Kinno Ryuta, Shiromaru Azusa, Mori Yukiko, Futamura Akinori, Kuroda Takeshi, Yano Satoshi, Murakami Hidetomo, Ono Kenjiro
Division of Neurology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan.
Front Aging Neurosci. 2017 Dec 7;9:405. doi: 10.3389/fnagi.2017.00405. eCollection 2017.
The Wechsler Memory Scale-Revised (WMS-R) is one of the internationally well-known batteries for memory assessment in a general memory clinic setting. Several factor structures of the WMS-R for patients aged under 74 have been proposed. However, little is known about the factor structure of the WMS-R for patients aged over 75 years and its neurological significance. Thus, we conducted exploratory factor analysis to determine the factor structure of the WMS-R for patients aged over 75 years in a memory clinic setting. Regional cerebral blood flow (rCBF) was calculated from single-photon emission computed tomography data. Cortical thickness and cortical fractal dimension, as the marker of cortical complexity, were calculated from high resolution magnetic resonance imaging data. We found that the four factors appeared to be the most appropriate solution to the model, including recognition memory, paired associate memory, visual-and-working memory, and attention as factors. Patients with mild cognitive impairments showed significantly higher factor scores for paired associate memory, visual-and-working memory, and attention than patients with Alzheimer's disease. Regarding the neuroimaging data, the factor scores for paired associate memory positively correlated with rCBF in the left pericallosal and hippocampal regions. Moreover, the factor score for paired associate memory showed most robust correlations with the cortical thickness in the limbic system, whereas the factor score for attention correlated with the cortical thickness in the bilateral precuneus. Furthermore, each factor score correlated with the cortical fractal dimension in the bilateral frontotemporal regions. Interestingly, the factor scores for the visual-and-working memory and attention selectively correlated with the cortical fractal dimension in the right posterior cingulate cortex and right precuneus cortex, respectively. These findings demonstrate that recognition memory, paired associate memory, visual-and-working memory, and attention can be crucial factors for interpreting the WMS-R results of elderly patients aged over 75 years in a memory clinic setting. Considering these findings, the results of WMS-R in elderly patients aged over 75 years in a memory clinic setting should be cautiously interpreted.
韦氏记忆量表修订版（WMS-R）是国际上知名的用于普通记忆门诊环境中记忆评估的成套测验之一。针对74岁以下患者的WMS-R已提出了几种因素结构。然而，对于75岁以上患者的WMS-R因素结构及其神经学意义知之甚少。因此，我们进行了探索性因素分析，以确定记忆门诊环境中75岁以上患者的WMS-R因素结构。通过单光子发射计算机断层扫描数据计算局部脑血流量（rCBF）。从高分辨率磁共振成像数据计算皮质厚度和皮质分形维数，作为皮质复杂性的标志物。我们发现，四个因素似乎是该模型最合适的解决方案，包括识别记忆、配对联想记忆、视觉与工作记忆以及注意力作为因素。轻度认知障碍患者在配对联想记忆、视觉与工作记忆以及注意力方面的因素得分显著高于阿尔茨海默病患者。关于神经影像学数据，配对联想记忆的因素得分与左侧胼胝体周围和海马区域的rCBF呈正相关。此外，配对联想记忆的因素得分与边缘系统的皮质厚度显示出最强的相关性，而注意力的因素得分与双侧楔前叶的皮质厚度相关。此外，每个因素得分与双侧额颞叶区域的皮质分形维数相关。有趣的是，视觉与工作记忆和注意力的因素得分分别与右侧后扣带回皮质和右侧楔前叶皮质的皮质分形维数选择性相关。这些发现表明，识别记忆、配对联想记忆、视觉与工作记忆以及注意力可能是解释记忆门诊环境中75岁以上老年患者WMS-R结果的关键因素。考虑到这些发现，对于记忆门诊环境中75岁以上老年患者的WMS-R结果应谨慎解释。
