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The development of treatments for attention impairments is hampered by limited knowledge about the malleability of underlying neural functions. We conducted the first randomized controlled trial to determine the modulations of brain activity associated with working memory (WM) training in adults with attention-deficit hyperactivity disorder (ADHD). At baseline, we assessed the aberrant functional brain activity in the n-back WM task by comparing 44 adults with ADHD with 18 healthy controls using fMRI. Participants with ADHD were then randomized to train on an adaptive dual n-back task or an active control task. We tested whether WM training elicits redistribution of brain activity as observed in healthy controls, and whether it might further restore aberrant activity related to ADHD. As expected, activity in areas of the default-mode (DMN), salience (SN), sensory-motor (SMN), frontoparietal (FPN), and subcortical (SCN) networks was decreased in participants with ADHD at pretest as compared with healthy controls, especially when the cognitive load was high. WM training modulated widespread FPN and SN areas, restoring some of the aberrant activity. Training effects were mainly observed as decreased brain activity during the trained task and increased activity during the untrained task, suggesting different neural mechanisms for trained and transfer tasks.

Studies have indicated that video gaming is positively associated with cognitive performance in select cognitive domains, but the magnitudes of these associations have been called into question, as they have frequently been based on extreme groups analyses that have compared video gamers with non-gamers. When including the whole range of participants, and not just extreme cases, these effects were observed to reduce markedly (Unsworth et al., 2015). To further study this issue, we compared the associations between video gaming and aspects of working memory (WM) performance in an extreme groups design to those of a design that includes the full range of participants in a large adult sample (n = 503). WM was measured with three composite scores (verbal WM, visuospatial WM, n-back). The extreme groups analyses showed that video gamers performed better than non-gamers on all three WM measures, while the whole sample analyses indicated weak positive associations between the time spent playing video games and visuospatial WM and n-back performance. Thus, study design modulated the effects, but two of the three associations between WM and video gaming were consistent across both analysis techniques. A separate study confirmed that our questionnaire-based estimate of gaming hours was reliable when compared with one-week diaries of videogame playing. While the present cross-sectional results preclude causal inferences, possible mechanisms of WM - videogame playing associations and future research directions are discussed. Overall, our results indicate that cognition - videogame playing relationships, albeit weak, are not solely due to recently discussed methodological artefacts concerning the particular analytical approach and survey reliability.

Working memory (WM) is a key cognitive system that is strongly related to other cognitive domains and relevant for everyday life. However, the structure of WM is yet to be determined. A number of WM models have been put forth especially by factor analytical studies. In broad terms, these models vary by their emphasis on WM contents (e.g., visuospatial, verbal) vs. WM processes (e.g., maintenance, updating) as critical, dissociable elements. Here we conducted confirmatory and exploratory factor analyses on a broad set of WM tasks, half of them numerical-verbal and half of them visuospatial, representing four commonly used task paradigms: simple span, complex span, running memory, and n-back. The tasks were selected to allow the detection of both content-based (visuospatial, numerical-verbal) and process-based (maintenance, updating) divisions. The data were collected online which allowed the recruitment of a large and demographically diverse sample of adults (n = 711). Both factor analytical methods pointed to a clear division according to task content for all paradigms except n-back, while there was no indication for a process-based division. Besides the content-based division, confirmatory factor analyses supported a model that also included a general WM factor. The n-back tasks had the highest loadings on the general factor, suggesting that this factor reflected high-level cognitive resources such as executive functioning and fluid intelligence that are engaged with all WM tasks, and possibly even more so with the n-back. Together with earlier findings that indicate high variability of process-based WM divisions, we conclude that the most robust division of WM is along its contents (visuospatial vs. numerical-verbal), rather than along its hypothetical subprocesses.