老年脑梗死患者记忆障碍的临床护理研究

目的探讨老年脑梗死患者记忆功能的变化,以及这种变化对患者康复和生活质量的影响,做好针对性的护理工作。方法将98例老年脑梗死患者与98例健康老年人作为实验组和对照组,采用中国科学心理研究所许淑莲等编制的“临床记忆量表”进行测试。观察2组指向记忆、联想学习、图像自由回忆、无意义图形再认和人像特点联系回忆共5项分测验指标以及左右脑梗死患者5个分测验指标,进行统计学分析。结果经统计检验,2组患者5项分测验指标比较,均有显著性差异(P<0.05),左右脑梗死患者5项分测验指标比较,有显著性差异(P<0.05)。结论观察测评老年脑梗死患者记忆功能变化,可以评定临床治疗效果,提供临床护理指导,有助于老年脑梗死患者记忆功能的恢复。     

Differential coding of hyperalgesia in the human brain: a functional MRI study

Neuropathic pain can be both ongoing or stimulus-induced. Stimulus-induced pain, also known as hyperalgesia, can be differentiated into primary and secondary hyperalgesia. The former results from sensitization of peripheral nociceptive structures, the latter involves sensitization processes within the central nervous system (CNS). Hypersensitivity towards heat stimuli, i.e. thermal hyperalgesia, is a key feature of primary hyperalgesia, whereas secondary hyperalgesia is characterized by hypersensitivity towards mechanical (e.g. pin-prick) stimulation. Using functional magnetic resonance imaging (fMRI), we investigated if brain activation patterns associated with primary and secondary hyperalgesia might differ. Thermal and pin-prick hyperalgesia were induced on the left forearm in 12 healthy subjects by topical capsaicin (2.5%, 30 min) application. Equal pain intensities of both hyperalgesia types were applied during fMRI experiments, based on previous quantitative sensory testing. Simultaneously, subjects had to rate the unpleasantness of stimulus-related pain. Pin-prick hyperalgesia (i.e. subtraction of brain activations during pin-prick stimulation before and after capsaicin exposure) led to activations of primary and secondary somatosensory cortices (S1 and S2), associative-somatosensory cortices, insula and superior and inferior frontal cortices (SFC, IFC). Brain areas activated during thermal hyperalgesia (i.e. subtraction of brain activations during thermal stimulation before and after capsaicin exposure) were S1 and S2, insula, associative-somatosensory cortices, cingulate cortex (GC), SFC, middle frontal cortex (MFC) and IFC. When compared to pin-prick hyperalgesia, thermal hyperalgesia led to an increased activation of bilateral anterior insular cortices, MFC, GC (Brodmann area 24' and 32') and contralateral SFC and IFC, despite equal pain intensities. Interestingly, stronger activations of GC, contralateral MFC and anterior insula significantly correlated to higher ratings of the stimulus-related unpleasantness. We conclude that thermal and mechanical hyperalgesia produce substantially different brain activation patterns. This is linked to different psychophysical properties.     

无错性学习对脑损伤患者记忆障碍的影响

目的 评价无错性学习对脑损伤患者记忆过程的影响及其作用。方法 将符合人选标准的117例脑损伤患者随机分为3组，完成本研究的有84例患者：（1）计算机辅助训练组（电脑组，n=30）；（2）治疗师主导的面对面训练组（面对面组，n=24）；（3）对照组（n=30）。电脑组和面对面组均采用无错性学习的方法，接受4周具有同样内容的记忆障碍训练课程，但分别以软件版和画册版形式进行，对照组不接受任何记忆训练。3组均随访1个月。用Rivermead行为记忆测试．中文版（RBMT-CV）和香港文字记忆学习测试量表．中文版（HKLLT）进行相应的评价。结果 电脑组、面对面组在训练后，随访与训练前相比，组内比较RBMT-CV和HKLLT均具有良好的增长效应和延续效应，分值的提高有统计学意义（P〈0．0l或P〈0．05），电脑组和面对面组组间比较，HKLLT除提取过程外，编码与保存在训练后和随访期间随时间变化的趋势差异有统计学意义（P〈0．01或P〈0．05）。结论 无错性学习是一个改善脑损伤后记忆功能的有效方法，这种学习模式可以影响记忆的全过程；电脑组、面对面组对记忆的编码与保存效果比对照组更好，并且训练效果可持续1个月。     

