Suades-González E, Jódar-Vicente M, Pérdrix-Solàs D
Servicio de Neurología, Corporació Sanitària Parc Taulí, E-08208Sabadell (Barcelona), Espana.
Rev Neurol. 2009;49(12):623-9.
Memory deficits are frequent in mild subcortical vascular pathology and in the early stage of Alzheimer's disease.
To study the memory deficits in patients with subcortical vascular cognitive impairment (SVCI) vs. mild stage Alzheimer's disease patients (AD), using the Weschler Memory Scale-III (WMS-III) word lists test, to examine the adequacy of this test to show the different memory patterns in this population, that could contribute to early differential diagnosis.
Three groups of patients were compared: AD (n = 25), SVCI-leukoaraiosis (n = 17) and SVCI-multi infarct (n = 16). The three groups did not differ in age, education or severity of illness.
Patients with SVCI showed a memory impairment in free recall with an improvement in their performance on the recognition task. The AD group, however, showed low scores in free recall as in recognition tasks, with a major number of false positive errors. Significant differences were also found between the SVCI-leukoaraiosis and SVCI-multi infarct groups, with the latter showing the best performance in long term retention and a minor trend to respond with false positive errors.
The WMS-III word lists test is a good instrument to differentiate the memory profile between SVCI and AD, with the recognition task being the most discriminative one. The worst impairment in leukoaraiosis patients in comparison to the multi infarct group, suggests that white matter diffuse lesion could affect more directly the recall processes mediatised by the frontal lobe.
记忆缺陷在轻度皮质下血管病变和阿尔茨海默病早期较为常见。
使用韦氏记忆量表第三版(WMS-III)单词列表测试,研究皮质下血管性认知障碍(SVCI)患者与轻度阿尔茨海默病(AD)患者的记忆缺陷,以检验该测试能否充分显示该人群不同的记忆模式,这可能有助于早期鉴别诊断。
比较三组患者:AD组(n = 25)、SVCI-脑白质疏松症组(n = 17)和SVCI-多发梗死组(n = 16)。三组在年龄、教育程度或疾病严重程度方面无差异。
SVCI患者在自由回忆中表现出记忆损害,而在识别任务中的表现有所改善。然而,AD组在自由回忆和识别任务中得分均较低,且有较多的假阳性错误。SVCI-脑白质疏松症组和SVCI-多发梗死组之间也存在显著差异,后者在长期记忆方面表现最佳,且假阳性错误反应的趋势较小。
WMS-III单词列表测试是区分SVCI和AD记忆特征的良好工具,其中识别任务的区分度最高。与多发梗死组相比,脑白质疏松症患者的损害最严重,这表明白质弥漫性病变可能更直接地影响由额叶介导的回忆过程。