Pal Sandip, Sengupta Prasenjit, Ghosal Malay, Pal Asutosh, Acharya Rudraprasad, Biswas Debsadhan
Department of Neurology, Medical College Hospital, Kolkata, West Bengal, India.
Department of Psychiatry, Medical College Hospital, Kolkata, West Bengal, India.
Ann Indian Acad Neurol. 2019 Apr-Jun;22(2):170-174. doi: 10.4103/aian.AIAN_185_18.
Excepting amnesia, impairment of other domains also hampers the activity of daily living in Alzheimer's disease (AD). Although prosopagnosia poses problem in interacting with other persons, it rarely causes problem during interaction with close relatives as known voice acts as cue for recognition.
In a cohort of AD, we planned to study errors in recognition, naming, and assigning relationship of close relatives, to assess the type and frequency of errors and to explain with current knowledge and hypothesis.
This cross-sectional study was conducted in Memory Clinic of Medical College Hospital, Kolkata, India, between July 2013 and June 2015. Patients were evaluated by history, general neurological examination, and neuropsychological tests. A structured questionnaire was used to assess recognition (use of honorifics) and naming defect of close relatives.
AD was diagnosed in 42 patients. Prosopagnosia was found in 14 and anomia in 6 patients. Four patients exhibited problem during conversation with close relatives. They assigned name and relation of one generation earlier to close relatives with proper recognitions.
We got predictive error of name and relation assignment of close relatives by one generation back with normal recognition. It can be explained by two memory traces in connection of face-visual and name (with/without relation) representation, earlier being hierarchically older and more resistant to wearing.
We hypothesize that the name/relation store is orderly conserved. In AD, after degradation of part of name/relation store, a new wiring might be built up between these two traces.
除失忆外，其他领域的损害也会妨碍阿尔茨海默病（AD）患者的日常生活活动。尽管面孔失认症在与他人互动时会造成问题，但正如已知声音可作为识别线索一样，在与近亲互动时很少引发问题。
在一组AD患者中，我们计划研究对近亲的识别、命名及关系判断方面的错误，以评估错误的类型和频率，并依据现有知识和假设进行解释。
这项横断面研究于2013年7月至2015年6月在印度加尔各答医学院医院记忆门诊进行。通过病史、常规神经学检查及神经心理学测试对患者进行评估。使用结构化问卷评估对近亲的识别（敬称的使用）和命名缺陷。
确诊42例AD患者。发现14例有面孔失认症，6例有命名障碍。4例患者在与近亲交谈时出现问题。他们能正确识别近亲，但将其名字和关系归为早一代的。
我们发现，在识别正常的情况下，对近亲名字和关系的判断出现了提前一代的预测性错误。这可以通过与面孔视觉和名字（有无关系）表征相关的两种记忆痕迹来解释，较早的痕迹在层级上更古老且更抗衰退。
我们推测名字/关系存储是有序保存的。在AD中，部分名字/关系存储退化后，这两种痕迹之间可能会建立新的联系。
