Cognitive performance in tests sensitive to frontal lobe dysfunction in the elderly depressed
Cognitive performance in tests sensitive to frontal lobe dysfunction in the elderly depressed
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DOI：
10.1017/s0033291700035662
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发表时间：
1996-05-01
影响因子：
6.9
通讯作者：
Levy, R
中科院分区：
文献类型：
--
作者：
Beats, BC;Sahakian, BJ;Levy, R
本文报告了24例老年抑郁症患者在心境障碍期间和从心境障碍中恢复时，与15例年龄和性别匹配的对照组相比，各种认知功能的损害概况，特别强调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）。与对照组和他们自己相比，抑郁组在所有检查的领域的恢复中发现了障碍。抑郁症组表现出赤字的视觉空间识别记忆，注意力转移在额外的维度转移阶段，并在处理和电机速度的措施没有受损的准确性在视觉搜索任务。在计划任务中也发现了障碍，更困难的问题所需的动作数量不成比例地增加，并且一旦任务开始，运动反应减慢和处理时间增加的证据。在类似的测试中，与患有阿尔茨海默型痴呆症（DAT）和帕金森病的患者的表现进行了比较。在测试性能的反应lavonin被发现与抑郁症发作的次数和CT扫描心室大小，如测量的计算机测面。在恢复期，残余抑郁评分与测试表现的潜伏期和脑室脑比率相关。因此，结果表明，老年抑郁症与额纹状体功能障碍敏感性测试的显著缺陷相关。有些缺陷似乎是抑郁症特有的，有些在临床恢复后不会缓解。然而，这些障碍必须在广泛的认知缺陷的背景下解释。
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.