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毒扁豆碱对遗忘综合征的作用(作者译)

[Effects of physostigmine on amnesic syndromes (author's transl)].

作者信息

Laurent B, Hibert-Kuntzler O, Chazot G, Michel D, Schott B

出版信息

Rev Neurol (Paris). 1981;137(11):649-60.

PMID:7336018
Abstract

Eserine sulphate (physostigmine) tests were conducted in 23 patients with amnesia due to cerebral lesions. Psychometric examinations were performed before and after treatment. Results were analysed statistically for the whole group, and after distribution of patients as a function of the etiology, of the mechanism involved, and of the presumed lesions: 1) amnesias related to lesions along Papez' circuit as shown on CT scans were compared with those with normal CT scans; 2) amnesias of the "hippocampic" types were compared with other neuropsychological types. After eserine sulphate learning ability rapidly improved, in all cases, whereas spontaneous or assisted recall was only slightly improved. No significant differences in learning or recall were noted between the group with normal CT scans and that with evidence of bilateral lesions. In contrast, the efficiency of physostigmine was clearly related to the nature of neuropsychological disorders both for learning and recall of verbal material : a positive effect occurred only in the group with obvious evocation and recall disorders (mamillary, thalamic, or cingular lesions). For improvement to occur the product had be be injected before learning. The role of cholinergic mediators in memory is discussed with regard to these observations. Overall benefit was poor since lasting improvement in fixation was noted in one case only. Thus eserine sulphate appears of little value for prolonged therapy. It may be useful for a functional test during neuropsychological investigations.

摘要

对23例因脑部病变导致失忆的患者进行了硫酸依色林(毒扁豆碱)测试。在治疗前后进行了心理测量检查。对整个组进行了统计分析,并根据病因、涉及的机制和推测的病变对患者进行分类后分析:1)将CT扫描显示与帕佩兹环路病变相关的失忆症患者与CT扫描正常的患者进行比较;2)将“海马型”失忆症患者与其他神经心理类型进行比较。硫酸依色林治疗后,所有病例的学习能力迅速提高,而自发或辅助回忆仅略有改善。CT扫描正常的组与有双侧病变证据的组在学习或回忆方面未发现显著差异。相比之下,毒扁豆碱的疗效在学习和言语材料回忆方面都与神经心理障碍的性质明显相关:仅在有明显唤起和回忆障碍(乳头体、丘脑或扣带回病变)的组中出现了积极效果。为了出现改善,药物必须在学习前注射。根据这些观察结果讨论了胆碱能介质在记忆中的作用。总体益处不佳,因为仅在一例中观察到了持久的记忆巩固改善。因此,硫酸依色林对于长期治疗似乎价值不大。它可能在神经心理调查期间的功能测试中有用。

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