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具有功能性记忆障碍的患者与遗忘型轻度认知障碍患者的神经心理学特征明显不同。

Distinctive neuropsychological profiles differentiate patients with functional memory disorder from patients with amnestic-mild cognitive impairment.

机构信息

1Department of Neuroscience,University of Sheffield,UK.

2Sheffield Teaching Hospital NHS Foundation Trust,Sheffield,UK.

出版信息

Acta Neuropsychiatr. 2018 Apr;30(2):90-96. doi: 10.1017/neu.2017.21. Epub 2017 Jul 17.

Abstract

OBJECTIVES

Patients with functional memory disorder (FMD) report significant memory failures in everyday life. Differentiating these patients from those with memory difficulties due to early stage neurodegenerative conditions is clinically challenging. The current study explored whether distinctive neuropsychological profiles could be established, suitable to differentiate patients with FMD from healthy individuals and those experiencing amnestic mild cognitive impairment (a-MCI).

METHODS

Patients with a clinical diagnosis of FMD were compared with patients with a-MCI, and healthy matched controls on several tests assessing different cognitive functions. Patients with clinically established mood disorders were excluded. Patients with FMD and a-MCI were broadly comparable on the level of their subjective memory complaints as assessed by clinical interview.

RESULTS

The neuropsychological profile of the FMD patients, although they expressed subjective memory and attention concerns during their clinical interview was distinct from patients with a-MCI on tests of memory [semantic fluency, age of acquisition (AoA) analysis of semantic fluency, verbal and non-verbal memory]. FMD patients did not differ significantly from healthy controls, but their scores on the letter fluency and digit cancellation tasks were not significantly different from those of the a-MCI patients indicating a possible sub-threshold deficit on these tasks.

CONCLUSION

Whilst subjective complaints are common within the FMD population, no objective impairment could be detected, even on a sensitive battery of tasks designed to detect subtle deficits caused by an early neurodegenerative brain disease. This study indicates that FMD patients can be successfully differentiated from patients with neurodegenerative memory decline by characterising their neuropsychological profile.

摘要

目的

功能性记忆障碍(FMD)患者在日常生活中报告严重的记忆失败。将这些患者与因早期神经退行性疾病而导致记忆困难的患者区分开来具有临床挑战性。本研究探讨是否可以建立独特的神经心理学特征,以区分 FMD 患者与健康个体和遗忘型轻度认知障碍(a-MCI)患者。

方法

将具有临床诊断 FMD 的患者与 a-MCI 患者和健康匹配对照者进行比较,评估了几种不同认知功能的测试。排除了具有临床确诊情绪障碍的患者。FMD 患者和 a-MCI 患者在其主观记忆主诉水平上大致相似,这是通过临床访谈评估的。

结果

尽管 FMD 患者在临床访谈中表达了主观记忆和注意力问题,但他们的神经心理学特征与 a-MCI 患者在记忆测试(语义流畅性、语义流畅性的获得年龄(AoA)分析、言语和非言语记忆)上有所不同。FMD 患者与健康对照组无显著差异,但他们在字母流畅性和数字取消任务上的得分与 a-MCI 患者无显著差异,表明这些任务可能存在亚阈值缺陷。

结论

尽管在 FMD 人群中常见主观抱怨,但即使在设计用于检测早期神经退行性脑疾病引起的细微缺陷的敏感任务组合上,也未检测到客观损害。这项研究表明,通过描述其神经心理学特征,可以成功区分 FMD 患者和神经退行性记忆下降患者。

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