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肌萎缩侧索硬化症患者的动作知识受损。

Impaired action knowledge in amyotrophic lateral sclerosis.

作者信息

Grossman M, Anderson C, Khan A, Avants B, Elman L, McCluskey L

机构信息

Department of Neurology-2 Gibson, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104-4283, USA.

出版信息

Neurology. 2008 Oct 28;71(18):1396-401. doi: 10.1212/01.wnl.0000319701.50168.8c. Epub 2008 Sep 10.

Abstract

BACKGROUND

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative condition affecting the motor system, but recent work also shows more widespread cognitive impairment. This study examined performance on measures requiring knowledge of actions, and related performance to MRI cortical atrophy in ALS.

METHODS

A total of 34 patients with ALS performed measures requiring word-description matching and associativity judgments with actions and objects. Voxel-based morphometry was used to relate these measures to cortical atrophy using high resolution structural MRI.

RESULTS

Patients with ALS were significantly more impaired on measures requiring knowledge of actions than measures requiring knowledge of objects. Difficulty on measures requiring action knowledge correlated with cortical atrophy in motor cortex, implicating degraded knowledge of action features represented in motor cortex of patients with ALS. Performance on measures requiring object knowledge did not correlate with motor cortex atrophy. Several areas correlated with difficulty for both actions and objects, implicating these brain areas in components of semantic memory that are not dedicated to a specific category of knowledge.

CONCLUSION

Patients with amyotrophic lateral sclerosis are impaired on measures involving action knowledge, and this appears to be due to at least two sources of impairment: degradation of knowledge about action features represented in motor cortex and impairment on multicategory cognitive components contributing more generally to semantic memory.

摘要

背景

肌萎缩侧索硬化症(ALS)是一种影响运动系统的神经退行性疾病,但最近的研究也表明存在更广泛的认知障碍。本研究考察了在需要动作知识的测试中的表现,并将ALS患者的相关表现与MRI皮质萎缩情况进行关联。

方法

共有34例ALS患者进行了需要对动作和物体进行词语描述匹配及关联性判断的测试。使用基于体素的形态测量法,通过高分辨率结构MRI将这些测试结果与皮质萎缩情况相关联。

结果

与需要物体知识的测试相比,ALS患者在需要动作知识的测试中受损明显更严重。需要动作知识的测试中的困难程度与运动皮质的萎缩相关,这表明ALS患者运动皮质中所表征的动作特征知识退化。需要物体知识的测试中的表现与运动皮质萎缩无关。有几个脑区与动作和物体测试的困难程度均相关,这表明这些脑区参与了语义记忆中并非专门针对特定知识类别的成分。

结论

肌萎缩侧索硬化症患者在涉及动作知识的测试中存在障碍,这似乎至少源于两个方面的损伤:运动皮质中所表征的动作特征知识的退化,以及对更广泛地构成语义记忆的多类别认知成分的损伤。

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