Department of Neurology, Drexel University, College of Medicine, 245 North 15th Street, Philadelphia, PA 19102, USA.
J Int Neuropsychol Soc. 2012 Jan;18(1):20-8. doi: 10.1017/S1355617711001238. Epub 2011 Oct 7.
Libon et al. (2010) provided evidence for three statistically determined clusters of patients with mild cognitive impairment (MCI): amnesic (aMCI), dysexecutive (dMCI), and mixed (mxMCI). The current study further examined dysexecutive impairment in MCI using the framework of Fuster's (1997) derailed temporal gradients, that is, declining performance on executive tests over time or test epoch. Temporal gradients were operationally defined by calculating the slope of aggregate letter fluency output across 15-s epochs and accuracy indices for initial, middle, and latter triads from the Wechsler Memory Scale-Mental Control subtest (Boston Revision). For letter fluency, slope was steeper for dMCI compared to aMCI and NC groups. Between-group Mental Control analyses for triad 1 revealed worse dMCI performance than NC participants. On triad 2, dMCI scored lower than aMCI and NCs; on triad 3, mxMCI performed worse versus NCs. Within-group Mental Control analyses yielded equal performance across all triads for aMCI and NC participants. mxMCI scored lower on triad 1 compared to triads 2 and 3. dMCI participants also performed worse on triad 1 compared to triads 2 and 3, but scored higher on triad 3 versus triad 2. These data suggest impaired temporal gradients may provide a useful heuristic for understanding dysexecutive impairment in MCI.
利邦等人(2010 年)提供了轻度认知障碍(MCI)患者三个统计学确定的聚类证据:遗忘型(aMCI)、执行功能障碍型(dMCI)和混合型(mxMCI)。本研究进一步使用福斯特(1997 年)详细的时间梯度框架研究 MCI 中的执行功能障碍,即随着时间或测试时间的推移,执行测试的表现下降。时间梯度通过计算在 15 秒的时间间隔内字母流畅性输出的斜率以及韦氏记忆量表-心理控制子测验(波士顿修订版)中初始、中间和最后三个三字母组的准确性指数来操作定义。对于字母流畅性,dMCI 的斜率比 aMCI 和 NC 组更陡。三字母组 1 的组间心理控制分析显示,dMCI 的表现比 NC 参与者差。在三字母组 2 中,dMCI 的得分低于 aMCI 和 NC;在三字母组 3 中,mxMCI 的表现比 NC 差。组内心理控制分析显示,aMCI 和 NC 参与者在所有三字母组中的表现相等。与三字母组 2 和 3 相比,mxMCI 在三字母组 1 的得分较低。dMCI 参与者在三字母组 1 的表现也比三字母组 2 和 3 差,但在三字母组 3 的得分高于三字母组 2。这些数据表明,受损的时间梯度可能为理解 MCI 中的执行功能障碍提供有用的启发式方法。