COMPARISON OF IMPLICIT AND EXPLICIT COGNITIVE REHABILITATION OF MEMORY IN PATIENT

研究项目1： 外显记忆缺陷是遗忘型轻度认知障碍（aMCl）的特征，这是阿尔茨海默病的先兆。虽然认知康复治疗可以改善其他类型神经损伤后的记忆功能，但在aMCl中研究此类方法的研究明显缺乏。拟议的项目直接建立在我们ADRC赞助的试点研究的可喜成果的基础上，该研究已经证明了在使用记忆策略（即外显记忆训练）的训练后，通过功能性磁共振成像（fMRI）测量的显着行为改善和大脑活动增加。总共75名aMCl患者将被随机分配到1）外显记忆训练2）依赖于保留的内隐记忆能力（间隔提取）的基于排练的训练或3）教育对照组。患者将接受训练前和训练后的功能磁共振成像，同时他们试图学习和记住物体位置的关联。在这些功能磁共振成像会议之间，治疗组将接受三次培训，包括教学和实践阶段（即当患者将策略应用于关联时），或者仅为对照组提供教学。将在1个月时评估长期保留。这种设计将使我们能够直接比较每种干预（具体目标1）以及这些方法（具体目标2）的神经基质所导致的行为变化。我们还将确定影响治疗有效性的个体特征，这对于为未来患者开发和选择适当的干预措施至关重要（具体目标3）。

Research Project 1: Explicit memory deficits are characteristic of amnestic mild cognitive impairment (aMCl), a condition that often precedes Alzheimer's disease. Although cognitive rehabilitation has Improved memory functioning following other types of neurologic Injury, there is a striking lack of research investigating such methods In aMCl. The proposed project builds directly on the promising results of our ADRC sponsored pilot study that has demonstrated significant behavioral Improvement and increased brain activity as measured by functional magnetic resonance Imaging (fMRI) following training in the use of mnemonic strategies (i.e. explicit memory training). A total of 75 patients with aMCl will be randomly assigned to either 1) explicit memory training 2) rehearsal-based training that relies on preserved implicit memory abilities (spaced retrieval) or 3) an educational control group. Patients will undergo pre- and post-training fMRI while they attempt to learn and remember object-location associations. Between these fMRI sessions, the treatment groups will receive three training sessions that Include both didactics and practice periods (i.e. when patients apply the strategies to associations), or just didactics forthe control group. Long-term retention will be assessed at 1 month. This design will allow us to directly compare the behavioral changes resulting from each Intervention (Specific Aim 1) as well as the neural substrates of these approaches (Specific Aim 2). We will also Identify individual characteristics that affect treatment effectiveness, which could be crucial for the development and selection of appropriate Interventions for future patients (Specific Aim 3).