Episodic Memory Impairment Mediates the Loss of Awareness in Mild Cognitive Impairment.
Episodic Memory Impairment Mediates the Loss of Awareness in Mild Cognitive Impairment.
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DOI：
10.3389/fnagi.2021.802501
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发表时间：
2021
影响因子：
4.8
通讯作者：
Vannini P
中科院分区：
文献类型：
--
作者：
Gagliardi G;Vannini P
意识丧失是阿尔茨海默病（AD）的常见症状，并导致功能能力的显著丧失。AD患者意识丧失的潜在机制尚不清楚，尽管先前的研究结果表明主要执行功能（EF）或情景记忆（EM）功能障碍是其原因。因此，我们的主要研究目的是探讨EF和EM功能障碍在整个AD临床谱中淀粉样蛋白相关意识丧失中的参与。来自阿尔茨海默病神经影像学倡议的共895名参与者（362名临床正常[CN]，422名轻度认知障碍[MCI]和111名痴呆症患者）被用于分析。对202名参与者进行了亚组分析，这些参与者的临床诊断从CN进展到MCI或MCI进展到痴呆以及痴呆患者。在每个临床组中使用中介模型，以意识（用日常认知功能问卷评估）作为因变量，以确定EF和/或EM是否会介导淀粉样蛋白对意识的影响。我们还将主观和举报投诉作为因变量进行了这些分析。所有变量之间的直接相关性也进行了。我们发现了各组意识下降的证据，在CN组中观察到意识增加，在MCI和痴呆组中观察到意识下降。我们的研究结果表明，EM，而不是EF，部分介导的淀粉样蛋白和意识之间的关系，更大的淀粉样蛋白和较低的EM性能与较低的意识。当分别分析各组时，仅在MCI组和包含进展者和痴呆患者的组中观察到这一发现。当分别对主观投诉和举报人投诉重复分析时，仅对举报人投诉重复分析结果。我们的研究结果表明，EM的下降，在较小程度上，EF，介导的淀粉样蛋白对意识的影响。与先前证明病感失认症在前驱期发展的研究一致，我们的研究结果表明，意识下降是参与者无法更新他/她对他/她的认知表现的洞察力的结果（即，表现出石化的自我）。
Loss of awareness is a common symptom in Alzheimer's Disease (AD) and responsible for a significant loss of functional abilities. The mechanisms underlying loss of awareness in AD is unknown, although previous findings have implicated dysfunction of primary executive functioning (EF) or episodic memory (EM) to be the cause. Therefore, our main study objective was to explore the involvement of EF and EM dysfunction in amyloid-related loss of awareness across the clinical spectrum of AD. A total of 895 participants (362 clinically normal [CN], 422 people with mild cognitive impairment [MCI] and 111 with dementia) from the Alzheimer's Disease Neuroimaging Initiative were used for the analyses. A sub-analysis was performed in 202 participants who progressed in their clinical diagnosis from CN to MCI or MCI to dementia as well as dementia patients. Mediation models were used in each clinical group with awareness (assessed with the Everyday Cognitive function questionnaire) as a dependent variable to determine whether EF and/or EM would mediate the effect of amyloid on awareness. We also ran these analyses with subjective and informant complaints as dependent variables. Direct correlations between all variables were also performed. We found evidence for a decline in awareness across the groups, with increased awareness observed in the CN group and decreased awareness observed in the MCI and dementia groups. Our results showed that EM, and not EF, partially mediated the relationship between amyloid and awareness such that greater amyloid and lower EM performance was associated with lower awareness. When analyzing each group separately, this finding was only observed in the MCI group and in the group containing progressors and dementia patients. When repeating the analyses for subjective and informant complaints separately, the results were replicated only for the informant's complaints. Our results demonstrate that decline in EM and, to a lesser degree, EF, mediate the effect of amyloid on awareness. In line with previous studies demonstrating the development of anosognosia in the prodromal stage, our findings suggest that decreased awareness is the result of an inability for the participant to update his/her insight into his/her cognitive performance (i.e., demonstrating a petrified self).
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影响因子：
2.6
作者：
Amariglio RE;Becker JA;Carmasin J;Wadsworth LP;Lorius N;Sullivan C;Maye JE;Gidicsin C;Pepin LC;Sperling RA;Johnson KA;Rentz DM
通讯作者：
Rentz DM
影响因子：
9.9
作者：
Derby, Carol A.;Burns, Leah C.;Lipton, Richard B.
通讯作者：
Lipton, Richard B.
影响因子：
2.6
作者：
Correia, Stephen;Ahern, David C.;Deoni, Sean C. L.
通讯作者：
Deoni, Sean C. L.
DOI：
10.1016/j.dadm.2016.09.002
发表时间：
2017
期刊：
Alzheimer's & dementia (Amsterdam, Netherlands)
影响因子：
--
作者：
Baker JE;Lim YY;Pietrzak RH;Hassenstab J;Snyder PJ;Masters CL;Maruff P
通讯作者：
Maruff P
DOI：
10.1186/s13195-020-00700-8
发表时间：
2020-10-14
期刊：
Alzheimer's research & therapy
影响因子：
--
作者：
Cacciamani F;Sambati L;Houot M;Habert MO;Dubois B;Epelbaum S;INSIGHT-PreAD study group
通讯作者：
INSIGHT-PreAD study group