Department of Psychology, Rowan University, 201 Mullica Hill Rd, Glassboro, NJ 08028, USA.
Department of Geriatrics and Gerontology, New Jersey Institute for Successful Aging, School of Osteopathic Medicine, Rowan University, 42 E Laurel Rd, Stratford, NJ 08084, USA.
J Int Neuropsychol Soc. 2019 Nov;25(10):1001-1010. doi: 10.1017/S1355617719000808. Epub 2019 Sep 23.
Previous research in mild cognitive impairment (MCI) suggests that visual episodic memory impairment may emerge before analogous verbal episodic memory impairment. The current study examined working memory (WM) test performance in MCI to assess whether patients present with greater visual versus verbal WM impairment. WM performance was also assessed in relation to hippocampal occupancy (HO), a ratio of hippocampal volume to ventricular dilation adjusted for demographic variables and intracranial volume.
Jak et al. (2009) (The American Journal of Geriatric Psychiatry, 17, 368-375) and Edmonds, Delano-Wood, Galasko, Salmon, & Bondi (2015) (Journal of Alzheimer's Disease, 47(1), 231-242) criteria classify patients into four groups: little to no cognitive impairment (non-MCI); subtle cognitive impairment (SCI); amnestic MCI (aMCI); and a combined mixed/dysexecutive MCI (mixed/dys MCI). WM was assessed using co-normed Wechsler Adult Intelligence Scale-IV (WAIS-IV) Digit Span Backwards and Wechsler Memory Scale-IV (WMS-IV) Symbol Span Z-scores.
Between-group analyses found worse WMS-IV Symbol Span and WAIS-IV Digit Span Backwards performance for mixed/dys MCI compared to non-MCI patients. Within-group analyses found no differences for non-MCI patients; however, all other groups scored lower on WMS-IV Symbol Span than WAIS-IV Digit Span Backwards. Regression analysis with HO as the dependent variable was statistically significant for WMS-IV Symbol Span performance. WAIS-IV Digit Span Backwards performance failed to reach statistical significance.
Worse WMS-IV Symbol Span performance was observed in patient groups with measurable neuropsychological impairment and better WMS-IV Symbol Span performance was associated with higher HO ratios. These results suggest that visual WM may be particularly sensitive to emergent illness compared to analogous verbal WM tests.
先前关于轻度认知障碍（MCI）的研究表明，视觉情节记忆障碍可能先于类似的言语情节记忆障碍出现。本研究通过检查 MCI 患者的工作记忆（WM）测试表现，来评估患者是否存在更严重的视觉 WM 损伤还是言语 WM 损伤。WM 表现还与海马体占有率（HO）相关联，HO 是海马体体积与脑室扩张之比，经人口统计学变量和颅内体积调整。
Jak 等人（2009）（《美国老年精神病学杂志》，17，368-375）和 Edmonds、Delano-Wood、Galasko、Salmon 和 Bondi（2015）（《阿尔茨海默病杂志》，47（1），231-242）标准将患者分为四组：无或很少认知障碍（非 MCI）；轻微认知障碍（SCI）；遗忘型 MCI（aMCI）；以及混合/执行功能障碍型 MCI（混合/dys MCI）。WM 使用协方差 Wechsler 成人智力测验-IV（WAIS-IV）数字倒背和 Wechsler 记忆测验-IV（WMS-IV）符号跨度 Z 分数进行评估。
混合/dys MCI 组的 WMS-IV 符号跨度和 WAIS-IV 数字倒背得分低于非 MCI 组，组间分析结果发现。非 MCI 组内分析没有差异；然而，所有其他组的 WMS-IV 符号跨度得分均低于 WAIS-IV 数字倒背。以 HO 为因变量的回归分析对 WMS-IV 符号跨度表现具有统计学意义。WAIS-IV 数字倒背表现未达到统计学意义。
在有可测量神经心理学损伤的患者组中观察到 WMS-IV 符号跨度表现更差，而更好的 WMS-IV 符号跨度表现与更高的 HO 比值相关。这些结果表明，与类似的言语 WM 测试相比，视觉 WM 可能对新发疾病更为敏感。
