COMPARISON OF IMPLICIT AND EXPLICIT COGNITIVE REHABILITATION OF MEMORY IN PATIENT

研究项目1： 显性记忆缺陷是遗忘性轻度认知障碍(AMCL)的特征，这种情况通常是阿尔茨海默病的先兆。尽管认知康复在其他类型的神经损伤后改善了记忆功能，但研究AMCL的这种方法的研究明显缺乏。拟议的项目直接建立在我们ADRC赞助的试点研究的令人振奋的结果基础上，该研究表明，在使用助记策略(即显性记忆训练)的培训后，通过功能磁共振成像(FMRI)测量，行为显著改善，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)依靠保留的内隐记忆能力(空间提取)的排练训练，或3)教育控制组。患者将在训练前和训练后接受功能磁共振检查，同时尝试学习和记住物体与位置的关联。在这些fMRI课程之间，治疗组将接受包括教学和练习(即当患者将策略应用于联想)的三个培训课程，或者只接受对照组的教学。长期留存将在1个月内进行评估。这一设计将使我们能够直接比较每个干预(特定目标1)导致的行为变化以及这些方法的神经基础(特定目标2)。我们还将确定影响治疗效果的个体特征，这可能对为未来的患者制定和选择适当的干预措施(具体目标3)至关重要。

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).