轻度认知损害患者情节记忆的编码和提取

为了研究轻度认知损害患者情节记忆编码和提取的改变,采用神经心理学方法评定正常老年人和轻度认知损害患者(MCI)情节记忆编码和提取.结果表明:除存在记忆力损害以外,MCI组定向力、语言能力、执行等能力显著低于正常老年组(P《0.01);MCI组患者情节记忆编码正确率显著低于正常老年组(P《0.01),下降约22.81%;MCI组情节记忆提取正确率显著低于正常老年组(P《0.05),下降约6.84%.提示轻度认知损害患者情节记忆编码和提取均存在不同程度的损害,而情节记忆编码的损害更明显.     

轻度认知损害患者情节记忆的编码和提取

为了研究轻度认知损害患者情节记忆编码和提取的改变 ,采用神经心理学方法评定正常老年人和轻度认知损害患者 (MCI)情节记忆编码和提取。结果表明 :除存在记忆力损害以外 ,MCI组定向力、语言能力、执行等能力显著低于正常老年组 (P <0 .0 1) ;MCI组患者情节记忆编码正确率显著低于正常老年组 (P <0 .0 1) ,下降约2 2 .81% ;MCI组情节记忆提取正确率显著低于正常老年组 (P <0 .0 5 ) ,下降约 6 .84 %。提示轻度认知损害患者情节记忆编码和提取均存在不同程度的损害 ,而情节记忆编码的损害更明显。     

不同意识状态下中风患者脑干诱发电位特点

为探讨中风患者在不同意识状态下BAEP特点，分别对27例有意识障碍及25例无意识改变的非脑干部位性中风患者进行BAEP的测定。结果：意识障碍组的Ⅲ、Ⅴ波潜伏期及Ⅴ－Ⅲ、Ⅲ－I波间期延长，同正常对照组及无意识障碍中风组间均有非常显著的差异（P＜0．001），2例Ⅲ、Ⅴ波均消失的昏迷患者死亡。无意识改变的中风患者组Ⅲ、Ⅴ波潜伏期及Ⅴ－Ⅲ、Ⅲ—Ｉ波间期同正常对照组间无显著差异（P＞0．05）。表明非脑干部位性中风患者出现意识障碍，脑干功能继发性受损，同时显示BAEP能对有意识障碍的中风患者的预后做出有价值的判断。     

抽动-秽语综合征内隐和外显记忆的研究

目的：研究抽动－秽语综合征的外显记忆与内隐记忆特点。方法：采用配对病例对照研究设计，选取确诊的抽动－秽语综合征患者及匹配健康对照各26例，用加工、分离程度的方法测定其意识性提取及自动提取在丙认测验中的贡献。结果：与健康对照组相比，抽动－秽语综合征患者的外显记忆显著低于对照组，内隐记忆差异无显著性。按年龄分层比较后，病例组7－8岁年龄段的外显记忆与同年龄对照组相比差异有显著性，其他年龄段差异无显著性。结论：抽动－秽语综合征患者的外显记忆受损而内隐记忆正常，说明外显记忆与内隐记忆属于两个独立的记忆系数。     

丘脑病变与记忆障碍的关系研究

目的 探讨丘脑病变与记忆障碍的关系.方法 给35例丘脑病变患者及30名正常对照者进行简易精神状态检查、临床痴呆评定量表检测.排除丘脑病变组中重度认知功能障碍、无明显记忆力下降及双侧丘脑病变者,其他病例和正常对照者进行临床记忆量表(CMS)检测;分别比较左、右侧丘脑病变患者及与正常对照组之间的检查结果.观察有、无记忆力障碍患者头颅CT、MRI显示的丘脑病变位置.结果 丘脑病变组有重度认知功能障碍l例、记忆障碍27例(左侧丘脑病变15例,右侧丘脑病变12例),无明显记忆障碍7例.CMS评分示,左侧丘脑病变组各分项评分和总记忆商均显著低于正常对照组(均P＜0.001),而右侧丘脑病变组图像自由回忆和无意义图形再认评分与正常对照组的差异无统计学意义.左侧丘脑病变组指向记忆、联想学习、无意义图形再认评分和总记忆商显著低于右侧丘脑病变组(均P＜0.01).有记忆障碍患者的丘脑病灶位于丘脑内侧或前方,而无记忆障碍患者的病灶位于丘脑外侧和后方.结论 丘脑病变常引起记忆障碍,左侧丘脑病变的记忆障碍比右侧重,言语性记忆障碍较显著;丘脑病变的位置与记忆障碍有关.     

