Beats B C, Sahakian B J, Levy R
Institute of Psychiatry, London.
Psychol Med. 1996 May;26(3):591-603. doi: 10.1017/s0033291700035662.
The paper reports the profile of impairment across a variety of cognitive functions with special emphasis on tests sensitive to frontal lobe dysfunction, in 24 elderly depressed patients during and on recovery from mood disorder, compared with 15 age- and sex-matched controls. Traditional neuropsychological tests and a recently developed battery of computerized tests (CANTAB) were used. Impairments were found in the depressed group compared to controls and to themselves on recovery across all domains examined. The depressed group showed deficits on visuospatial recognition memory, attentional shifting at the extra-dimensional shift stage and in measures of both processing and motor speed without impaired accuracy in a visual search task. Impairments were also found on a planning task with disproportionately increased numbers of moves needed for more difficult problems and evidence of both slowed motor response and increased processing time once the task was commenced. Performance on recovery improved across all tasks. Comparisons were made with the performance of patients suffering from dementia of the Alzheimer type (DAT) and Parkinson's disease on similar tests. Response latencies in test performance were found to correlate with the number of episodes of depression suffered and with ventricular size on CT scan, as measured by computerized planimetry. On recovery, residual depression scores correlated with latency of test performance and with ventricular brain ratio. The results, thus, show that depression in the elderly is associated with a significant degree of deficit on tests sensitive to frontostriatal dysfunction. Some of the deficits appear specific to depression and some do not remit following clinical recovery. However, these impairments have to be interpreted in the context of a broad profile of cognitive deficit.
该论文报告了24例老年抑郁症患者在情绪障碍发作期间及恢复过程中，与15名年龄和性别匹配的对照组相比，各种认知功能的损伤情况，特别强调了对额叶功能障碍敏感的测试。使用了传统的神经心理学测试和最近开发的一系列计算机化测试（CANTAB）。与对照组以及恢复后的自身相比，抑郁症组在所有检查领域均存在损伤。抑郁症组在视觉空间识别记忆、维度外转换阶段的注意力转移以及处理和运动速度测量方面存在缺陷，但在视觉搜索任务中准确性未受损。在一项规划任务中也发现了损伤，对于更困难的问题，所需移动次数不成比例地增加，并且一旦任务开始，就有运动反应减慢和处理时间增加的证据。恢复后的表现则在所有任务中均有所改善。将其与阿尔茨海默型痴呆（DAT）患者和帕金森病患者在类似测试中的表现进行了比较。发现测试表现中的反应潜伏期与抑郁症发作次数以及CT扫描测量的脑室大小相关，通过计算机平面测量法测量。恢复时，残留抑郁评分与测试表现潜伏期以及脑室脑比率相关。因此，结果表明老年人的抑郁症与对额纹状体功能障碍敏感的测试中的显著缺陷有关。一些缺陷似乎是抑郁症特有的，一些在临床恢复后并未缓解。然而，这些损伤必须在广泛的认知缺陷背景下进行解释。
