Kim Ji Eun, Park So Hee, Hong Yun Jeong, Hwang Jihye, Han Noh Eul, Lee Sun Mi, Roh Jee Hoon, Kim Jae Seung, Lee Jae Hong
Department of Neurology, University of Ulsan College of Medicine, Gangneung Asan Hospital, Gangneung, Korea.
Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
J Clin Neurol. 2019 Jan;15(1):27-37. doi: 10.3988/jcn.2019.15.1.27. Epub 2018 Oct 26.
Semantic memory remains more stable than episodic memory across the lifespan, which makes it potentially useful as a marker for distinguishing pathological aging from normal senescence. To obtain a better understanding of the transitional stage evolving into Alzheimer's dementia (AD), we focused on the amnestic mild cognitive impairment (aMCI) stage stratified based on β-amyloid (Aβ) pathology.
We analyzed the raw data from Korean version of the Boston Naming Test (K-BNT) and the Controlled Oral Word Association Test (COWAT). For K-BNT, the frequencies of six error types and accuracy rates were evaluated. For a qualitative assessment of the COWAT, we computed the number of switching, number of clusters, and mean cluster size.
The data from 217 participants were analyzed (53 normal controls, 66 with Aβ- aMCI, 56 with Aβ+ aMCI, and 42 disease controls). There were fewer semantically related errors and more semantically unrelated errors on the K-BNT in Aβ+ aMCI than in Aβ- aMCI, without a gross difference in the z score. We also found that Aβ+ aMCI showed a more prominent deficit in the number of clusters in the semantic fluency task [especially for animal names (living items)] than Aβ- aMCI.
In spite of similar clinical manifestations, Aβ+ aMCI was more similar to AD than Aβ- aMCI in terms of semantic memory disruption. Semantic memory may serve as an early indicator of brain Aβ pathology. Therefore, semantic memory dysfunction deserves more consideration in clinical practice. Longitudinal research with the follow-up data is needed.
语义记忆在整个生命周期中比情景记忆更稳定，这使其有可能作为区分病理性衰老与正常衰老的标志物。为了更好地理解向阿尔茨海默病痴呆（AD）演变的过渡阶段，我们聚焦于基于β-淀粉样蛋白（Aβ）病理学分层的遗忘型轻度认知障碍（aMCI）阶段。
我们分析了韩国版波士顿命名测试（K-BNT）和受控口语词联想测试（COWAT）的原始数据。对于K-BNT，评估了六种错误类型的频率和准确率。对于COWAT的定性评估，我们计算了转换次数、聚类数和平均聚类大小。
分析了217名参与者的数据（53名正常对照者、66名Aβ-aMCI患者、56名Aβ+aMCI患者和42名疾病对照者）。与Aβ-aMCI相比，Aβ+aMCI在K-BNT上语义相关错误更少，语义无关错误更多，z分数无显著差异。我们还发现，与Aβ-aMCI相比，Aβ+aMCI在语义流畅性任务中的聚类数（尤其是动物名称类，即有生命物品类）方面表现出更明显的缺陷。
尽管临床表现相似，但在语义记忆破坏方面，Aβ+aMCI比Aβ-aMCI更类似于AD。语义记忆可能是脑Aβ病理学的早期指标。因此，语义记忆功能障碍在临床实践中值得更多关注。需要进行有随访数据的纵向研究。