高压氧对实验性小鼠脑缺氧学习记忆功能的影响

本文以Y迷宫分辨学习和1次性被动回避反应为学习记忆的指标,结合病理髓鞘组织染色观察了高压氧对实验性小鼠脑缺氧学习记忆功能的影响。结果显示:(1)高压氧对正常小鼠学习记忆功能无显著影响;(2)实验性脑缺氧可造成小鼠学习记忆功能明显损害,在脑缺氧后2、4、6d进行高压氧治疗,对小鼠学习记忆功能都有明显改善,但不能恢复到正常水平,8d后进行高压氧治疗,则对其学习记忆无显著作用;(3)脑缺氧后均有不同程度的髓鞘脱失,与学习记忆功能的损害有明显的一致性。     

重症急性胰腺炎大鼠的脑损伤及保护对策

目的:观察重症急性胰腺炎(SAP)大鼠的脑损伤以及血脑屏障在SAP大鼠脑损伤中的作用。方法:经胰胆管逆行注射3 .5 %牛磺胆酸钠(2 .5mL·kg-1)建立大鼠SAP模型,观察经生长激素和生长抑素不同处理各组动物的血清炎性介质、内毒素和磷脂酶A2的变化,分析各组脑水肿、血脑屏障和脑细胞凋亡与胰腺病理评分的相关性。结果:SAP组动物血清炎性介质、内毒素、磷脂酶A2 表达水平、胰腺病理评分和脑损伤程度较假手术组呈显著性升高(P <0 .0 1)。生长抑素和生长激素联合治疗SAP组动物血清各项指标、胰腺病理评分和脑损伤程度与SAP组相比有显著性减轻。应用多元回归分析显示脑水肿、血脑屏障和脑细胞凋亡与胰腺病理评分有相关性;发现血脑屏障是脑损伤指标中最重要的指标。结论:SAP时脑损伤主要影响血脑屏障,继而引起脑水肿和脑细胞的凋亡。胰腺病理评分与脑损伤程度呈正相关。生长激素和生长抑素联合治疗能显著降低SAP大鼠胰腺病理评分和脑损伤程度。     

轻度颅脑损伤中应激因素对大鼠学习记忆的影响

目的探讨应激因素(惊吓)对轻度脑损伤大鼠恢复期学习记忆的影响。方法将30只实验大鼠随即分为损伤组、惊吓组与正常对照组。对Hall[1]脑损伤装置进行改进,制造清醒状态下大鼠轻度脑损伤模型。伤前3d及伤后10d通过Morris水迷宫试验检测损伤组、惊吓组与对照组学习记忆能力的差异。结果损伤组、惊吓组学习记忆能力与对照组比较有统计学意义(P<0.05),损伤组与惊吓组之间比较无统计学意义(P>0.05)。结论在轻度颅脑损伤中应激因素对学习记忆改变有重要意义。     

超声检查颈动脉对预测脑梗死患者预后的临床意义

目的 探讨超声检查颈动脉预测脑梗死患者预后的临床意义.方法 选取脑梗死患者117例,根据入院时颈动脉超声中显示颈动脉内-中膜厚度分为正常组、增厚组和斑块组.3组均在入院时和治疗4周后进行美国国立卫生研究院卒中量表评分(NIHSS评分)和SSS评分,治疗3个月后评价其认知功能和颈动脉超声血流动力学指数.结果 3组治疗4周后的NIHSS评分和SSS评分均显著低于入院时(P＜0.01);增厚组入院时和治疗4周后的NIHSS评分和SSS评分均显著高于同期正常组,而斑块组均显著高于同期正常组和增厚组(P＜0.01).堵厚组治疗3个月后的各项记忆评分均显著低于正常组,而斑块组均显著低于正常组和增厚组(P＜0.01).增厚组治疗3个月后的RI、PI显著高于正常组,PSV和Vmean显著低于正常组(P＜0.01);斑块组治疗3个月后的RI、PI显著高于正常组和增厚组,PSV和Vmean显著低于正常组和增厚组(P＜0.01).结论 通过颈动脉超声早期检测可预测脑梗死患者的神经功能和血流动力学改变,对预测患者预后具有重要意义.     

