Lakerveld J, Kotchoubey B, Kübler A
Institute of Medical Psychology and Behavioural Neurobiology, University of Tübingen, Tübingen, Germany.
J Neurol Neurosurg Psychiatry. 2008 Jan;79(1):25-9. doi: 10.1136/jnnp.2007.116178. Epub 2007 May 22.
Subtle cognitive deficits have been found in a substantial percentage of patients with early stage amyotrophic lateral sclerosis (ALS). Cognitive function in later stages of the disease remain to be investigated because the neuropsychological tests that are usually employed, such as written or verbal fluency tests, cannot be performed by those patients because of motor or speech impairment, or both.
In the present study, 11 patients with late stage ALS who were severely physically impaired and matched controls underwent a neuropsychological test battery to explore their cognitive function with respect to disease related functional status. Testing was restricted to tasks that used a binary (yes/no) signal and did not require verbalisation or measures of reaction time to index performance.
Although some patients displayed deficits in aspects of executive function, learning and memory, overall test results indicated normal cognitive function. A statistically highly significant negative correlation was found between the performance on two learning and memory tasks and the functional status of the patients.
The results of this study indicate a superior performance on learning and memory tasks of patients whose disease had further progressed. This may have important implications for our view on cognitive function in relation to the course of the disease.
在相当比例的早期肌萎缩侧索硬化症(ALS)患者中发现了细微的认知缺陷。由于疾病后期的患者存在运动或言语障碍,或两者皆有,通常采用的神经心理学测试,如书面或言语流畅性测试,无法对其进行,因此疾病后期的认知功能仍有待研究。
在本研究中,11名身体严重受损的晚期ALS患者和匹配的对照组接受了一套神经心理学测试,以探讨他们在与疾病相关的功能状态方面的认知功能。测试仅限于使用二元(是/否)信号且不需要言语表达或反应时间测量来评估表现的任务。
尽管一些患者在执行功能、学习和记忆方面存在缺陷,但总体测试结果表明认知功能正常。在两项学习和记忆任务的表现与患者的功能状态之间发现了具有统计学高度显著性的负相关。
本研究结果表明,疾病进展更严重的患者在学习和记忆任务上表现更优。这可能对我们关于疾病进程中认知功能的观点具有重要意义。