Large-scale directional connections among multi resting-state neural networks in human brain: a functional MRI and Bayesian network modeling study

This study examined the large-scale connectivity among multiple resting-state networks (RSNs) in the human brain. Independent component analysis was first applied to the resting-state functional MRI (fMRI) data acquired from 12 healthy young subjects for the separation of RSNs. Four sensory (lateral and medial visual, auditory, and sensory-motor) RSNs and four cognitive (default-mode, self-referential, dorsal and ventral attention) RSNs were identified. Gaussian Bayesian network (BN) learning approach was then used for the examination of the conditional dependencies among these RSNs and the construction of the network-to-network directional connectivity patterns. The BN based results demonstrated that sensory networks and cognitive networks were hierarchically organized. Specially, we found the sensory networks were highly intra-dependent and the cognitive networks were strongly intra-influenced. In addition, the results depicted dominant bottom-up connectivity from sensory networks to cognitive networks in which the self-referential and the default-mode networks might play respectively important roles in the process of resting-state information transfer and integration. The present study characterized the global connectivity relations among RSNs and delineated more characteristics of spontaneous activity dynamics.     

创伤后应激障碍的记忆损害与脑结构MRI特点探讨

目的探讨创伤后应激障碍的记忆损害与脑结构MRI特点,为提高此类患者临床诊断与治疗效果提供可靠依据。材料与方法选取研究组（患者）和对照组（健康志愿者）各16例,进行记忆功能评估,所有受检者均行MRI检查,记录两组的记忆功能评估结果、MRI检查结果,进行统计学分析。结果研究组创伤后应激障碍患者理解记忆、延迟理解记忆、视觉再生、延迟视觉再生评分均显著低于对照组（P〈0．05）,两组对比结果具有统计学意义;研究组患者经MRI检查可知,其脑部额叶与颞叶脑区灰质体积显著小于对照组。结论可根据创伤后应激障碍表现为记忆损害患者脑部额叶与颞叶脑区灰质体积显著小于健康人群这一显著特点,对发生严重创伤后应激障碍患者进行脑部MRI检查,从而准确判断其是否出现记忆障碍,并判断其临床治疗效果。     

Age-related adaptations of brain function during a memory task are also present at rest

Several studies have demonstrated age-related regional differences in the magnitude of the BOLD signal using task-based fMRI. It has been suggested that functional changes reflect either compensatory or de-differentiation mechanisms, both of which assume response to a specific stimulus. Here, we have tested whether ageing affects both task-based and resting brain function, and the extent to which functional changes are mediated by reductions in grey matter (GM) volume.Two groups, of 22 healthy younger and 22 older volunteers, underwent an imaging protocol involving structural and functional MRI, both during a memory task and at rest. The two groups had similar socio-demographical characteristics and cognitive performance. Image analysis revealed both structural and functional differences. Increased BOLD signal in older relative to younger volunteers was mainly observed in the frontal lobes, both during the task and at rest. Functional changes in the frontal lobes were largely located in brain regions spared from GM loss, and adding GM covariates to the fMRI analysis did not significantly alter the group differences. Our results are consistent with the suggestion that, during normal ageing, the brain responds to neuronal loss by fine-tuning connections between spared neurons. Longitudinal studies will be necessary to fully test this hypothesis.     

Right-hemispheric organization of language following early left-sided brain lesions: functional MRI topography

Left-hemispheric (LH) brain lesions acquired early in life can induce language organization in the undamaged right hemisphere (RH). This study addresses the anatomical correlates of language processing in the RH of such individuals. Five hemiparetic patients with left periventricular brain lesions of pre- and perinatal origin were included, in whom fMRI during a word generation task had yielded predominantly RH activation; five age- and sex-matched healthy right-handers served as controls. The patterns of activation in the RH of patients showed a striking similarity with the LH patterns of the normal controls, and voxel-wise comparison failed to detect significant differences. This demonstrates that in patients with early LH damage, RH recruitment for language occurs in brain areas homotopic to the LH regions involved in language processing under normal circumstances.     

