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    政大機構典藏 > 理學院 > 心理學系 > 學位論文 >  Item 140.119/49441
    Please use this identifier to cite or link to this item: https://nccur.lib.nccu.edu.tw/handle/140.119/49441

    Title: 失憶型輕度認知功能障礙患者在模擬空間脈絡記憶之表現
    Spatial-context memory in amnesic-mild cognitive impairment
    Authors: 王宣閔
    Contributors: 楊建銘
    Keywords: 輕度認知功能障礙
    mild cognitiv impairment
    Alzheimer`s disease
    Date: 2008
    Issue Date: 2010-12-08 11:38:06 (UTC+8)
    Abstract: 失憶型輕度認知功能障礙(a-MCI)患者被認為是演變成為阿茲海默症的高危險群,在早期由於海馬迴結構的神經纖維糾結,患者會開始產生記憶障礙。Braak和Braak在1991年將神經纖維糾結分成六個時期,開始會先從海馬迴結構的前內鼻區和側海馬迴產生病變,最後才會順延到海馬迴本體。由於前內鼻區主要處理事件及物件特徵,側海馬迴主要處理空間背景訊息,海馬迴本體主要處理空間位置記憶,所以本研究假設事件及物件特徵與空間背景訊息的配對記憶在a-MCI階段就會產生障礙,而空間位置記憶則在輕度阿茲海默症會開始產生障礙,如果不同階段神經病變的認知功能表現,可以在研究結果中呈現出來,或許可以協助找到早期偵測海馬迴結構病變的神經認知功能指標。
    Background: Amnesic mild cognitive impairment (a-MCI) was identified to have a high risk to become Alzheimer’s disease (AD). In early stage of AD, because of neurofibrillary tangles, patient began complaining progressive memory deficits. The progressive course of neurofibrillary tangles was divided into 6 stages (Braak and Braak, 1991). Initially, the neurofibrillary tangles destroyed perirhinal and parahippocampus neurons, which may correspond to the a-MCI stage and then proceed to hippocampal body that correspond to early AD. According to previous studies, the perirhinal is primarily associated with item features encoding, the parahippocampus associated with scene features encoding, and the hippocampus associated with spatial location memory. Based on these findings, we hypothesized that the item and scene features association memory would show impairments in a-MCI and the spatial location memory would not be impaired in a-MCI but in early AD. If the different stages could be discriminated by the performance on spatial context memory test that we design, it can be utilized in clinical settings to assist the diagnosis of a-MCI.
    Method: Three groups of subjects were selected from the clinic of the neurological department of Chang Gung Memorial Hospital, including normal subjects (n=30), a-MCI subjects not diagnosed with dementia (n=30), and mild AD subjects (n=30). All of them were administered a package of neuropsychological tests and a self-developed spatial context memory test that include three sub-tests: (1) a spatial location memory test: subjects have to recognize the location of a building that was appeared in a map; (2) an event-place association memory test: subjects need point out which spatial scene that was associated with this event; and (3) a place-object association memory test: subjects need point out which object that was associated with this place shown before.
    Result: In neuropsychological tests, a-MCI group demonstrated significant impairment in delay retrieval and memory retention in comparison to their performance on tests for other cognitive functions. The AD group showed decline in overall cognitive functions including declarative memory and others. In the spatial context memory test, both the spatial location memory test and the place-object association memory subtest showed a decline in a-MCI group, and a further decline in AD group; the event-place association memory test presented significant decreases in both a-MCI and AD group in comparison to normal control, but no difference between the two clinical groups.
    Conclusion: The current study shows that the spatial context memory in a-MCI patients has greater impairment than their general cognitive function. Compared with other screening test, the spatial context memory has greater sensitivity and specificity to discriminate a-MCI from NC.
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