Spatial cognition and the human navigation network in AD and MCI
Spatial cognition and the human navigation network in AD and MCI
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DOI：
10.1212/01.wnl.0000271376.19515.c6
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发表时间：
2007-09-04
期刊：
影响因子：
9.9
通讯作者：
Gorno-Tempini, M. L.
中科院分区：
文献类型：
--
作者：
Deipolyi, A. R.;Rankin, K. P.;Gorno-Tempini, M. L.
背景：阿尔茨海默病（AD）导航障碍的机制尚不清楚。我们的特点是导航AD和轻度认知障碍（MCI），以检验这一假设，即导航残疾反映了选择性的空间认知障碍，并涉及到特定的脑regions.Methods萎缩：我们比较了13轻度AD和21 MCI患者与24个控制的路线学习任务，从事各种空间过程。使用结构MRI和优化的基于体素的形态测量学，我们还调查了一个子集的受试者（10 AD，12 MCI，21对照）的空间能力的神经相关性：AD和MCI患者有效地识别地标作为对照组，但不能找到他们的位置在地图上或回忆他们遇到的顺序。一半的AD患者和四分之一的MCI患者在路上迷路了，而对照组的比例不到10%。无论诊断如何，迷路的患者的右后海马和顶叶体积都低于没有迷路的患者和对照组。识别地图上位置的能力与右后海马和顶骨体积相关，而顺序记忆评分与双侧额叶下部体积相关。结论：阿尔茨海默病和轻度认知障碍（MCI）的导航障碍涉及空间认知的选择性损害，并与右侧导航网络的萎缩有关。MCI中广泛的空间障碍表明，导航测试可以提供认知和神经损伤的早期标志。
Background: The mechanisms underlying navigation impairments in Alzheimer disease ( AD) are unknown. We characterized navigation in AD and mild cognitive impairment ( MCI) to test the hypothesis that navigation disability reflects selective impairments in spatial cognition and relates to atrophy of specific brain regions.Methods: We compared 13 mild AD and 21 MCI patients with 24 controls on a route-learning task that engaged various spatial processes. Using structural MRI and optimized voxel-based morphometry, we also investigated the neural correlates of spatial abilities in a subset of subjects ( 10 AD, 12 MCI, 21 controls).Results: AD and MCI patients recognized landmarks as effectively as controls, but could not find their locations on maps or recall the order in which they were encountered. Half of AD and one-quarter of MCI patients got lost on the route, compared with less than 10% of controls. Regardless of diagnosis, patients who got lost had lower right posterior hippocampal and parietal volumes than patients and controls who did not get lost. The ability to identify locations on a map correlated with right posterior hippocampal and parietal volumes, whereas order memory scores correlated with bilateral inferior frontal volumes.Conclusions: The navigation disability in Alzheimer disease and mild cognitive impairment ( MCI) involves a selective impairment of spatial cognition and is associated with atrophy of the right-lateralized navigation network. Extensive spatial impairments in MCI suggest that navigation tests may provide early markers of cognitive and neural damage.