Laboratory of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Via Ardeatina, 306, 00179, Rome, Italy.
Department of Systems Medicine, Tor Vergata University, Rome, Italy.
J Neurol. 2019 Oct;266(10):2447-2456. doi: 10.1007/s00415-019-09411-z. Epub 2019 Jun 18.
Patients with subcortical ischemic vascular dementia (SIVD) perform better than Alzheimer's disease patients (AD) on the Free and Cued Recall Selective Reminding test (FCSRT). In this test, SIVD are able to overcome their strategic retrieval deficit, whereas AD patients, whose memory impairment is due to a hippocampal storage deficit, are not. However, the FCSRT does not assess the advantage passing from free to assisted learning, which is expected to be different in frontal and hippocampal damage. We compared SIVD, AD and healthy subjects on the free recall of a 15-word list not assisted at encoding and on the free and cued recall of the FCRST. Indexes of Encoding, Cueing and Total (measuring the advantage passing from the 15-word list free recall to the free and cued recall of the FCRST) were computed. The two groups performed comparably poorly on the free recall of the 15-word list, but SIVD outperformed AD patients in the free and cued recall of the FCSRT and took greater advantage than AD patients on both learning and recall when passing from the unassisted to the assisted paradigms. All indexes significantly predicted diagnostic group membership, but the Total Index showed the larger classification accuracy with 80% of AD and 71% of SIVD correctly classified. These results confirm that the FCRST is able to differentiate AD and SIVD patients with a good level of accuracy. However, the evaluation of memory performance variation as a function of support to encoding provides additional data able to increase diagnostic reliability.
皮质下缺血性血管性痴呆(SIVD)患者在自由和线索回忆选择性提醒测试(FCSRT)中的表现优于阿尔茨海默病(AD)患者。在这个测试中,SIVD 能够克服他们的策略性检索缺陷,而 AD 患者的记忆损伤是由于海马体存储缺陷引起的,因此无法克服。然而,FCSRT 并没有评估从自由学习到辅助学习的优势,这在额叶和海马体损伤中预计是不同的。我们比较了 SIVD、AD 和健康受试者在未辅助编码的 15 个单词列表的自由回忆、FCRST 的自由和线索回忆上的表现。计算了编码、线索和总指数(测量从 15 个单词列表的自由回忆到 FCRST 的自由和线索回忆的优势)。两组在 15 个单词列表的自由回忆上表现相当差,但 SIVD 在 FCSRT 的自由和线索回忆上优于 AD 患者,并且在从无辅助到辅助范式的转换中,在学习和回忆方面都获得了比 AD 患者更大的优势。所有指数都显著预测了诊断组别的归属,但总指数的分类准确率更高,80%的 AD 和 71%的 SIVD 被正确分类。这些结果证实,FCRST 能够以较高的准确性区分 AD 和 SIVD 患者。然而,评估记忆表现随支持编码的变化提供了额外的数据,能够提高诊断的可靠性。