老年人前瞻性记忆损害的研究

目的 了解健康老年人前瞻性记忆改变的情况,初步探讨老年人基于事件的前瞻性记忆(EBPM)和基于时间的前瞻性记忆(TBPM)损害程度的区别.方法 建立前瞻性记忆的神经心理学测验方法,测试教育程度相匹配的40名健康老年人和40名健康成年人的EBPM和TBPM.结果 与成年组[EBPM(6.25±1.60)分;TBPM(5.38±0.87)分]相比,老年组的EBPM[(2.50±0.85)分和TBPM(4.93±1.07)分]均较成年组差(P＜0.01,P＜0.05),而EBPM损伤指数的差异亦有统计学意义(P＜0.01).老年组前瞻性记忆的EBPM和TBPM存在双分离.结论 老年人存在前瞻性记忆的损害,EBPM损害较TBPM损害更为显著.EBPM和TBPM的双分离表明其可能有不同的神经机制,推测额叶可能特异性地参与了EBPM.     

颞叶癫痫对前瞻性记忆的影响

目的 探讨颞叶癫痫对基于事件的前瞻性记忆(event-based prospective memory,EBPM)和基于时间的前瞻性记忆(time-based prospective memory,TBPM)的影响,验证颞叶参与前瞻性记忆的神经机制假说.方法 采用McDaniel等建立的前瞻性记忆神经心理学试验方法,测试62例颞叶癫痫患者(33例服用抗癫痫药物和29例未服用药物,颞叶癫痫组)和年龄、教育程度相匹配的30名健康者(健康对照组)的EBPM和TBPM.结果 颞叶癫痫组简易精神状态检查(MMSE)、数字广度测试(DS)、词汇流畅性测试(VFT)的成绩均低于健康对照组,且MMSE、VFT两组间差异有统计学意义.与健康对照组[ EBPM测试(6.83±1.34)分,TBPM测试(5.00±1.70)分]相比,颢叶癫痫组的EBPM测试[(3.95±2.77)分]和TBPM测试[(3.08±2.42)分]的成绩差异均有统计学意义(t=6.72、4.39,均P＜0.01),且TBPM测试得分均低于EBPM.其中服药和未服药两组间EBPM测试成绩[(3.82±2 70)、(4.10±2.90)分]差异无统计学意义(t=-0.40,P ＞0.05),两组间TBPM测试成绩[(2.55±2.20)、(3.69±2.55)分]差异亦无统计学意义(t=-1.90,P＞0.05).结论 颞叶癫痫患者存在前瞻性记忆损害,提示颞叶参与前瞻性记忆的神经机制过程;与EBPM相比,TBPM损害更明显,提示TBPM需要更多的自我发动过程.     

缺血性脑白质病变患者前瞻性记忆损害

目的 了解缺血性脑白质病变(WMIL)患者前瞻性记忆改变的情况,初步探讨WMIL患者基于事件的前瞻性记忆(EBPM)和基于时间的前瞻性记忆(TBPM)损害的特点.方法 建立前瞻性记忆的神经心理学测验方法,测试年龄、受教育程度等相匹配的30例对照者和30例WMIL患者的EBPM和TBPM.结果 WMIL患者的TBPM成绩(分)较对照组明显损害(2.2±1.4、5.0±1.1,t=-8.483.P<0.01),而EBPM成绩(分)较对照组差异无统计学意义(4.3±1.6、4.0±1.5,t=0.667,P>0.05);且TBPM成绩与白质病变严重程度、白质病变对脑内胆碱能通路的损伤程度均呈负相关(r=-0.387、-0.416,均P<0.05).结论 WMIL患者存在前瞻性记忆的损害,表现为TBPM损害突出,且病变越严重TBPM损害越明显,而EBPM却相对正常;WMIL患者TBPM损害程度与其对脑内胆碱能通路的损伤程度相关,提示胆碱能通路损害可能参与TBPM的发病机制.     

