Bangor University, Bangor, UK.
Neurorehabil Neural Repair. 2013 Jun;27(5):448-59. doi: 10.1177/1545968312471902. Epub 2013 Jan 31.
People with Alzheimer disease (AD) are capable of new learning when cognitive support is provided, suggesting that there is plasticity even in a degenerating brain. However, it is unclear how a cognition-focused intervention operates on a neural level.
The present study examined the effects of cognitive rehabilitation (CR) on memory-related brain activation in people with early-stage AD, as measured by functional magnetic resonance imaging (fMRI).
A total of 19 participants either received 8 weeks of CR treatment (n = 7) or formed a control group (n = 12). We scanned participants pretreatment and posttreatment while they learned and recognized unfamiliar face-name pairs.
Following treatment, the CR group showed higher brain activation during recognition of face-name pairs in the left middle and inferior frontal gyri, the left insula, and 2s regions in the right medial parietal cortex. The control group showed decreased activation in these areas during recognition after the intervention period. Neither group showed an activation change during encoding. Behavioral performance on face-name learning did not improve for either group.
We suggest that CR may have operated on the process of recognition through partial restoration of function in frontal brain areas that are less compromised in early-stage AD and that physiological markers may be more sensitive indicators of brain plasticity than behavioral performance.
提供认知支持时，阿尔茨海默病（AD）患者能够进行新的学习，这表明即使在退化的大脑中也存在可塑性。然而，目前尚不清楚以认知为焦点的干预措施在神经水平上是如何起作用的。
本研究通过功能性磁共振成像（fMRI）检测认知康复（CR）对早期 AD 患者记忆相关脑激活的影响。
共有 19 名参与者接受了 8 周的 CR 治疗（n=7）或形成对照组（n=12）。我们在参与者进行学习和识别不熟悉的人脸-姓名对时对他们进行预处理和后处理扫描。
治疗后，CR 组在识别人脸-姓名对时的左中、下额回、左岛叶和右内侧顶叶皮层的 2s 区的大脑激活更高。干预后，对照组在识别过程中这些区域的激活减少。两个组在编码过程中均未显示出激活变化。两组在人脸-姓名学习上的行为表现均未改善。
我们认为，CR 可能通过部分恢复早期 AD 中受影响较小的额叶脑区的功能来作用于识别过程，并且生理标记可能比行为表现更能敏感地反映大脑的可塑性。
