Coste Cécile, Navarro Béatrice, Vallat-Azouvi Claire, Brami Marie, Azouvi Philippe, Piolino Pascale
Paris Descartes University, Sorbonne Paris Cité, Institute of Psychology, Memory and Cognition Laboratory, France; Inserm UMR S 894, Center of Psychiatry and Neuroscience, Paris Descartes University, France; Adults Neurological Unity, Hôpitaux de Saint-Maurice, Saint-Maurice, France.
Paris Descartes University, Sorbonne Paris Cité, Institute of Psychology, Memory and Cognition Laboratory, France; Inserm UMR S 894, Center of Psychiatry and Neuroscience, Paris Descartes University, France.
Neuropsychologia. 2015 May;71:133-45. doi: 10.1016/j.neuropsychologia.2015.03.014. Epub 2015 Mar 17.
We investigated for the first time the episodic/semantic distinction in remembering the past and imagining the future in traumatic brain injury (TBI), and explored cognitive mechanisms that may underlie their deficits. Fifteen severe TBI patients and 15 control participants performed a battery of neuropsychological tests and a set of verbal fluency tasks designed to assess semantic (personality traits knowledge and general events), and episodic (specific events and details) facets of self-representations according to three time periods (remote/retrograde past, recent/anterograde past, future). Compared to controls, TBI patients showed deficits in both semantic and episodic self-representations, regardless of the time period, and controlling for basic cognitive functions. By contrast, a subjective evaluation of self-concept measuring the degree of certitude and the valence of self did not differ between patients and controls. The deficits were mainly predicted by altered executive function (i.e., updating) for past periods, as well as by general semantic and feature binding in working memory for the future period, independently of the injury characteristics. For controls, only episodic self-representation for each time period was mediated by executive or working memory functions, while semantic self-representation was mediated by the certitude of the self. This study highlights the dual role of semantic and episodic representations in temporally extended self, and shows the global disruption of self-representations across extended time in severe TBI. This encourages the extension of past and future thinking research to TBI populations to provide important insights into the nature and origin of these deficits and their role in recovery and to suggest future lines of research on rehabilitation procedures.
我们首次研究了创伤性脑损伤（TBI）患者在回忆过去和想象未来时情景/语义的区别，并探索了可能导致其缺陷的认知机制。15名重度TBI患者和15名对照参与者进行了一系列神经心理学测试和一组言语流畅性任务，这些任务旨在根据三个时间段（遥远/逆行过去、近期/顺行过去、未来）评估自我表征的语义（人格特质知识和一般事件）和情景（特定事件和细节）方面。与对照组相比，TBI患者在语义和情景自我表征方面均存在缺陷，无论时间段如何，且在控制基本认知功能的情况下亦是如此。相比之下，对自我概念的主观评估（测量确定程度和自我效价）在患者和对照组之间并无差异。这些缺陷主要由过去时间段的执行功能改变（即更新）以及未来时间段工作记忆中的一般语义和特征绑定所预测，与损伤特征无关。对于对照组，每个时间段的情景自我表征仅由执行或工作记忆功能介导，而语义自我表征则由自我的确定程度介导。本研究强调了语义和情景表现在时间扩展自我中的双重作用，并表明重度TBI患者在扩展时间内自我表征的整体破坏。这鼓励将过去和未来思维研究扩展至TBI人群，以深入了解这些缺陷的本质、起源及其在恢复中的作用，并为康复程序的未来研究方向提供建议。
