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阿尔茨海默病型痴呆中关于有生命和无生命概念的语义损伤纵向概况。

Longitudinal profiles of semantic impairment for living and nonliving concepts in dementia of Alzheimer's type.

作者信息

Garrard P, Lambon Ralph M A, Watson P C, Powis J, Patterson K, Hodges J R

机构信息

National Hospital for Neurology and Neurosurgery, London, UK.

出版信息

J Cogn Neurosci. 2001 Oct 1;13(7):892-909. doi: 10.1162/089892901753165818.

Abstract

Two types of theoretical account have been proposed to explain the phenomenon of category-specific impairment in tests of semantic memory: One stresses the importance of different cortical regions to the representation of living and nonliving categories, while the other emphasize the importance of statistical relationships among features of concepts belonging to these two broad semantic domains. Theories of the latter kind predict that the direction of a domain advantage will be determined in large part by the overall damage to the semantic system, and that the profiles of patients with progressive impairments of semantic memory are likely to include a point at which an advantage for one domain changes to an advantage for the other. The present series of three studies employed semantic test data from two separate cohorts of patients with probable dementia of Alzheimer's type (DAT) to look for evidence of such a crossover. In the first study, longitudinal test scores from a cohort of 58 patients were examined to confirm the presence of progressive semantic deterioration in this group. In the second study, Kaplan-Meier survival curves based on serial naming responses and plotted separately for items belonging to living and nonliving domains indicated that the representations of living concepts (as measured by naming) deteriorated at a consistently and significantly faster rate than those of nonliving concepts. A third study, carried out to look in detail at the performance of mildly affected patients, employed an additional cross-sectional cohort of 20 patients with mild DAT and utilized a graded naming assessment. This study also revealed no evidence for a crossover in the advantage of one domain over the other as a function of disease severity. Taken together with the model of anatomical progression in DAT based on the work of Braak and Braak (1991), these findings are interpreted as evidence for the importance of regional cerebral anatomy to the genesis of semantic domain effects in DAT.

摘要

为了解释语义记忆测试中特定类别损伤的现象,人们提出了两种理论解释:一种强调不同皮质区域对生物和非生物类别的表征的重要性,而另一种则强调属于这两个广泛语义领域的概念特征之间统计关系的重要性。后一种理论预测,领域优势的方向在很大程度上将由语义系统的整体损伤决定,并且语义记忆进行性损伤患者的概况可能包括这样一个点,即一个领域的优势转变为另一个领域的优势。本系列三项研究使用了来自两个不同队列的可能患有阿尔茨海默病型痴呆(DAT)患者的语义测试数据,以寻找这种交叉的证据。在第一项研究中,检查了一组58名患者的纵向测试分数,以确认该组中存在进行性语义衰退。在第二项研究中,基于连续命名反应绘制的Kaplan-Meier生存曲线,并分别针对属于生物和非生物领域的项目进行绘制,结果表明生物概念的表征(通过命名测量)比非生物概念的表征以一致且显著更快的速度衰退。第三项研究旨在详细观察轻度受影响患者的表现,使用了另外一组20名轻度DAT患者的横断面队列,并采用了分级命名评估。这项研究也没有发现随着疾病严重程度的变化,一个领域相对于另一个领域的优势存在交叉的证据。结合基于Braak和Braak(1991)的工作的DAT解剖学进展模型,这些发现被解释为区域脑解剖学对DAT中语义领域效应发生的重要性的证据。

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