks primarily loading on WM, such as n -back, complex span, running span, or updating…”
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“35, [86]), indicating a trend towards similar levels of improvement for cognitive measures of WM resulting from a face-to-face intervention compared to computerized delivery protocols.”
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“According to a recent meta-analysis and systematic review, the effect size of attentional training for patients after TBI was estimated to be small to medium (Virk et al., 2015; Hallock et al., 2016; Weicker et al., 2016).”
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“It is in line with meta-analyses demonstrating transfer effects to WM measures (near transfer; e.g., Soveri et al., 2017; Weicker et al., 2016).”
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Exploring Individual Differences as Predictors of Performance Change During Dual-N-Back Training
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Multisensory Facilitation of Working Memory Training
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“It is a well-researched computerized working memory training program that has been found efficacious in improving attention, working memory, and executive functioning in populations experiencing attention difficulties [33,34].”
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Self-citationTraining Change Detection Leads to Substantial Task-Specific Improvement
Buschkuehl, M., Jaeggi, S. M., Mueller, S. T., Shah, P., & Jonides, J. J. (2017) · Journal of Cognitive Enhancement · doi:10.1007/s41465-017-0055-y · Cited by 13
“shown transfer to non-trained variants of WM tasks (e.g., Karbach and Verhaeghen 2014; Soveri et al. 2017; Weicker et al. 2016).”
BackgroundResultFar-Transfer Effects of Strategy-Based Working Memory Training
Chan, S., Mueller, U., & Masson, M. E. J. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.01285 · Cited by 15
“Independent reviews of training studies have arrived at different conclusions with regard to the effectiveness of WM training (see Klingberg, 2010; Shipstead et al., 2010; Morrison and Chein, 2011; Melby-Lervåg and Hulme, 2013; Karbach and Verhaeghen, 2014; Karr et al., 2014; Au et al., 2015; Melby-Lervåg et al., 2016…”
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“) Conversely, substantial transfer to other cognitive functions is not predicted, since evidence for ‘far’ transfer in the elderly and patients is brittle (11).”
BackgroundMethodSelf-citationNo evidence that working memory training alters gray matter structure: A MRI surface -based analysis
Lawlor‐Savage, L., Clark, C. M., & Goghari, V. M. (2018) · Behavioural Brain Research · doi:10.1016/j.bbr.2018.12.008 · Cited by 13
Neurophysiological indices of the transfer of cognitive training gains to untrained tasks
Wang, X., & Covey, T. J. (2020) · Neurobiology of Learning and Memory · doi:10.1016/j.nlm.2020.107205 · Cited by 10
Müller, S., Klein, T. A., Benke, T., Bohlhalter, S., Hildebrandt, H., Meiling, C., Hucke, B., Münte, T. F., Penner, I., Schwerdtfeger, K., et al. (2020) · Zeitschrift für Neuropsychologie · doi:10.1024/1016-264x/a000300 · Cited by 11
Self-citationEffects and Ways of Tailored Gamification in Software-Based Training in Cognitive Rehabilitation
Gabele, M., Weicker, J., Wagner, S., Thoms, A., Hußlein, S., & Hansen, C. (2021) · User Modeling, Adaptation, and Personalization · doi:10.1145/3450613.3456828 · Cited by 8
“Functionally effective software-based training is used in cognitive rehabilitation after acquired brain injury [68, 70].”
MethodSelf-citationTransparency in Cognitive Training Meta-analyses: A Meta-review
Sandoval‐Lentisco, A., López‐Nicolás, R., Tortajada, M., López-López, J. A., & Sánchez‐Meca, J. (2024) · Neuropsychology Review · doi:10.1007/s11065-024-09638-2 · Cited by 10
“…2017; Lampit et al., 2014, 2019; Leung et al., 2015), more than 1 session (das Nair et al., 2016; Loetscher et al., 2019; Melby-Lervåg et al., 2016; Weicker et al., 2016), at least 3 sessions (Nguyen et al., 2019), at least 10 sessions (Giustiniani et al., 2022; Scionti et al., 2020), at least 20…”
Tsai, N., Au, J., & Jaeggi, S. M. (2016) · Bilingual processing and acquisition · doi:10.1075/bpa.3.04tsa · Cited by 9
Are Measures of Transfer Effects Missing the Target?