Neural basis of temporal context memory: a functional MRI study

Temporal context information is crucial to understanding human episodic memory. Human lesion and neuroimaging data indicate that prefrontal regions are important for retrieving temporal context memory, although the exact nature of their involvement is still unclear. We employed functional magnetic resonance imaging (fMRI) to elucidate the neural basis of two kinds of temporal context memory: the temporal order of items between lists and within a list. On the day of the fMRI experiment, subjects memorized a list of 30 pictures in the morning and another list of 30 pictures in the afternoon. During the scanning session, the subjects performed three tasks. In a between-lists task, they were asked to judge the temporal order between two items that had been presented in different lists. In a within-list task, they were asked to judge the temporal order between two items that had been presented in a single list. We found bilateral prefrontal activities during these two temporal context memory tasks compared with a simple item-recognition task. Furthermore, in direct comparison between these two tasks, we found differential prefrontal activities. Thus, right prefrontal activity was associated with temporal order judgment of items between lists, whereas left prefrontal activity was related to temporal order judgment of items within a list. These results indicate that retrieval processes of two kinds of temporal context memory are supported by different, but overlapping, sets of cerebral regions. We speculate that this reflects different cognitive processes for retrieving temporal context memory between separate episodes and within a single episode.     

小动物脑功能磁共振成像研究进展

本文主要介绍血氧水平依赖的小动物脑功能磁共振成像的研究条件、范围和研究方法,并简述小动物在发展非血氧水平依赖功能磁共振技术中所起的作用。尽管小动物脑磁共振成像研究受到麻醉等条件的限制,这项研究已经在神经科学及神经药理学范围作出了诸多贡献,并受到越来越多的重视。     

功能磁共振成像在脑损伤康复期演变中的应用

脑损伤患者在康复过程中会伴有不同程度的脑组织重塑和功能重组.功能磁共振成像(fMRI)能够获得脑组织的解剖学、生理学及病理学信息,并且在一定程度上反映各功能区间的相互联系.因此.fMRI技术能够反映脑损伤康复过程中脑组织发生的结构和功能变化,为临床开展有针对性的治疗提供有价值的信息.     

Symptom experience in patients with primary brain tumours: A longitudinal exploratory study

PurposeThis study was undertaken to further understand the symptom experience and the impact of symptoms in daily life in people treated for brain tumours.MethodsA qualitative prospective longitudinal design was used with 9 people who were interviewed over 4 time points (soon after diagnosis, 3 months, 6 months and 12-months post-diagnosis), providing 21 interviews in total.ResultsKey issues for these participants were ongoing fatigue, memory loss and inability to drive. Fatalistic views about the outcomes of their disease were the norm. Participants made adjustments to their lives to accommodate their functional limitations. These included making home alterations, introducing regular exercise to their lives and using complementary therapies. Their expectations did not always match with the reality of the situation, which made several participants angry and dissatisfied with health care professionals.ConclusionsIssues of quality of life are paramount in this group of poor prognosis patients, therefore, health professionals should provide preparatory information to patients on what to expect from the illness and its treatments. Health professionals should also assist patients to manage debilitating symptoms such as fatigue and cognitive impairment.     

The representation of social interaction in episodic memory: a functional MRI study

The representation of social interaction in episodic memory is a critical factor for the successful navigation of social relationships. In general, it is important to separate episodic memory during social interaction from episodic memory during the self-generation of action events. Different cortical representations have been associated with social interaction vs. self-generated episodic memory. Here we clarified the cortical representation of the effect of context (social vs. solitary) on episodic memory by comparing it with the generation effect (self vs. other) on episodic memory. Each participant learned words while engaged in a sentence generation and a reading task, and subsequently each participant was scanned with functional magnetic resonance imaging (fMRI) while they performed a recognition task using the words that had been learned. The experiment was comprised of four conditions and we looked at two situations that involved a social context and non-social (solitary) context task. In the learning session before entering the MRI, two participants collaborated in a social context either generating (social-contextual self-generation condition: SS) or reading (social-contextual other-generation condition: SO) a sequence of sentences alternately to construct a meaningful story narrative. In the non-social context, the participants generated (non-social-contextual self-generation condition: NS) or read (non-social-contextual other-generation condition: NO) a sequence of sentences individually. The stimuli for the recognition session consisted of learned words and novel words. Activation for social context retrieval was identified in the right medial prefrontal cortex (mPFC), and activation for self-generated retrieval was identified in the left mPFC and the left middle cingulate cortex. These results indicate that dissociable regions within the medial prefrontal cortices contribute to the processes involved in the representation of social interaction, including social context and self-generation in the retrieval of episodic memory.     

