Gras-Vincendon A, Bursztejn C, Danion J-M
Service psychothérapique pour enfants et adolescents, hôpitaux universitaires de Strasbourg, Strasbourg, France.
Encephale. 2008 Dec;34(6):550-6. doi: 10.1016/j.encep.2007.10.010. Epub 2008 Mar 4.
Autism is an early developmental disorder with cognitive impairments that leads to learning and social integration disabilities. The characterization of memory functions in individuals with autism has been the subject of numerous investigations, with widely varying conclusions. The notable differences between these studies can be attributed to variations in the age, intelligence and level of severity of the participants with autism.
The purpose of our review of the recent literature is to describe the memory function of individuals with autism. Some of the different memory subtypes are intact, others are impaired. Short-term memory (digit span) is not impaired while working memory is impaired in some of its components, but the findings are inconsistent. More recent studies demonstrate reduced spatial working memory abilities in autism and extend previous findings by demonstrating that these deficits are significant when tasks impose heavier demands on working memory. Episodic long-term memory, as measured by free recall, cued recall or recognition tasks, is intact, but participants with autism perform significantly less well than controls as the complexity of the verbal or visual material to be recalled increases. Source or contextual memory involves a variety of characteristics specifying the conditions under which specific items or facts are acquired: it has been investigated in individuals with autism with different methods. Deficits in source memory for temporal information have been found, but there were no reality monitoring deficits. Recent findings indicate that the nature of source memory confusion in autism does not appear to reflect a generalized deficit in attaching context to memories, but rather is dependant on the specific to-be-remembered information that involves social aspects of context. The self-reference effect is missing, with individuals with autism recalling events performed by themselves less well than the events performed by a peer, suggesting they have difficulties in relation to processes involving the self. Studies involving assessment of subjective states of awareness during recognition show less conscious recollection and more feelings of familiarity. Recent investigations are consistent in demonstrating memory impairments related to the failure of subjects with autism to use organizing strategies or meaning to support memory, an effect which grows with the increasing complexity of the material. Memory deficits in autism may be related more to retrieval and less to encoding, as deficit in source memory in participants with autism is largely eliminated when source was supported at test.
The neuroanatomical basis of the specificities of memory impairment in autism is still uncertain, but it is suggested that autism involves an impairment in the conversion of limbic inputs into medial prefrontal outputs. Memory deficits found in individuals with autism may explain some of the clinical symptoms. Failure to encode all the information, especially its social aspects, may therefore contribute to dysfunction in the social, communication, and reasoning domains. Abnormal memory functioning in autism is also related to more general cognitive impairments, including executive function deficits and central coherence weakness. Evidence of the normality of certain memory capacities, at least in individuals with moderate autistic symptomatology, is encouraging for adaptive improvements in cognitive functioning.
自闭症是一种早期发育障碍,伴有认知缺陷,会导致学习和社交融合障碍。自闭症患者记忆功能的特征一直是众多研究的主题,结论差异很大。这些研究之间显著的差异可归因于自闭症患者在年龄、智力和严重程度方面的差异。
我们对近期文献进行综述的目的是描述自闭症患者的记忆功能。不同的记忆亚型中,有些是完好的,有些则受损。短期记忆(数字广度)未受损,而工作记忆的某些成分受损,但研究结果并不一致。最近的研究表明,自闭症患者的空间工作记忆能力下降,并且扩展了先前的研究结果,表明当任务对工作记忆的要求更高时,这些缺陷会更加显著。通过自由回忆、线索回忆或识别任务测量的情景长期记忆是完好的,但随着要回忆的言语或视觉材料复杂性的增加,自闭症患者的表现明显不如对照组。来源或情境记忆涉及多种特征,这些特征指定了获取特定项目或事实的条件:已经用不同方法对自闭症患者进行了研究。已发现自闭症患者在时间信息的来源记忆方面存在缺陷,但不存在现实监测缺陷。最近的研究结果表明,自闭症患者来源记忆混淆的本质似乎并不反映在将情境与记忆联系起来方面存在普遍缺陷,而是取决于涉及情境社会方面的特定要记忆的信息。自我参照效应缺失,自闭症患者回忆自己执行的事件的能力不如同龄人执行的事件,这表明他们在涉及自我的过程中存在困难。涉及识别过程中主观意识状态评估的研究表明,有意识的回忆较少,熟悉感较多。最近的研究一致表明,自闭症患者的记忆障碍与未能使用组织策略或意义来支持记忆有关,随着材料复杂性的增加,这种影响会更加明显。自闭症患者的记忆缺陷可能更多地与检索有关,而与编码关系较小,因为当在测试中提供来源支持时,自闭症患者在来源记忆方面的缺陷基本消除。
自闭症患者记忆障碍特异性的神经解剖学基础仍不确定,但有人认为自闭症涉及边缘系统输入向内前额叶输出转换的损伤。自闭症患者中发现的记忆缺陷可能解释了一些临床症状。因此,未能编码所有信息,尤其是其社会方面的信息,可能导致社交、沟通和推理领域的功能障碍。自闭症患者异常的记忆功能也与更普遍的认知缺陷有关,包括执行功能缺陷和中央连贯性缺陷。至少在中度自闭症症状患者中,某些记忆能力正常的证据,对于认知功能的适应性改善是令人鼓舞的。