UCL Institute of Cognitive Neuroscience and UCL Institute of Neurology, London, United Kingdom.
Hippocampus. 2010 Oct;20(10):1154-69. doi: 10.1002/hipo.20715.
We used a recently developed test of spatial memory--the Four Mountains Test--to investigate the core cognitive processes underpinning topographical disorientation in patients with amnestic mild cognitive impairment (a-MCI) and mild Alzheimer's disease (AD). Performance of these clinical groups was compared with age-matched controls, patients with frontotemporal lobar degeneration (FTLD), and patients with subjective memory impairments. We investigated the perception (concurrent match-to-sample) and short-term retention (2-s delayed match-to-sample) of the configuration of topographical features in computer-generated landscapes shown from different viewpoints. Thirty-one patients were tested (7 AD, 6 a-MCI, 7 temporal variant FTLD, 5 frontal variant FTLD, 6 subjective memory impairment) and 25 age- and gender-matched controls. Brain MRI was available for 27 patients; medial temporal lobe atrophy was assessed using a visual rating scale. Patients with a-MCI or mild AD were impaired on topographical short-term memory, but not perception. No other group differences were found on the topographical subtests. Notably, patients with temporal variants of FTLD performed normally, regardless of the laterality of damage. Subtests for the perception and retention of nonspatial aspects of the landscapes (weather conditions, seasonal and daily variations in lighting and color) were poor at differentiating the patient groups. These results indicate a core deficit in representing topographical layout, even for very short durations, within the context of more general long-term memory impairments found in AD, and suggest that this function is particularly sensitive to the earliest stages of the disease.
我们使用了一种新开发的空间记忆测试——四山测试，来研究遗忘型轻度认知障碍（a-MCI）和轻度阿尔茨海默病（AD）患者的拓扑定向障碍的核心认知过程。将这些临床组的表现与年龄匹配的对照组、额颞叶变性（FTLD）患者和主观记忆障碍患者进行了比较。我们研究了从不同视角呈现的计算机生成景观中拓扑特征配置的感知（同时匹配样本）和短期保留（2 秒延迟匹配样本）。对 31 名患者（7 名 AD、6 名 a-MCI、7 名颞叶变异 FTLD、5 名额叶变异 FTLD、6 名主观记忆障碍）和 25 名年龄和性别匹配的对照组进行了测试。27 名患者可进行脑部 MRI；使用视觉评分量表评估内侧颞叶萎缩。a-MCI 或轻度 AD 患者的拓扑短期记忆受损，但感知不受影响。在拓扑子测试中没有发现其他组间差异。值得注意的是，无论损伤的侧别如何，FTLD 的颞叶变异型患者表现正常。用于区分患者群体的景观非空间方面的感知和保留（天气条件、光照和颜色的季节性和日常变化）的子测试效果不佳。这些结果表明，即使在 AD 中发现的更普遍的长期记忆损伤的背景下，代表拓扑布局的核心能力存在缺陷，即使是非常短暂的时间，并且表明该功能对疾病的最早阶段特别敏感。
