Dissociation of long-term verbal memory and fronto-executive impairment in first-episode psychosis.
Dissociation of long-term verbal memory and fronto-executive impairment in first-episode psychosis.
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DOI：
10.1017/s0033291709005935
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发表时间：
2009-11
影响因子：
6.9
通讯作者：
Joyce EM
中科院分区：
文献类型：
--
作者：
Leeson VC;Robbins TW;Franklin C;Harrison M;Harrison I;Ron MA;Barnes TR;Joyce EM
言语记忆在精神分裂症患者中经常受到严重影响，并被认为是不良临床结果的中介因素。虽然编码缺陷得到了很好的证明，但尚不清楚保持能力是否受损。这一区别很重要，因为加速遗忘意味着内侧颞叶(MTL)功能障碍导致的巩固功能受损，而编码和提取功能受损则意味着前额叶皮质受累。我们评估了一组健康志愿者(n=97)和发病前智商和性别匹配的首发精神病患者(n=97)，其中大多数人发展为精神分裂症。我们将言语学习和回忆的表现与视觉空间工作记忆、计划和注意定势转移以及当前智商的测量进行了比较。精神分裂症组的所有表现指标，包括言语记忆保持，一种解释学习障碍的记忆保存分数，都显著受损。即使在考虑了学习和回忆的影响后，延迟回忆组之间的差异仍然存在。因素分析表明，在患者中，除了语言记忆保持外，所有变量都加载在一个因素上，而在对照组中，语言记忆和额叶执行措施是可分离的。结果提示，精神分裂症患者的智商、执行功能和语言学习缺陷可能反映了前额叶皮质信息处理的普遍异常，而不是不同认知域的具体损害。然而，言语记忆障碍可能有不同的病因。
Verbal memory is frequently and severely affected in schizophrenia and has been implicated as a mediator of poor clinical outcome. Whereas encoding deficits are well demonstrated, it is unclear whether retention is impaired. This distinction is important because accelerated forgetting implies impaired consolidation attributable to medial temporal lobe (MTL) dysfunction whereas impaired encoding and retrieval implicates involvement of prefrontal cortex. We assessed a group of healthy volunteers (n=97) and pre-morbid IQ- and sex-matched first-episode psychosis patients (n=97), the majority of whom developed schizophrenia. We compared performance of verbal learning and recall with measures of visuospatial working memory, planning and attentional set-shifting, and also current IQ. All measures of performance, including verbal memory retention, a memory savings score that accounted for learning impairments, were significantly impaired in the schizophrenia group. The difference between groups for delayed recall remained even after the influence of learning and recall was accounted for. Factor analyses showed that, in patients, all variables except verbal memory retention loaded on a single factor, whereas in controls verbal memory and fronto-executive measures were separable. The results suggest that IQ, executive function and verbal learning deficits in schizophrenia may reflect a common abnormality of information processing in prefrontal cortex rather than specific impairments in different cognitive domains. Verbal memory retention impairments, however, may have a different aetiology.