The neuropsychology of vascular cognitive impairment: is there a specific cognitive deficit?
The neuropsychology of vascular cognitive impairment: is there a specific cognitive deficit?
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DOI：
10.1016/j.jns.2004.09.002
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发表时间：
2004-11-15
影响因子：
4.4
通讯作者：
Desmond, DW
中科院分区：
文献类型：
--
作者：
Desmond, DW
血管性认知障碍（VCI）的概念涵盖了由脑血管疾病（CVD）引起的整个认知障碍连续体的患者，范围从没有明显认知缺陷的高危患者（“脑风险”阶段）到血管性痴呆（VaD）。阿尔茨海默病（AD）和VaD患者的神经心理学特征存在公认的差异。在VaD患者中，执行功能往往受到不成比例的损害，包括计划和排序，心理处理速度，非结构化任务的表现和注意力。VaD患者的语言产生可能会受损，但主要语言功能往往会保留。VaD患者也表现出比AD患者更明显的持续性。记忆障碍在AD+CVD患者中通常是明显的，但记忆障碍也可能作为累及内侧颞叶的大脑后动脉区域中风的主要后果发生，或作为涉及由于原发性执行功能障碍引起的注意力不集中的认知综合征的次要后果发生。AD患者可能表现出由后部皮质结构如颞叶和顶叶介导的功能（包括记忆）的更大缺陷。AD患者表现出更快的信息衰减率，降低的能力，从线索中受益，以促进检索，和更高频率的入侵错误;此外，语言功能的某些方面，如命名，可能会加剧口头记忆任务的缺陷。AD倾向于影响词汇，而VaD倾向于影响句法。当AD患者表现出持续性行为时，他们往往是由语义知识测试引起的。(C)2004 Elsevier B. V.保留所有权利。
The concept of Vascular Cognitive Impairment (VCI) encompasses patients across the entire continuum of cognitive impairment resulting from cerebrovascular disease (CVD), ranging from high-risk patients with no frank cognitive deficit (the "brain-at-risk" stage) through vascular dementia (VaD).There are accepted differences in the neuropsychological profile of patients with Alzheimer's disease (AD) and VaD. In patients with VaD, executive functions that tend to be disproportionately impaired include planning and sequencing, speed of mental processing, performance on unstructured tasks, and attention. Language production may be impaired in patients with VaD but primary language functions otherwise tend to be preserved. Patients with VaD also exhibit significantly more perseverations than patients with AD. Memory impairment is typically evident in patients with AD+CVD but memory impairment may also occur as a primary consequence of stroke in the posterior cerebral artery territory with involvement of the medial temporal lobe, or as a secondary consequence of a cognitive syndrome involving inattention due to primary executive dysfunction.Compared to VaD, patients with AD may exhibit greater deficits in functions (including memory) mediated by posterior cortical structures, such as the temporal and parietal lobes. AD patients exhibit a faster rate of information decay, reduced ability to benefit from cues to facilitate retrieval, and higher frequency of intrusion errors; in addition, certain aspects of language function, such as naming, may exacerbate deficits on verbal memory tasks. AD tends to affect lexicon while VaD tends to affect syntax. When patients with AD exhibit perseverations, they tend to be elicited by tests of semantic knowledge. (C) 2004 Elsevier B.V. All rights reserved.