Miotto Eliane C, Savage Cary R, Evans Jonathan J, Wilson Barbara A, Martin Maria G M, Balardin Joana B, Barros Fabio G, Garrido Griselda, Teixeira Manoel J, Amaro Junior Edson
Department of Neurology, Hospital das Clinicas, University of Sao Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 255, 5° andar, Consolação-CEP 05403-900, São Paulo, SP, Brazil.
Clin Neurol Neurosurg. 2013 Mar;115(3):309-16. doi: 10.1016/j.clineuro.2012.05.024. Epub 2012 Jun 28.
Memory deficit is a frequent cognitive disorder following acquired prefrontal cortex lesions. In the present study, we investigated the brain correlates of a short semantic strategy training and memory performance of patients with distinct prefrontal cortex lesions using fMRI and cognitive tests.
Twenty-one adult patients with post-acute prefrontal cortex (PFC) lesions, twelve with left dorsolateral PFC (LPFC) and nine with bilateral orbitofrontal cortex (BOFC) were assessed before and after a short cognitive semantic training using a verbal memory encoding paradigm during scanning and neuropsychological tests outside the scanner.
After the semantic strategy training both groups of patients showed significant behavioral improvement in verbal memory recall and use of semantic strategies. In the LPFC group, greater activity in left inferior and medial frontal gyrus, precentral gyrus and insula was found after training. For the BOFC group, a greater activation was found in the left parietal cortex, right cingulated and precuneus after training.
The activation of these specific areas in the memory and executive networks following cognitive training was associated to compensatory brain mechanisms and application of the semantic strategy.
记忆缺陷是获得性前额叶皮质损伤后常见的认知障碍。在本研究中,我们使用功能磁共振成像(fMRI)和认知测试,研究了不同前额叶皮质损伤患者进行简短语义策略训练后的大脑相关性及记忆表现。
21名急性前额叶皮质(PFC)损伤后的成年患者,其中12名左侧背外侧前额叶皮质(LPFC)损伤患者和9名双侧眶额皮质(BOFC)损伤患者,在进行简短认知语义训练前后,于扫描期间使用言语记忆编码范式,并在扫描外进行神经心理学测试。
语义策略训练后,两组患者在言语记忆回忆和语义策略使用方面均表现出显著的行为改善。在LPFC组中,训练后左侧额下回、额中回、中央前回和岛叶的活动增强。对于BOFC组,训练后左侧顶叶皮质、右侧扣带回和楔前叶的激活增强。
认知训练后,记忆和执行网络中这些特定区域的激活与代偿性脑机制及语义策略的应用有关。