重性抑郁障碍首次发病患者记忆损害及其与血清皮质醇水平的关系

目的:探讨重性抑郁障碍首次发病患者记忆损害与血清皮质醇的关系。方法:对30例重性抑郁障碍首次发病患者和30名正常对照者进行韦氏记忆量表(WMS)测量以评定其记忆水平,同时进行血清皮质醇的浓度测定。结果:重性抑郁障碍组的韦氏记忆商数及心智、图片、再认、再生、联想、理解、背数因子分显著低于正常对照组﹙P0.01﹚;韦氏记忆因子中的心智、图片、再认、再生、联想、背数、理解、记忆商数与HAMD总分以及HAMD因子中的焦虑/躯体化、认识障碍、阻滞、睡眠障碍显著负相关(P0.05);血清皮质醇浓度与韦氏记忆因子中的心智、图片、再认、再生、联想、背数、记忆商数显著负相关(r分别=-0.432,-0.410,-0.399,-0.421,-0.472,-0.436,P0.05);重性抑郁障碍患者的韦氏记忆各因子得分与其年龄、病程存在负相关(P0.05)。结论:重性抑郁障碍首次发病患者急性期存在记忆功能减退,并与血清皮质醇浓度可能存在相关性。     

Conscious and unconscious uses of memory in multiple sclerosis

Conscious and unconscious uses of memory and priming were studied in 30 patients with multiple sclerosis (MS) and 15 normal control (NC) subjects. MS patients were classified into two subgroups according to their cognitive status; 15 of them were cognitively deteriorated (the MS-D group) and 15 cognitively preserved (the MS-P group). A process dissociation procedure [J. Mem. Lang. 30 (1991) 513] was used to separate conscious and unconscious memory performance in a word stem completion task. The results showed that the MS-D group had deficient conscious memory performance, but had intact unconscious memory as well as priming. The MS-P group showed normal conscious and unconscious uses of memory and priming. Thus, in MS-related cognitive decline, conscious memory seems to be vulnerable, whereas unconscious memory remains intact. The results provide neuropsychological support for the distinction between conscious and unconscious memory processes. Moreover, the results show the importance of studying cognitively homogenous MS groups as opposed to heterogenous ones, in order to find the underlying mechanisms of memory deficits in MS. Interestingly, the neural systems needed for the unconscious use of memory do not seem to deteriorate even in MS patients with deficient overall cognitive capacity. This finding encourages the development of future rehabilitation programs, suggesting that unconscious remembering might help MS patients with deficient conscious memory to cope with their daily activities.     

Dendritic development of hippocampal CA1 pyramidal cells in a neonatal hypoxia–ischemia injury model

It is believed that neonatal hypoxia–ischemia (HI) brain injury causes neuron loss and brain functional defects. However, the effect of HI brain injury on dendritic development of the remaining pyramidal cells of the hippocampus and the reaction of contralateral hippocampal neurons require further studies. The Morris water maze and Golgi–Cox staining were used to evaluate the learning and memory and dendritic morphology of pyramidal cells. The results of Golgi–Cox staining showed CA1 pyramidal neurons of HI injury models with fewer bifurcations and shorter dendrite length than the naive control group. The density of dendritic spines of hippocampal CA1 pyramidal neurons was significantly lower in the HI brain injury group than in controls. With respect to hippocampal function, the HI brain injury group presented cognitive deficits in the reference memory task and probe trail. In the HI group, the pyramidal cells of left hippocampus that did not experienced ischemia but did experience hypoxia had more complex dendrites and higher density of spine than the HI injury side and control. The functional implementation of injured hippocampus might depend mainly on the hypertrophy of contralateral hippocampus after HI brain injury. Corticosterone can partially prevent the hippocampal pyramidal cells from HI injury and reduce the difference of the bilateral hippocampus pyramidal cells, but there was no improvement in learning and memory. © 2013 Wiley Periodicals, Inc.     

Sustained activity within the default mode network during an implicit memory task

Recent neuroimaging studies have shown that several brain regions - namely, the posterior cingulate cortex (PCC), ventral medial prefrontal cortex (vmPFC), and the bilateral angular gyrus - are more active during resting states than during cognitive tasks (i.e., default mode network). Although there is evidence showing that the default mode network is associated with unconscious state, it is unclear whether this network is associated with unconscious processing when normal human subjects perform tasks without awareness. We manipulated the level of conscious processing in normal subjects by asking them to perform an implicit and an explicit memory task, and analyzed signal changes in the default mode network for the stimuli versus baseline in both tasks. The functional magnetic resonance imaging (fMRI) analysis showed that the level of activation in regions within this network during the implicit task was not significantly different from that during the baseline, except in the left angular gyrus and the insula. There was strong deactivation for the explicit task when compared with the implicit task in the default mode regions, except in the left angular gyrus and the left middle temporal gyrus. These data suggest that the activity in the default network is sustained and less disrupted when an implicit memory task is performed, but is suspended when explicit retrieval is required. These results provide evidence that the default mode network is associated with unconscious processing when human subjects perform an implicit memory task.     