遗忘型轻度认知损害患者的前瞻性记忆障碍

目的 探讨遗忘型轻度认知损害(amnesia mild cognitive impairment,aMCI)患者前瞻性记忆(prospective memory,PM)改变的特征,初步了解基于事件的PM(event-based prospective memory,EBPM)和基于时间的PM(time-based prospective memory,TBPM)在aMCI患者中的损害情况.方法 建立PM的神经心理学测验方法,对30例aMCI患者以及年龄、受教育程度相匹配的30名健康老年人进行测试.结果 与健康对照组[EBPM:(2.33±0.66)分、TBPM:(4.90±1.03)分]相比,aMCI组的EBPM成绩[(0.90±1.09)分]和TBPM成绩[(4.23 ±1.14)分]差异均有统计学意义(t=-6.143,P<0.01;t=-2.383,P<0.05).结论 aMCI患者的记忆障碍不仅表现为回顾性记忆(retrospective memory,RM)损害,PM损害可能更为突出,且EBPM的损害程度大于TBPM和RM,提示EBPM的测查可能有利于aMCI的早期识别.     

早中期帕金森病患者前瞻性记忆损害的特点

目的 探讨早中期帕金森病(PD)患者前瞻性记忆损害的特点.方法 采用安徽医科大学前瞻性记忆检查方法,对15例早中期PD患者和15名健康对照者进行基于事件的前瞻性记忆(EBPM)和基于时间的前瞻性记忆(TBPM)检查.结果 PD组EBPM的检查成绩明显低于对照组,二者分别为(3.93±2.69)分和(6.00±2.17)分,差异有统计学意义(t=-2.318,P<0.05);PD组与对照组TBPM的检查成绩分别为(3.47±1.96)分和(3.80 ±1.70)分,差异无统计学意义(t=-0.498,P>0.05).结论 早中期PD患者存在EBPM损害,而TBPM相对保留.     

慢性精神分裂症前瞻性记忆损害与回顾性记忆损害分析

目的分析慢性精神分裂症患者前瞻性记忆(prospective memory,PM)与回顾性记忆(retrospective memory,RM)损害状况,探讨慢性精神分裂症患者PM与RM的关联。方法纳入50例慢性精神分裂症患者和50名正常对照,用中文版剑桥前瞻性记忆测试量表(Cambridge prospective memory test,C-CAMPROMPT)评估基于事件的前瞻性记忆(event-based PM,EBPM)和基于时间的前瞻性记忆(time-based PM,TBPM),数字序列(digital span,DS)测验评估工作记忆(working memory,WM),逻辑记忆(logical memory)测验和视觉再现(visual reproduction,VR)测验分别评估即刻听觉逻辑记忆(immediate auditory logical memory,IALM)、延迟性听觉逻辑记忆(delayed auditory logical memory,DALM)和即刻视觉再现记忆(immediate visual reproduction memory,IVRM)、延迟性视觉再现记忆(delayed visual reproduction memory,DVRM),并根据标准分数将患者各量表得分转换为可进行量表间比较的损伤指数。结果患者组的EBPM[(7.9±3.4)vs.(13.7±2.9)]、TBPM[(6.9±3.6)vs.(13.0±3.2)]、DS-顺背[(5.8±2.0)vs.(7.5±2.2)]、DS-倒背[(6.5±1.9)vs.(8.2±2.8)]、IALM[(8.3±3.1)vs.(11.9±2.5)]、DALM[(7.4±3.7)vs.(11.8±2.6)]、IVRM[(8.0±2.7)vs.(11.2±3.8)]及DVRM[(7.7±3.5)vs.(10.8±2.7)]得分均低于对照组,差异有统计学意义(均P<0.05);患者组EBPM损伤指数和TBPM损伤指数均大于DS-顺背损伤指数、DS-倒背损伤指数、IALM损伤指数、IVRM损伤指数、DVRM损伤指数(均P<0.05),与DALM损伤指数差异均无统计学意义(P>0.05)。患者组PM总分与除IVRM(P=0.155)外RM各测验得分的相关关系均有统计学意义(均P<0.05)。结论慢性精神分裂症患者存在前瞻性记忆和回顾性记忆损害,前瞻性记忆损害较回顾性记忆损害严重,且两种损害相互关联。     

重症肌无力患者基于事件和基于时间的前瞻性记忆研究

目的探讨重症肌无力(MG)患者前瞻性记忆(PM)的损害情况。方法运用经典PM的神经心理学测验方法,分别检测MG组和正常对照组(NC组)的基于事件的PM(EBPM)和基于时间的PM(TBPM)。结果 MG患者的EBPM得分(EBPM=5.9±1.1)明显低于NC组(EBPM=7.4±0.9)(t=-4.785,P0.01),而两组间的TBPM差异无统计学意义(MG组:TBPM=5.3±0.6,NC组:TBPM=5.5±0.7)(t=-0.668,P0.05)。结论 MG患者的EBPM存在损害,而TBPM无明显损害。     

