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.     

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.     

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。     

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.     

前额叶损伤患者基于事件和基于时间的前瞻性记忆损害

目的探讨前额叶(PFC)损伤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)的损害情况,验证PFC参与前瞻性记忆神经机制的假说。方法建立前瞻性记忆的神经心理学测验方法,测试年龄、教育程度相匹配的30名健康人和30例前额叶损伤患者的EBPM和TBPM。结果与健康对照组[EBPM(6.00±1.91)分;TBPM(5.30±0.92)分]相比,前额叶损伤组的EBPM[(1.47±1.07)分]差异有统计学意义(P<0.01),而TBPM[(4.77±1.17)分]的差异却无统计学意义(P>0.05)。左右侧PFC损伤组的EBPM[(1.40±1.12)、(1.64±1.01)分]和TBPM[(4.60±1.06)、(4.86±1.29)分]的差异均无统计学意义(P>0.05)。结论前额叶损伤患者的EBPM存在损害,而TBPM却相对正常,这说明EBPM和TBPM可能有着不同的脑机制。相对于TBPM,前额叶可能更多地参与了EBPM的认知加工。     

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。     

帕金森病患者记忆扫视的特点

目的 研究帕金森病(PD)患者记忆扫视的特点,探讨记忆扫视对PD辅助诊断的价值.方法 选取53例早、中期PD患者作为PD组,同时选取36名年龄匹配的健康受试者作为对照组.对所有受试者进行记忆扫视检查和事件相关电位P300检查,并对检查结果进行比较;同时,对29例早期PD亚组患者的记忆扫视结果进行单独分析.结果 与健康受试者相比,PD组患者记忆扫视速度、初始增益明显降低,记忆扫视潜伏期明显延长,多余扫视和多阶模式扫视的发生率明显增多(U=124.000、37.000;均P＜0.0l),这些异常在早期PD患者亚组中已经非常明显;PD患者事件相关电位P300潜伏期[( 384.76±34.48) ms]较健康受试者[(352.42±24.99) ms]延长(t=-4.791,P＜0.01);多阶模式扫视的发生率对区分PD患者和健康受试者具有很好的敏感度(96.2％)和特异度(94.4％).结论 PD患者记忆扫视各项指标检查结果明显异常,可能是PD患者脑干扫视通路和额叶功能损害的反映.记忆扫视检查在PD的辅助诊断方面可能具有一定的应用价值.     

帕金森病认知功能障碍的事件相关电位P300及磁共振-弥散张量成像研究

目的探讨事件相关电位(ERPs) P300与磁共振-弥散张量成像(MR-DTI)联合检查在评价帕金森病认知功能障碍(PD-CI)患者的脑部损害及其在PD-CI早期诊断及临床病情评估中的价值。方法选择30例PD患者(PD组)和30例健康对照者(对照组)进行MoCA量表认知功能评定及P300潜伏期、波幅检测;对每例受试者进行MRDTI扫描,计算各感兴趣区(ROI)各向异性分数(FA),分析MoCA评分、P300电位P3潜伏期及波幅、FA值间的相关关系。结果 PD组MoCA量表得分较对照组显著降低(P0.05),存在PD-CI;PD组P300电位P3潜伏期较对照组显著延长(P0.05),两组P300波幅比较差异无显著性。PD组额叶、黑质FA值与对照组比较,差异有显著性(P0.05);两组颞叶、纹状体FA值比较差异无显著性。PD组MoCA量表得分与P300潜伏期呈负相关(P0.05)、与额叶平均FA值呈正相关(P0.05)。PD组P300潜伏期与额叶平均FA值呈负相关(P0.05)。结论 ERPs P300与MR-DTI联合检查可以检测出PD-CI患者可能存在的隐匿性脑损伤,分别从结构和电生理两方面为PD-CI早期诊断提供客观指标;额叶认知功能下降与ERPs P300异常和FA值降低相关。     

慢性原发性失眠患者的前瞻性记忆研究

目的 探讨慢性失眠对患者前瞻性记忆的损害情况.初步探讨慢性失眠引起前瞻性记忆损害的可能神经机制.方法 采用前瞻性记忆的神经心理学测试方法,对42例慢性原发性失眠患者及40名正常睡眠者进行基于事件和基于时间的前瞻性记忆测试.结果 与正常睡眠组[(5.58±0.35)分]比较,慢性原发性失眠组[(3.44±0.40)分]患者基于事件的前瞻性记忆差异有统计学意义(t=3.933,P=0.000);基于事件的前瞻性记忆的回溯成分差异无统计学意义(t=1.308,P =0.195);基于时间的前瞻性记忆差异无统计学意义(t=0.787,P=0.433);基于时间的前瞻性记忆的同溯成分差异无统计学意义(Z=-0.776,P=0.437).结论 慢性失眠影响患者基于事件的前瞻性记忆,而基于时间的前瞻性记忆及同溯成分相对正常.     

The prospective memory of patients with idiopathic REM sleep behavior disorder

BackgroundIdiopathic rapid eye movement sleep behavior disorder (iRBD) likely represents the prodromal stage of synucleinopathy. The present study was to investigate if there was prospective memory (PM) impairment and the relationship between different PM tasks and traditional cognitive tests in patients with iRBD.MethodsA total of 28 patients with iRBD, 25 with Parkinson's disease (PD) and 21 healthy controls were included. The Cambridge Prospective Memory Test (CAMPROMPT) was used to measure the PM including time-based (TBPM) and event-based PM (EBPM). Standard cognitive tests were administered to all participants.ResultsEBPM scores were lower only in patients with iRBD, while the obvious PM abnormalities were found in patients with PD. The patients with iRBD and PD performed worse on delayed recall of the Rey Auditory Verbal Learning Test (RAVLT) and copy of the Rey–Osterrieth complex figure (ROCF). The EBPM correlated with attention, executive function, and immediate memory besides working memory in patients with iRBD. The PM tasks involved in more memory functions in PD patients.ConclusionsThe patients with iRBD were impaired on both episodic memory and EBPM tasks that correlated with attention, executive function, and immediate memory. The PM abnormality was an early cognitive change in iRBD to which more attention should be paid more attention.     