The prognostic value of the brain sodium-potassium ATPase enzyme concentration in head injury

Sodium-potassium adenosine triphosphatase (ATPase) enzyme was determined in the brain tissue of 11 patients with head injury and 6 control patients. Patients with head injury included in this study were selected from two categories: (a) patients in deep coma due to severe head injury [Glasgow Coma Scale (GCS)<8; 6 cases]; (b) patients with depressed skull fractures with dural tears who were conscious and able to give an adequate verbal response (GCS>10; 5 cases). The level of the enzyme was significantly reduced in comatose patients with severe head injury as compared to the controls (P<0.001) or to conscious patients with depressed fractures (P<0.001). In the group of conscious patients with depressed fractures, the enzyme level was no different from that of the controls (P = 0.4215). All comatose patients with severely reduced enzyme levels subsequently died, whereas those with depressed fractures with normal enzyme levels survived. The relationship between a low enzyme level and brain edema in severe head injury is discussed.     

脑创伤后长期意识障碍患者脑干听觉诱发电位表现与预后清醒的关系

目的 探讨重型创伤性颅脑损伤(TBI)后长期意识障碍患者脑干听觉诱发电位(BAEP)表现与预后清醒的关系.方法 分析63例重型TBI后意识障碍超过2周患者的BAEP表现,主要为BAEP中Ⅰ、Ⅲ、Ⅴ波各波峰潜伏期(PL),Ⅰ～Ⅲ、Ⅲ～Ⅴ波峰间潜伏期(IPL)及Ⅰ波与Ⅴ波波幅比.预后以TBI后6个月患者是否清醒为标准,分为清醒组与未清醒组,组间运用两独立样本t检验以筛选出有意义的指标.结果 本组患者清醒率为34.9%(22/63),BAEP指标异常率为66.7%(42/63).双侧Ⅰ、Ⅲ、Ⅴ波PL,Ⅰ～Ⅲ波、Ⅲ～Ⅴ波IPL及Ⅰ/Ⅴ波幅比均正常的21例中有16例清醒(清醒率为76.2%),双侧Ⅴ波PL异常的8例及双侧Ⅲ～Ⅴ波IPL异常的7例均未清醒,单侧Ⅴ波消失的2例未清醒.清醒组与未清醒组间比较发现双侧差异均有统计学意义的指标为Ⅴ波PL及Ⅲ～Ⅴ波IPL.结论 BAEP的Ⅴ波PL及Ⅲ～Ⅴ波IPL变化可客观、准确地反映脑损伤的程度及预测患者的预后.

Abstract：

Objective To explore the correlation between brainstem auditory evoked potential (BAEP) findings and outcome in long-term unconscious patients with severe traumatic brain injury (TBI).Methods BAEP findings were recorded and analyzed in 63 patients suffering from severe TBI with duration of disturbance of unconsciousness for more than 2 weeks. The peak latency (PL) of wave Ⅰ, Ⅲ and Ⅴ, the interpeak latency (IPL) of wave Ⅰ-Ⅲ and Ⅲ-Ⅴ and the amplitude ratio of wave Ⅰ and Ⅴ were analyzed. Conscious or unconscious at 6 months after the injury was considered as the outcome criterion,and based on these, the patients were divided into conscious and unconscious groups; the significant indicators were chosen in the 2 groups using independent-sample t test. Results The probabilities of awakening in these patients were 34.9% (22/63) with abnormal index of BAEP indicators reaching 66.7%. Sixteen patients were sober at last in 21 patients with normal PL of wave Ⅰ, Ⅲ and Ⅴ, IPL of wave Ⅰ-Ⅲ and Ⅲ-Ⅴ, and amplitude ratio of wave Ⅰ and Ⅴ in bilateral side (the probabilities of awakening were 76.2%); 8 patients having abnormal PL of wave Ⅴ in bilateral side and 7 having abnormal IPL of wave Ⅲ-Ⅴ in bilateral side were unconscious; 2 patients having disappeared wave Ⅴ in unilateral side were unconscious. PL of wave Ⅴ and IPL of wave Ⅲ-Ⅴ in bilateral side were significantly different between the conscious group and the unconscious group. (P＜0.05). Conclusion BAEP findings (PL of wave Ⅴ and IPL of wave Ⅲ-Ⅴ in bilateral side) can objectively and accurately demonstrate the cerebral dysfunction and predict the outcome of the patients.     