早期未治疗帕金森病患者前瞻性记忆损害和事件相关电位改变的特点

目的 探讨早期未治疗PD患者前瞻性记忆损害情况和事件相关电位(ERPs)改变的特点.方法 选择自2007年1月至2010年10月在河南省人民医院神经内科门诊确诊的早期未治疗的PD患者33例(PD组)和同期该家医院31名健康体检者(健康对照组)进行研究,研究项目包括基于事件的前瞻性记忆(EBPM)、基于时间的前瞻性记忆(TBPM)和ERPs综合检查.结果 PD组EBPM和TBPM评分均明显低于对照组,差异均有统计学意义(P＜ 0.05); PD组N2、P300潜伏期均较健康对照组明显延长,P300波幅与对照组比较明显降低,差异均有统计学意义(P＜0.05).相关分析结果显示,PD患者的P300潜伏期与EBPM和TBPM均呈明显正相关,r值分别为0.628、0.582,P值均为0.000.结论 早期未治疗PD患者存在EBPM和TBPM损害；P300潜伏期可作为判定PD患者EBPM和TBPM损害程度的电生理指标.     

前额叶损伤患者情绪记忆的改变

目的 探讨前额叶损伤患者情绪记忆的损害情况,验证前额叶参与情绪记忆神经机制的假说.方法 建立情绪记忆的神经心理学测验方法,测试年龄、教育程度相匹配的40名健康人和40例前额叶损伤患者的情绪记忆情况.结果 与健康对照组[正性(11.68±2.18)分和负性(12.93±1.33)分]相比,前额叶损伤组[正性(8.20±2.02)分和负性(8.68±1.14)分]情绪效价图片再认成绩差异有统计学意义(t=7.41、-2.75,P＜0.05),而中性的情绪效价图片再认成绩差异无统计学意义.左、右侧前额叶损伤组的正性[(8.90±2.01)分、(7.50±1.79)分]和负性[(7.30±1.10)分、(9.05±1.00)分]情绪效价图片再认成绩差异均有统计学意义(Z=-2.15、-2.07,P＜0.05).结论 前额叶损伤患者的情绪记忆存在损害,且左、右侧前额叶损伤患者的正性与负性效价记忆相对存在不同差别的损害,表明其可能有不同的神经机制.

Abstract：

Objective To investigate the emotional memory impairment in patients with lesions located in prefrontal cortex(PFC), and to test the hypothesis that prefrontal cortex is involved in the emotional memory network. Methods The 40 patients with lesions in PFC and forty age-education-level matched healthy adults were given emotional memory tasks using positive, neutral and negative valence images. Results Compared with the healthy adults(positively(11.68 ± 2. 18)and negatively(12. 93 ±1.33)), the patients had significant loss in positively(8. 20 ± 2.02)and negatively(8. 68 ± 1.14)valence image memorizing(t = 7.41, - 2. 75, both P ＜ 0. 05). There was no insignificant impairment in neutral stimuli. Performance difference between left PFC and right PFC in positively(8. 90 ±2. 01 vs 7.50 ± 1.79)and negatively(7.30 ± 1.10 vs 9. 05 ± 1. 00)valence image recognition was significant(Z = -2. 15,-2. 07,both P ＜ 0. 05). Conclusion The results suggest that emotional memory is impaired in the patients with lesions in PFC. The impairment difference between left PFC and right PFC indicates that they may have different neuromechanisms.     

阿尔茨海默病的前瞻性记忆损害

目的 探讨阿尔茨海默病（Alzheimer's disease,AD）患者前瞻性记忆(prospective memory,PM)改变的特征,初步了解基于事件的前瞻性记忆(EBPM)和基于时间的前瞻性记忆( TBPM)在早期AD患者中的损害情况。方法 建立前瞻性记忆的神经心理学测验方法,测试20例AD患者（AD组）以及年龄、教育程度相匹配的20例遗忘型轻度认知损害（amnesia mild cognitive impairment,aMCI）患者（aMCI组）及30名健康人（NC组）。结果 与NC组及aMCI组前瞻性记忆(2.23 +0.77、4.83+1.09,1.00+1.03、3.10±1.52)及情景记忆成绩(0.70±0.12、0.66 +0.16,0.45±0.07、0.54±0.10)相比,AD组的成绩(0.20±0.41、2.05±1.43,0.33±0.12、0.32±0.10)差异均有统计学意义,而EBPM的成绩差异更明显（t=-2.792,P＜0.01;t=-10.761,P＜0.01）。结论 早期AD患者的记忆障碍不仅表现为情景记忆的损害,前瞻性记忆损害可能更为突出,且AD的前瞻性记忆损害与aMCI患者呈现了一致性,提示前瞻性记忆的早期测查可能会有利于AD的早期诊断。     