Errorless learning of prospective memory tasks: An experimental investigation in people with memory disorders

The term prospective memory (PM) refers to memory for future intentions. PM problems are frequent in people with cognitive impairment and, because they are central to the realisation of many everyday goals, are important in rehabilitation. Event-based PM tasks (EBPM) are environmentally-cued and have primarily mnemonic demands, whereas time-based PM tasks (TBPM) require self-initiated retrieval, and have greater executive demands. Errorless learning (EL) is an encoding method that results in superior retrospective memory compared with “errorful” learning (EF). As this EL advantage (ELA) likely stems from its reduced explicit memory demands, and there is no such advantage for executive tasks, a greater ELA for EBPM than TBPM was predicted. Fourteen adults with neurological memory impairment completed PM tasks under four counterbalanced conditions: EL of EBPM, EL of TBPM, EF of EBPM, and EF of TBPM. A significant ELA was observed for EBPM (d = .63), but not TBPM (d = –.01). These results extend the evidence for EL within cognitive rehabilitation, by showing for the first time that the method can benefit future action in addition to retrospective memory. The clinical implications are also clear: errorless learning techniques may be usefully employed to support completion of day-to-day EBPM tasks.     

帕金森病合并抑郁患者认知功能和P300的研究

目的 探讨帕金森病（PD）合并抑郁患者认知功能和P300的改变。方法 对67例PD患者依据Zung抑郁自评量表（SDS）和汉密顿抑郁量表（HAMD）评分分为PD抑郁组（22例）和PD非抑郁组（45例），分别对两组患者进行认知功能评定和P300检测，并对结果进行比较和相关性分析。结果 本组PD患者简明智力状态量表（MMSE）评分尚在正常范围，但明显低于正常对照组（P〈0．05），PD抑郁组MMSE评分更低（P〈0.01）；与正常对照组比较，PD组P300潜伏期延长、波幅降低（均P〈0．05），PD抑郁组改变更为明显（均P〈0．01）；PD组P300潜伏期与MMSE评分呈负相关（r=-0．413，P〈0．05），波幅与MMSE评分呈正相关（r=0．398，P〈0．05）。结论 PD患者存在认知功能障碍，以记忆损害最为明显；抑郁对认知功能有负性影响，P300检测可以早期发现PD患者的认知功能障碍。     

Prospective memory impairment in patients with white matter lesions

Objective: A vast majority of the episodic memory literature in white matter lesions (WML) had focused on “retrospective memory (RM)”, little was known about prospective memory (PM) in WML patients. The aim of our study was to investigate the effect of WML patients on event-based prospective memory (EBPM) and time-based prospective memory (TBPM). In addition, our study attempted to understand the possible mechanisms of PM damage in WML patients.

Methods: A total of 42 WML patients and 40 age and education level matched healthy controls were included. EBPM (an action whenever particular words were presented) and TBPM (an action at certain times) were performed to test the involvement of PM in WML. The extent of WML within cholinergic pathways were assessed using the cholinergic pathways hyperintensities scale (CHIPS).

Results: A significant difference was found in the performance of Montreal Cognitive Assessment (MOCA) (21.8?±?3.9 vs. 26.6?±?1.7, p?<?0.05) and TBPM (2.88?±?1.21 vs. 4.27?±?0.78, p?<?0.05), but not Mini-Mental State Examination (MMSE) (26.9?±?2.8 vs. 27.3?±?1.2, p?>?0.05) and EBPM (3.62?±?1.25 vs.4.47?±?1.11, p?>?0.05) in WML patients compared with the healthy controls. Moreover, TBPM and MOCA scores were negatively correlated with CHIPS scores.

Conclusions: WML patients were impaired in TBPM but not in EBPM, supporting that EBPM and TBPM have different neural mechanisms. Our results demonstrated that WML are involved in the TBPM probably by affecting the central cholinergic pathway.     

Recognition memory for unfamiliar faces in Parkinson's disease: behavioral and electrophysiologic measures

We analyzed event-related potentials (ERPs) and behavioral measurements during a recognition memory task in 15 normal elderly subjects and 15 patients with Parkinson's disease (PD). To elicit ERPs unfamiliar faces were repeated immediately after initial presentation (at lag 0), after one intervening face (at lag 1) or at lag 3. Compared to normal controls, PD patients showed decreased accuracy in recognizing new unfamiliar faces. P170 latency and amplitude were similar between both groups. ERP amplitude between 300 and 500 ms after the stimulus in control subjects showed a positive shift (ERP repetition effect) for lag 0 at all sites and for lag 1 and 3 repetitions at the Fz site, while effects in the PD group were not noted at any site, even for the lag 0 repetition. ERP waveforms for the first presentation of faces in PD patients showed a significant positive shift compared to normal controls. These data suggest intact perception but impaired recognition memory for unfamiliar faces in PD. In addition, recognition memory deficits in PD may result from impairment of comparison of structural representations of presented faces with stored representations of faces known to the observer.