1Monash Institute of Cognitive and Clinical Neurosciences,School of Psychological Sciences,Monash University,Melbourne,Australia.
J Int Neuropsychol Soc. 2018 Nov;24(10):1064-1072. doi: 10.1017/S1355617718000565. Epub 2018 Sep 10.
Anecdotal reports suggest that following traumatic brain injury (TBI) retrograde memories are initially impaired and recover in order of remoteness. However, there has been limited empirical research investigating whether a negative gradient in retrograde amnesia-relative preservation of remote over recent memory-exists during post-traumatic amnesia (PTA) compared with the acute phase post-emergence. This study used a repeated-measures design to examine the pattern of personal semantic (PS) memory performance during PTA and within two weeks of emergence to improve understanding of the nature of the memory deficit during PTA and its relationship with recovery.
Twenty patients with moderate-severe TBI and 20 healthy controls (HCs) were administered the Personal Semantic Schedule of the Autobiographical Memory Interview. The TBI group was assessed once during PTA and post-emergence. Analysis of variance was used to compare the gradient across lifetime periods during PTA relative to post-emergence, and between groups.
PS memory was significantly lower during PTA than post-emergence from PTA, with no relative preservation of remote memories. The TBI group was still impaired relative to HCs following emergence from PTA. Lower overall PS memory scores during PTA were associated with increased days to emerge from PTA post-interview.
These results suggest a global impairment in PS memory across lifetime periods particularly during PTA, but still present within 2 weeks of emergence from PTA. PS memory performance may be sensitive to the diffuse nature of TBI and may, therefore, function as a clinically valuable indicator of the likely time to emerge from PTA. (JINS, 2018, 24, 1064-1072).
有传闻报道称,创伤性脑损伤(TBI)后逆行性记忆最初受损,然后按时间顺序逐渐恢复。然而,关于在创伤后遗忘期(PTA)与苏醒后早期相比,逆行性遗忘是否存在负梯度(即,远记忆相对于近记忆的相对保存),目前仅有有限的实证研究。本研究采用重复测量设计,考察了 PTA 期间和苏醒后两周内个人语义(PS)记忆表现的模式,以增进对 PTA 期间记忆缺陷性质及其与恢复关系的理解。
对 20 名中重度 TBI 患者和 20 名健康对照者(HCs)进行个人语义时间表自传记忆访谈。TBI 组在 PTA 期间和苏醒后进行评估。方差分析用于比较 PTA 期间与苏醒后、以及组间的各生命阶段梯度。
与苏醒后相比,PTA 期间 PS 记忆显著降低,且远记忆无相对保存。TBI 组在 PTA 后仍比 HCs 组受损。PTA 期间 PS 记忆总分较低与 PTA 后访谈时苏醒天数增加有关。
这些结果表明,PS 记忆在各生命阶段均存在广泛损伤,特别是在 PTA 期间,但在 PTA 后两周内仍存在。PS 记忆表现可能对 TBI 的弥漫性性质敏感,因此可能成为 PTA 后可能苏醒时间的有临床价值的指标。(JINS,2018,24,1064-1072)。