Rehabilitation R&D Center of Excellence, Research Service Line, Atlanta VAMC, Decatur, Georgia, USA.
Hippocampus. 2012 Aug;22(8):1652-8. doi: 10.1002/hipo.22006. Epub 2012 Feb 27.
Learning and memory deficits typify patients with mild cognitive impairment (MCI) and are generally attributed to medial temporal lobe dysfunction. Although the hippocampus is perhaps the most commonly studied neuroanatomical structure in these patients, there have been few attempts to identify rehabilitative interventions that facilitate its functioning. Here, we present results from a randomized, controlled, single-blind study in which patients with MCI and healthy elderly controls (HEC) were randomized to either three sessions of mnemonic strategy training (MS) or a matched-exposure control group (XP). All participants underwent pre- and posttraining fMRI scanning as they encoded and retrieved object-location associations. For the current report, fMRI analyses were restricted to the hippocampus, as defined anatomically. Before training, MCI patients showed reduced hippocampal activity during both encoding and retrieval, relative to HEC. Following training, the MCI MS group demonstrated increased activity during both encoding and retrieval. There were significant differences between the MCI MS and MCI XP groups during retrieval, especially within the right hippocampus. Thus, MS facilitated hippocampal functioning in a partially restorative manner. We conclude that cognitive rehabilitation techniques may help mitigate hippocampal dysfunction in MCI patients.
学习和记忆缺陷是轻度认知障碍(MCI)患者的典型特征,通常归因于内侧颞叶功能障碍。尽管海马体可能是这些患者中最常研究的神经解剖结构,但很少有尝试确定促进其功能的康复干预措施。在这里,我们介绍了一项随机、对照、单盲研究的结果,该研究将 MCI 患者和健康老年对照组(HEC)随机分为记忆策略训练(MS)三组或匹配暴露对照组(XP)。所有参与者在编码和检索物体-位置关联时都接受了训练前后的 fMRI 扫描。对于当前的报告, fMRI 分析仅限于解剖定义的海马体。在训练之前,与 HEC 相比,MCI 患者在编码和检索过程中均表现出海马体活动减少。在训练后,MCI MS 组在编码和检索过程中均表现出活动增加。在检索过程中,MCI MS 和 MCI XP 组之间存在显着差异,尤其是在右侧海马体中。因此,MS 以部分恢复的方式促进了海马体的功能。我们得出结论,认知康复技术可能有助于减轻 MCI 患者的海马体功能障碍。