Söderqvist, S., & Nutley, S. B. (2017) · Journal of Cognitive Enhancement · doi:10.1007/s41465-017-0048-x · Cited by 11
Executive functioning in low birth weight children entering kindergarten
Miller, S. E., DeBoer, M. D., & Scharf, R. J. (2017) · Journal of Perinatology · doi:10.1038/jp.2017.147 · Cited by 9
The Cognitive and Academic Benefits of Cogmed: A Meta-AnalysisPreprint
Aksaylı, N. D., Sala, G., & Gobet, F. R. (2018) · doi:10.31234/osf.io/ygrh3 · Cited by 9
Maurer-Karattup, P., Neumann, O., Danneil, W., et al. (2022) · Zeitschrift für Neuropsychologie · doi:10.1024/1016-264x/a000362 · Cited by 8
Self-citationRichter, T., Shani, R., Tal, S., Derakshan, N., Cohen, N., Enock, P. M., McNally, R. J., Mor, N., Daches, S., Williams, A. D., et al. (2025) · npj Digital Medicine · doi:10.1038/s41746-025-01449-w · Cited by 8
Predicting cognition after subthalamic Deep Brain Stimulation in Parkinson’s Disease
Kübler, D., Stuke, H., Astalosch, M., et al. (2025) · npj Parkinson s Disease · doi:10.1038/s41531-025-01128-3 · Cited by 8
Ophey, A., Wenzel, J., Paul, R., Giehl, K., Rehberg, S., Eggers, C., Reker, P., van Eimeren, T., Kalbe, E., & Kambeitz‐Ilankovic, L. (2022) · Journal of Parkinson s Disease · doi:10.3233/jpd-223448 · Cited by 8
A novel digital approach for post-stroke cognitive deficits: a pilot study
Oliveri, M., Bagnato, S., Rizzo, S., Imbornone, E., Giustiniani, A., Catania, A., & Turriziani, P. (2023) · Restorative Neurology and Neuroscience · doi:10.3233/rnn-231305 · Cited by 8
“…that training of functionssubservedbyfrontalcircuitssupportsagen-eralizedimprovementofotherabilitiesindifferent neurologicaldiseases,regardlessofthespecificpat-ternofbraindamageandofcognitive/impairment (Karbach&Kray,2009;Weickeretal.,2016;Burgio etal.,2018;Nikraveshetal.,2021;Tarantinoetal., 2022).”
Does working memory training enhance intelligence?
Tsubomi, H., Saito, S., Osaka, M., & Osaka, N. (2019) · The Japanese journal of psychology · doi:10.4992/jjpsy.90.18402 · Cited by 8
Bossert, M., Westermann, C., Schilling, T. M., Weisbrod, M., Roesch-Ely, D., & Aschenbrenner, S. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.555052 · Cited by 8
Interpreting pediatric intelligence tests: a framework from evidence-based medicine
Freeman, A. J., & Chen, Y. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-802203-0.00003-1 · Cited by 10
Kolskår, K. K., Richard, G., Alnæs, D., Dørum, E. S., Sanders, A., Ulrichsen, K. M., Sánchez, J. M., Ihle‐Hansen, H., Nordvik, J. E., & Westlye, L. T. (2019) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/603985 · Cited by 11
“Our results revealed significant improvement on all included tasks from the training program, in line with previous reports (Spencer-Smith and Klingberg, 2015; Westerberg et al., 2007).”
ResultPan, D., Daotuan, W. A. N. G., & Li, X. (2018) · Acta Psychologica Sinica · doi:10.3724/sp.j.1041.2018.01105 · Cited by 7
Kerkhoff, G., & Kraft, A. (2024) · Brain Sciences · doi:10.3390/brainsci14030259 · Cited by 7
“Return to work or its failure is an important aspect of participation that has been neglected up to now in many therapy studies with VFD patients [32] or those suffering from visual neglect [51].”
BackgroundSala, G., Aksaylı, N. D., Semir, K., et al. (2018) · doi:10.31234/osf.io/5frzb · Cited by 7
Cognition-oriented treatments for older adults: A systematic overview of systematic reviewsPreprint
Gavelin, H. M., Lampit, A., Hallock, H., Sabatés, J., & Bahar‐Fuchs, A. (2019) · doi:10.31234/osf.io/y5f89 · Cited by 7
Xu, Z., Zhang, P., Tu, M., Zhang, M., & Lai, Y. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1209881 · Cited by 5
“This is most prominently demonstrated in working memory tasks, where functional training has been shown to enhance the brain’s working memory capacity (Weicker et al., 2016).”
BackgroundZuber, P., Geiter, E., de Quervain, D. J. ‐., & Magon, S. (2021) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2021.682474 · Cited by 6
Pahor, A., Jaeggi, S. M., & Seitz, A. R. (2018) · Wiley eBooks · doi:10.1002/9780470015902.a0028037 · Cited by 6
Metadata
- Authors
- Weicker, J., Villringer, A., & Thöne-Otto, A.
- Affiliations
- Max Planck Society (DE)
- Leipzig University (DE)
- Venue
- Neuropsychology
- Published
- 2016
- Volume
- 30
- Issue
- 2
- Pages
- 190-212
- ISSN
- 0894-4105 (ISSN-L)
- 1931-1559
- OpenAlex
- W1618038909
- Semantic Scholar
- 1016f832cb994fa36bd96a515015eb5bacbd71e9
- Cited by
- 147
- References
- 164
- Citations by year
- 2026: 2 · 2025: 10 · 2024: 8 · 2023: 6 · 2022: 10 · 2021: 17 · 2020: 16 · 2019: 27 · 2018: 20 · 2017: 21 · 2016: 9
- FWCI
- 25.60
- Type
- journal article
- Language
- en
- Open access
- green
- ul.qucosa.de
- Licence
- cc-by-nc-nd
- Locations
- Neuropsychology (publishedVersion)
- PubMed (publishedVersion)
- MPG.PuRe (Max Planck Society) (submittedVersion)
- Qucosa (Saxon State and University Library Dresden) (submittedVersion, cc-by-nc-nd)
- Funders
- German Max Planck Society
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- working memory training, working memory, brain injury, acquired brain injury, cognitive rehabilitation, transfer effects, cognitive control, attention, long-term memory, training sessions
- MeSH terms
- Attention, Brain Injuries, Humans, Intelligence, Learning, Memory, Short-Term, Thinking, Memory, Long-Term
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