正常人简体汉字词组短时记忆刺激的脑fMRI实验研究

目的 本实验是运用功能磁共振成像（fMRI)研究志愿者简体汉字词组短时记忆刺激的脑内活动区情况：方法 10例正常志愿者作为研究对象。运用单次激发GRE-EPI分别在横断位、冠状位和矢状位扫描采集fMRI图像，以简体汉字词组短时记忆为刺激：fMRI图像和T1W解剖图像在三个断面融合，并进行脑内活动区出现率分析：结果 横断位图像上出现24个活动区．冠状位图像上出现20个活动区，矢状位图像上出现24个活动区：结论 本实验的fMRI研究显示正常人简体汉字单词短时记忆刺激的脑内活动区主要位于PFC，颞叶一海马、枕叶和小脑等。     

认知功能训练对脑损伤后记忆障碍的影响

目的探讨认知功能训练对脑损伤后记忆障碍的影响及临床意义。方法将82例脑损伤患者设为研究组,79例同期来本院体检的健康人设为对照组,研究组在常规治疗护理的基础上给予5周的认知功能训练,在训练前,训练后分别进行韦氏记忆量表(WMS)测评。结果脑损伤后训练前,患者的长时记忆、短时记忆、瞬时记忆的各项分测验评分,以及记忆智商均明显低于对照组(P<0.05)。5周训练后WMS测评中,除回忆与训练前无显著差别外,其他各项分测验值以及记忆智商均明显优于训练前(P<0.05)。结论脑损伤后患者的记忆功能明显受到损害,早期认知功能训练可改善记忆障碍。     

Brain activation during the fist-edge-palm test: a functional MRI study

The purpose of our study is to clarify, using functional MRI, brain regions activated during the fist-edge-palm task (FEP) compared to relatively simple hand motor tasks using either the right or the left hand in right-handed normal volunteers. The FEP was introduced to detect a disorder of voluntary movement, and it is believed to be closely related to contralateral frontal lobe damage. However, this assumption still remains controversial. Ten subjects participated in this study. Hand motor tasks were as follows: (1) the FEP, in which the subjects were requested to place their hand in three different positions sequentially: a fist resting horizontally, a palm resting vertically, and a palm resting horizontally; (2) a fist-palm task (FP), in which the subjects were asked to clench and unclench their fist alternately; and (3) a control task requiring the subjects to knock lightly with their clenched fist. The contralateral sensomotor and premotor areas were activated in the FP with the right hand and the contralateral sensorimotor, premotor, and supplementary motor areas (SMA) were activated in the FP with the left hand. In the FEP with either hand, bilateral premotor and left parietal areas and ipsilateral cerebellum were also activated as well as contralateral sensorimotor area and SMA. Our results suggest that successful performance of the FEP requires the participation of more brain areas than FP, which may explain why some patients without frontal lobe damage failed to perform the FEP.     

Changes in brain activation patterns associated with learning of Korean words by Japanese: an fMRI study

We used functional magnetic resonance imaging (fMRI) to explore the change in brain activation associated with the learning of Korean words written in Han-gul characters (K-words) by young Japanese at two stages. Subjects were 12 right-handed native Japanese without previous knowledge of Korean words and characters. On the first day they were taught the pronunciation and meaning of 20 K-words. Then, after the first fMRI session (on day 2), they were given a set of 20 cards with the words and corresponding photographs. They also received a tape and were instructed to memorize the 20 K-words by studying them every day until the day of the second fMRI session (day 16). During the fMRI sessions, 20 Japanese words written in kana syllabograms (J-words) and the 20 previously presented K-words, as well as 20 new K-words (Kn-words) were presented visually for silent reading. The first J-word reading, relative to the first K-word reading, showed activation in the left angular gyrus. K-word reading relative to J-word reading during both sessions showed activation in occipital regions. Within these activated areas, session by condition interaction was found only in the left angular gyrus. The interaction between session and condition resulted from the fact that the differences in blood oxygenation-level-dependent signals between K-words and J-words and between Kn-words and J-words were significantly greater in the first session than in the second session. From the results, we concluded that patterns of brain activation changed as the memory of the 20 K-words became fixed through daily practice and that reading of both Korean words and Japanese syllabograms engaged the left angular gyrus.     

