Gainotti Guido, Ferraccioli Monica, Vita Maria Gabriella, Marra Camillo
Neuropsychology Service of the UCSC/Policlinico Gemelli, Catholic University of Rome, Rome, Italy.
J Int Neuropsychol Soc. 2008 Jul;14(4):611-9. doi: 10.1017/S1355617708080831.
We investigated whether MCI patients with hippocampal atrophy or multiple subcortical infarcts demonstrate neuropsychological patterns and markers considered typical of Alzheimer's disease (AD) and of vascular dementia (VD), respectively. An extensive neuropsychological battery, including tests of memory, visual-spatial and executive functions, language, attention, praxis and psychomotor speed, was administered to 36 mild cognitive impairment (MCI) patients with hippocampal atrophy and 41 MCI patients with multiple subcortical infarcts. Both groups of MCI patients were very mildly impaired and well matched in terms of MMSE scores. A clear, disproportionately severe, episodic memory disorder was observed in MCI patients with hippocampal atrophy. A less specific neuropsychological profile, consisting of impairment on an Action Naming task that is sensitive to frontal lobe lesions, was observed in MCI patients with multiple subcortical infarcts. In MCI patients, a disproportionately severe episodic memory impairment strongly points to an Alzheimer's type brain pathology, whereas the prevalence of executive deficits and other frontal lobe symptoms are a much weaker diagnostic marker of small vessel subcortical disease.
我们研究了患有海马萎缩或多发性皮质下梗死的轻度认知障碍（MCI）患者是否分别表现出被认为是阿尔茨海默病（AD）和血管性痴呆（VD）典型特征的神经心理学模式和标志物。对36例患有海马萎缩的轻度认知障碍（MCI）患者和41例患有多发性皮质下梗死的MCI患者进行了广泛的神经心理学测试，包括记忆、视觉空间和执行功能、语言、注意力、动作能力和精神运动速度测试。两组MCI患者的受损程度都非常轻微，且在简易精神状态检查表（MMSE）评分方面匹配良好。在患有海马萎缩的MCI患者中观察到明显的、不成比例的严重情景记忆障碍。在患有多发性皮质下梗死的MCI患者中观察到一种不太特异的神经心理学特征，包括在对额叶病变敏感的动作命名任务上的受损。在MCI患者中，不成比例的严重情景记忆损害强烈提示为阿尔茨海默病类型的脑病理，而执行功能缺陷和其他额叶症状的患病率是小血管皮质下疾病的一个较弱的诊断标志物。