Functional reorganisation of memory after traumatic brain injury: a study with H(2)(15)0 positron emission tomography

OBJECTIVE: To study the effects of moderate to severe traumatic brain injury (TBI) on the functional neuroanatomy supporting memory retrieval. METHODS: Subjects were six patients who had sustained a moderate to severe TBI about four years before scanning and had since made a good recovery. Eleven healthy young adults matched to the patients for age and education served as controls. An established H(2)(15)0 positron emission tomography paradigm was used to elicit brain activations in response to memory retrieval. TBI patients' patterns of brain activation were compared statistically with those of control subjects. Both group and individual case data were analysed. RESULTS: Both TBI patients and controls engaged frontal, temporal, and parietal regions known to be involved in memory retrieval, yet the TBI patients showed relative increases in frontal, anterior cingulate, and occipital activity. The hemispheric asymmetry characteristic of controls was attenuated in patients with TBI. Reduced activation was noted in the right dorsomedial thalamus. Although local aspects of this pattern were affected by the presence of focal lesions and performance differences, the overall pattern was reliable across patients and comparable to functional neuroimaging results reported for normal aging, Alzheimer's disease, and other patients with TBI. CONCLUSIONS: The TBI patients performed memory tasks using altered functional neuroanatomical networks. These changes are probably the result of diffuse axonal injury and may reflect either cortical disinhibition attributable to disconnection or compensation for inefficient mnemonic processes.     

High density ERP indices of conscious and unconscious semantic priming

The existence of differential brain mechanisms of conscious and unconscious processing is a matter of debate nowadays. The present experiment explores whether conscious and unconscious semantic priming in a lexical decision task at a long prime-target stimulus onset asynchrony (SOA) correlate with overlapping or different event related potential (ERP) effects. Results show that the N400 effect, which appeared when words were consciously perceived, completely disappeared when primes were masked at a level where the ability of participants to detect the prime was near chance. Instead, a rather different set of ERP effects was found to index unconscious semantic priming. This suggests that the processes at the basis of conscious and unconscious semantic analyses can under some circumstances be rather different. Moreover, our results support the notion that conscious and unconscious processes are at least partially separable in the brain.     

脑损害患者数字工作记忆的功能性磁共振研究

目的:探讨脑损害患者数字工作记忆脑区的激活特点.方法:采用1.5T磁共振扫描仪对9例脑损害患者在进行数字工作记忆时进行扫描,结果与正常对照者进行比较.结果:与正常对照组相比,脑损害组大脑皮质对数字工作记忆的激活区域和强度有不同程度的减少,激活广泛而散在,左右半球脑区激活的差距减小.同时,不同脑损害患者也有各自激活特点....     

A neuropsychological comparison of psychotic disorder following traumatic brain injury, traumatic brain injury without psychotic disorder, and schizophrenia

Neuropsychological functioning in individuals with psychotic disorder following traumatic brain injury (PDFTBI), traumatic brain injury without psychosis (TBIWP), and schizophrenia were compared against each other and to the means of normal subjects. It was predicted that the PDFTBI group would be similar to the schizophrenic group in patterns of deficits, but milder in severity. Compared to scores from a normal sample, the PDFTBI group scored significantly lower in intelligence, vocabulary, verbal memory, and executive functioning, while the schizophrenic group scored significantly lower in intelligence, working memory, verbal memory, visual spatial abilities, and executive functioning. No differences were found between normal subjects and the TBIWP group. Implications of our findings for the conceptualization of psychotic disorders are discussed.     

垂体前叶黄体生成素对重度颅脑创伤病情及预后的监测与评估

目的研究急性颅脑创伤病人垂体前叶黄体生成素（luteinizing hormone,LH）的动态变化及其对病情及预后的评估.方法随机选取1999年12月至2001年6月间急性颅脑创伤住院病人50例,按照GCS分数、GOS不同的预后、不同的创伤类型、CT中线移位程度等因素分别进行了分析研究.同时设立对照组12例.结果颅脑创伤组LH值明显高于正常对照组.颅脑创伤的程度越重,伤后即刻的LH值越高,而动态观察则快速下降,波动幅度大,其伤后入院即刻检测值与入院第3天的检测值之比值也就越大.如GCS 3～5分组,死亡组,重度中线移位组,脑挫伤组的情况都是如此.伤情较轻者,黄体生成素升高的程度较小,且伤后48 h逐渐恢复正常,波动幅度小,其伤后入院即刻检测值与伤后入院第3天的检测值之比值也就越小.结论颅脑创伤病人伤后LH的动态变化可以作为伤情判断和判断预后的重要指标之一.凡伤后LH明显升高而48 h后明显降低者,入院检测的LH值与入院后72 h所检测的LH比值大于3者,预示伤情严重且预后不良.