鼻咽癌放射治疗后脑损伤对长期生存病人记忆力减退的影响

目的探讨记忆力检测作为放射性脑损伤早期发现方法的可行性。方法检测142例放射治疗后长期生存的鼻咽癌患者记忆商和记忆五项分测验(指向记忆、联想学习、图像自由回忆、无意义图像再认和人像特征回忆),并设30例健康志愿者作为对照组。结果全组患者记忆商和记忆五项分测验结果均低于对照组,与对照组比较差异有统计学意义(P<0.01)。结论放射治疗后长期生存的鼻咽癌患者记忆力下降与放射性脑损伤有关,初步提示进行记忆力动态评测有助于早期发现鼻咽癌病人的放射性脑损伤,为临床治疗和护理提供依据,直接提高患者的生活质量。     

Individual differences in cognitive style and strategy predict similarities in the patterns of brain activity between individuals

Neuroimaging is being used increasingly to make inferences about an individual. Yet, those inferences are often confounded by the fact that topographical patterns of task-related brain activity can vary greatly from person to person. This study examined two factors that may contribute to the variability across individuals in a memory retrieval task: individual differences in cognitive style and individual differences in encoding strategy. Cognitive style was probed using a battery of assessments focused on the individual's tendency to visualize or verbalize written material. Encoding strategy was probed using a series of questions designed to assess typical strategies that an individual might utilize when trying to remember a list of words. Similarity in brain activity was assessed by cross-correlating individual t-statistic maps contrasting the BOLD response during retrieval to the BOLD response during fixation. Individual differences in cognitive style and encoding strategy accounted for a significant portion of the variance in similarity. This was true above and beyond individual differences in anatomy and memory performance. These results demonstrate the need for a multidimensional approach in the use of fMRI to make inferences about an individual.     

多发性硬化伴发记忆障碍MRI研究进展

多发性硬化（MS）是以中枢神经系统炎性脱髓鞘改变为主要表现的疾病,是中青年非创伤性神经功能残疾的主要原因,主要表现为记忆及信息处理速度、执行功能等多种认知领域障碍。MS伴发记忆障碍（MSMI）因发病隐匿而常被忽略,严重影响患者生活质量。随着神经功能影像学的快速发展,MRI已成为观察和诊断MS的重要手段,可为诊断MSMI提供影像学依据。本文就MSMI相关临床及MRI研究进展进行综述。     

Semantic memory involvement in the default mode network: a functional neuroimaging study using independent component analysis

The Default Mode Network (DMN) is a higher order functional neural network that displays activation during passive rest and deactivation during many types of cognitive tasks. Accordingly, the DMN is viewed to represent the neural correlate of internally-generated self-referential cognition. This hypothesis implies that the DMN requires the involvement of cognitive processes, like declarative memory. The present study thus examines the spatial and functional convergence of the DMN and the semantic memory system. Using an active block-design functional Magnetic Resonance Imaging (fMRI) paradigm and Independent Component Analysis (ICA), we trace the DMN and fMRI signal changes evoked by semantic, phonological and perceptual decision tasks upon visually-presented words. Our findings show less deactivation during semantic compared to the two non-semantic tasks for the entire DMN unit and within left-hemispheric DMN regions, i.e., the dorsal medial prefrontal cortex, the anterior cingulate cortex, the retrosplenial cortex, the angular gyrus, the middle temporal gyrus and the anterior temporal region, as well as the right cerebellum. These results demonstrate that well-known semantic regions are spatially and functionally involved in the DMN. The present study further supports the hypothesis of the DMN as an internal mentation system that involves declarative memory functions.