Neuroimaging in epilepsy in tropics

Epilepsy is a major public health problem in many tropical countries. Also, some of the tropical diseases are major contributors to the higher prevalence of epilepsy in these countries. The etiologic factors responsible for epilepsy in these countries are quite different from those in the developed world. This article discusses the etiologic factors and neuroimaging of epilepsy in light of the conditions in these tropical countries.     

癫痫与抑郁关系的研究进展

抑郁是癫痫患者中常见的精神障碍,严重地影响了患者的生活质量。传统的观点认为癫痫患者因为存在着诸多社会学问题易出现抑郁倾向,癫痫和抑郁是单向的联系,但大量的研究已经证明癫痫和抑郁之间存在双向的联系,一种异常状态的存在可能易转化为另一种异常状态的发展。癫痫和抑郁存在着共同的发病机制。本文主要就癫痫和抑郁的双向联系以及抗抑郁药物在癫痫患者中的应用进行阐述。     

Sudanophilic lipid accumulation in astrocytes in periventricular leukomalacia in monkeys

Summary Sudanophilic lipid accumulation is a characteristic feature of periventricular leukomalacia (PVL) of infants. At least two types of lipid-containing cells have been identified, one being the macrophage, the other the pre-myelin glial cell. A third type of lipid-containing cell has been seen in two monkeys with spontaneous PVL. Electron microscopically this cell appears to be an astrocyte. This probably represents a reaction of the astrocyte to hypoxia and may be the equivalent of the hypertrophic astrocytes found in human infants.Supported in part by NIH grant HDO 8633 and the Regional Primate Research Center Grant RR-00166     

Increase in cathepsin D activity in rat brain in aging

Cathepsin D-like activity in homogenates of five brain areas of 3-month-old and 24-month-old Fischer 344 rats was measured. With hemoglobin as substrate at pH 3.2, more than 90% of the activity was inhibited by pepstatin. In each area studied, activity was more than twice as high in the old rat brain: 140-160% higher in the cortex, cerebellum, pons-medulla, and striatum and 90-100% higher in the hippocampus and spinal cord. The greatly increased metabolic capacity in the absence of an increase in protein turnover may have a role in age-related pathological degeneration in the brain.     

Gender in Voice Perception in Autism

Deficits in the perception of social stimuli may contribute to the characteristic impairments in social interaction in high functioning autism (HFA). Although the cortical processing of voice is abnormal in HFA, it is unclear whether this gives rise to impairments in the perception of voice gender. About 20 children with HFA and 20 matched controls were presented with voice fragments that were parametrically morphed in gender. No differences were found in the perception of gender between the two groups of participants, but response times differed significantly. The results suggest that the perception of voice gender is not impaired in HFA, which is consistent with behavioral findings of an unimpaired voice-based identification of age and identity by individuals with autism. The differences in response times suggest that individuals with HFA use different perceptual approaches from those used by typically developing individuals.     

Increase in noradrenaline-synthesizing enzyme activity in medulla oblongata in Parkinson's disease

Summary Dopamine beta hydroxylase (DBH), the noradrenaline-synthesizing enzyme, and phenylethanolamine-N-methyltransferase (PNMT), the adrenaline-synthesizing enzyme, were assayed in 18 areas of brain stem in eight cases of parkinsonian syndromes and of four age- and postmortem delay-matched controls. Dissection was performed by the punch technique and enzyme activities assayed by radiometric methods. No significant change was found for PNMT activity. DBH activity was significantly increased in the A2-C2 area of the medulla oblongata (including the nucleus tractus solitarius) in the cases of Parkinson's disease.The A2-C2 area is known to be implicated in the control of blood pressure in rats. These findings are discussed in relation to orthostatic hypotension and the influence ofl-dopa therapy.Supported by grants from INSERM ATP 657897, ATP 8179113, CRL 79-1-356-6, DGRST (80 E 0882), FRMF, and Sandoz-France France     

Changes in parasympathetic system in medulla oblongata in male pigs in the course of tachycardia-induced cardiomyopathy

Background

Autonomic imbalance constituting a fundamental feature of heart failure (HF) has been assessed mainly at the periphery. Changes in the functioning of autonomic centers in the brain remain unclear. We investigated the molecular elements of parasympathetic system, i.e. α7 nicotinic acetylcholine receptor (α7nAChR) and enzymes metabolizing acetylcholine (acetylcholinesterase, AChE, choline acetyltransferase, ChAT) in medulla oblongata (MO) of male pigs with chronic tachycardia-induced cardiomyopathy.

