Chen I-Wen, Chen Chiung-Mei, Wu Yih-Ru, Hua Mau-Sun
Department of Neurology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center and College of Medicine, Chang-Gung University, Taoyuan, Taiwan.
Arch Clin Neuropsychol. 2017 Jun 1;32(4):391-400. doi: 10.1093/arclin/acx022.
Increased false memory recognition in patients with Huntington's disease (HD) has been widely reported; however, the underlying memory constructive processes remain unclear. The present study explored gist memory, item-specific memory, and monitoring ability in patients with HD.
Twenty-five patients (including 13 patients with mild HD and 12 patients with moderate-to-severe HD) and 30 healthy comparison participants (HC) were recruited. We used the Deese-Roediger-McDermott (DRM) paradigm to investigate participants' false recognition patterns, along with neuropsychological tests to assess general cognitive function.
Both mild and moderate-to-severe patients with HD showed significant executive functioning and episodic memory impairment. On the DRM tasks, both HD patient groups showed significantly impaired performance in tasks assessing unrelated false recognition and item-specific memory as compared to the HC group; moderate-to-severe patients performed more poorly than mild patients did. Only moderate-severe patients exhibited significantly poorer related false recognition index scores than HCs in the verbal DRM task; performance of HD patient groups was comparable to the HC group on the pictorial DRM task.
It appears that diminished verbatim memory and monitoring ability are early signs of cognitive decline during the HD course. Conversely, gist memory is relatively robust, with only partial decline during advanced-stage HD. Our findings suggest that medial temporal lobe function is relatively preserved compared to that of frontal-related structures in early HD. Thus, gist-based memory rehabilitation programs might be beneficial for patients with HD.
亨廷顿舞蹈症(HD)患者的错误记忆识别增加已被广泛报道;然而,潜在的记忆构建过程仍不清楚。本研究探讨了HD患者的要点记忆、特定项目记忆和监测能力。
招募了25名患者(包括13名轻度HD患者和12名中度至重度HD患者)和30名健康对照参与者(HC)。我们使用Deese-Roediger-McDermott(DRM)范式来研究参与者的错误识别模式,并通过神经心理学测试来评估一般认知功能。
轻度和中度至重度HD患者均表现出明显的执行功能和情景记忆损害。在DRM任务中,与HC组相比,两个HD患者组在评估无关错误识别和特定项目记忆的任务中表现均显著受损;中度至重度患者的表现比轻度患者更差。在言语DRM任务中,只有中度至重度患者的相关错误识别指数得分显著低于HC组;HD患者组在图片DRM任务中的表现与HC组相当。
逐字记忆和监测能力下降似乎是HD病程中认知衰退的早期迹象。相反,要点记忆相对较强,在HD晚期仅部分下降。我们的研究结果表明,与早期HD中额叶相关结构相比,内侧颞叶功能相对保留。因此,基于要点的记忆康复计划可能对HD患者有益。