Pillon B, Deweer B, Michon A, Malapani C, Agid Y, Dubois B
INSERM U 289, Hôpital de la Salpêtrère, Paris, France.
Neurology. 1994 Jul;44(7):1264-70. doi: 10.1212/wnl.44.7.1264.
To test the hypothesis that memory disorders of subcortico-frontal dementia result mainly from inefficiency of retrieval processes of stored information, we compared verbal learning in 15 patients with progressive supranuclear palsy, prototypical of "subcortical dementia," in free (California Verbal Learning Test) and controlled (Grober and Buschke's Test) encoding situations, with that of 19 controls, matched for age and level of education. The progressive supranuclear palsy patients showed memory deficits characterized by impaired immediate memory span, disturbed learning and consistency of recall, and abnormal number of false alarms at recognition, which were dramatically alleviated by controlled encoding associated with cued recall, using the same semantic cues. This memory profile was markedly different from that of patients with senile dementia of the Alzheimer type (n = 15), characterized by more rapid forgetting and less improvement in the controlled situation. Instead, it was similar to the memory pattern of patients with Parkinson's (n = 15) and Huntington's (n = 15) diseases. These results show a similar profile of memory disturbance in disorders involving damage to the striatofrontal system and suggest that the cortical and hippocampal lesions of PSP patients are insufficiently severe to interfere with the specific memory profile characteristic of the disease.
为了验证皮质下额叶痴呆的记忆障碍主要源于存储信息检索过程效率低下这一假说，我们将15例进行性核上性麻痹患者（“皮质下痴呆”的典型病例）在自由（加利福尼亚言语学习测验）和受控（格罗贝尔和布施克测验）编码情况下的言语学习情况，与19名年龄和教育水平相匹配的对照者进行了比较。进行性核上性麻痹患者表现出记忆缺陷，其特征为即刻记忆广度受损、学习和回忆一致性受干扰以及识别时错误警报数量异常，而通过与线索回忆相关的受控编码（使用相同的语义线索），这些缺陷得到了显著缓解。这种记忆特征与阿尔茨海默型老年痴呆患者（n = 15）明显不同，后者的特征是遗忘更快，在受控情况下改善较少。相反，它与帕金森病（n = 15）和亨廷顿病（n = 15）患者的记忆模式相似。这些结果显示出涉及纹状体额叶系统损伤的疾病中存在相似的记忆障碍特征，并表明进行性核上性麻痹患者的皮质和海马病变严重程度不足以干扰该疾病特有的特定记忆特征。