Methods

The mRNA levels of AChE, ChAT, α7nAChR and X-box binding protein 1 (spliced form, XBP1s) in MO were analyzed using qPCR, AChE and ChAT activities using spectrophotometry, proteasome activity using fluorometry, and the protein level of α7nAChR using Western blotting.

Results

The development of systolic HF was accompanied by an increase in circulating catecholamines, a decrease in the AChE and α7nAChR mRNA in MO, an increase in AChE activity (all p < 0.05), and no change in either the mRNA or activity of ChAT. Both circulating catecholamine levels and AChE activity were inversely related to systolic function of left myocardial ventricle (p < 0.05). The level of α7nAChR protein in MO and its cytoplasmatic fraction were higher in pigs with moderate and severe HF as compared to the other animals (p < 0.01). There was no difference in proteasome activity in MO between diseased and healthy animals, whereas the XBP1s mRNA decreased during HF progression (p < 0.05).

Conclusions

Molecular elements of parasympathetic system are changed within the medulla oblongata during the progression of systolic non-ischemic heart failure in male pigs, indicating a functional link between MO and heart in HF.     

Issues in evaluation of cognition in the elderly in developing countries

Background:

Developing regions of the world host the majority of elderly subjects who are at risk for dementia. Reliable epidemiological data from these countries is invaluable in tackling this global problem. Scarcity of such data in literature is largely attributable to problems that are unique to developing communities worldwide.

Objective:

To classify and describe the problems that interfere with the collection of reliable epidemiological data on cognitive impairment in the elderly in developing communities, and to suggest practical solutions for some of them.

Methods:

Inferring from the experiences of a large, ongoing, population-based study on the cognitive impairments in the elderly in South India and from the review of literature.

Conclusion:

A fatalistic attitude regarding aging in the communities, significant heterogeneity in educational abilities and activities of daily living, high illiteracy among rural subjects, and lack of an organized health care system and updated demographic figures are some of the major factors that contribute to technical, namely, methodology-related problems and practical, namely, subject-related problems in such epidemiological studies.     

Suicide in the elderly in Austria

In most countries men and women have the highest suicide rates in age groups over 60 years. We investigated suicide rates for the elderly in Austria, a country with one of the highest suicide rates in the world, for the period 1980–1991, using data from the Federal Statistical Division. Suicide rates remained stable over the last decade at a very high level. The mean rate for men was 85.2, for women 28.6/100 000. In men and women rates rise with age. The mean rate of men rises from 51.2 (60–64 years) to 117.3/100 000 (over 85 years); in women there is an increase from 21.4 (60–64 years) to 32.8/100 000 (over 85 years). We did not confirm findings in other countries, where suicide rates have increased in recent years.     

Characteristics of nociceptors in the periodontium--an in vitro study in rats

Recent studies have indicated that nociceptors can be classified into various types according to their physiological properties. These studies have clarified that the frequency distribution of various nociceptor types is different among body sites and animal species. In the present study, we investigated the physiological properties of rat's periodontal nociceptors in an in vitro jaw-nerve preparation. Responses were recorded from functional single filaments in the inferior alveolar nerve. To determine the nociceptor type, calibrated von Frey filaments, heat, and bradykinin (BK) stimuli were used. We found five subtypes of nociceptors in the periodontal ligaments of the lower incisor: Adelta-high threshold mechanonociceptors (Adelta-HTM, n=28), Adelta-mechanoheat nociceptors (Adelta-MH, n=6), Adelta-polymodal nociceptors (Adelta-POLY, n=26), C-high threshold mechanonociceptors (C-HTM, n=3) and C-polymodal nociceptors (C-POLY, n=4). Most nociceptors were Adelta-innervated, while only a small number of C-innervated nociceptors were found. The present results suggest that periodontal nociceptors transmit mainly fast pain, and may thus play a role in rapid detection of injure-related stimuli during mastication.