Dissociable mechanisms for memory impairment in bipolar disorder and schizophrenia
Dissociable mechanisms for memory impairment in bipolar disorder and schizophrenia
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DOI：
10.1017/s0033291706007902
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发表时间：
2006-08-01
影响因子：
6.9
通讯作者：
Velligan, Dawn I.
中科院分区：
文献类型：
--
作者：
Glahn, David C.;Barrett, Jennifer;Velligan, Dawn I.
背景。尽管精神分裂症和双相情感障碍中普遍存在记忆缺陷，但人们对这些损害背后的机制知之甚少。澄清两种疾病之间记忆缺陷重叠的性质和程度可能有助于区分这些疾病中受损的大脑系统，并指出改善患者治疗结果的认知补救策略。方法。我们检查了临床稳定的双相情感障碍门诊患者 (n = 40)、精神分裂症患者 (n = 40) 和健康对照受试者 (n = 40) 在非语言记忆任务中的表现。该任务包括使用不同的记忆策略（即使用上下文来组织熟悉的刺激或使用新刺激的整体表示）促进表现的条件。结果。与参考条件相比，双相情感障碍患者存在与组织功能障碍一致的缺陷，并且对新信息的检测能力较差。尽管精神分裂症患者的表现比其他组差，但只有当组织需求显着时，他们才会受到不同程度的损害。任务表现与临床症状的严重程度不相关。结论。这种明显的记忆障碍模式意味着双相情感障碍和精神分裂症中部分重叠的神经系统受到干扰。双相情感障碍特有的新刺激检测受损的证据表明，虽然双相情感障碍的认知功能障碍的绝对水平不如精神分裂症那么严重，但记忆力却存在微妙的破坏。这些发现可用于帮助患者利用完整的功能并学习未经培训就不会采用的新策略，从而规划有针对性的认知补救计划。
Background. Although memory deficits are consistently reported in schizophrenia and bipolar disorder, the mechanisms underlying these impairments are poorly understood. Clarifying the nature and degree of overlap in memory deficits between the two illnesses could help to distinguish brain systems disrupted in these illnesses, and indicate cognitive remediation strategies to improve patient outcomes.Method. We examined performance on a non-verbal memory task in clinically stable out-patients with bipolar disorder (n = 40), schizophrenia (n = 40), and healthy comparison subjects (n = 40). This task includes conditions in which distinct mnemonic strategies-namely, using context to organize familiar stimuli or using holistic representation of novel stimuli - facilitate performance.Result. When compared to a reference condition, bipolar patients had deficits consistent with organizational dysfunction and poor detection of novel information. Although patients with schizophrenia performed worse than the other groups, they were only differentially impaired when organizational demands were significant. Task performance was not correlated with severity of clinical symptomatology.Conclusions. This pattern of distinct memory impairments implies disturbances in partially overlapping neural systems in bipolar disorder and schizophrenia. Evidence of impairment in detection of novel stimuli that is unique to bipolar disorder suggests that, while the absolute level of cognitive dysfunction is less severe in bipolar disorder as compared to schizophrenia, subtle disruptions in memory are present. These findings can be used to plan targeted cognitive remediation programs by helping patients to capitalize on intact functions and to learn new strategies that they do not employ without training.