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161.
While cognitive skill learning is normally acquired implicitly through frontostriatal circuitry in healthy individuals, neuroimaging studies suggest that patients with Parkinson's disease (PD) do so by activating alternate, intact brain areas associated with explicit memory processing. To further test this hypothesis, 10 patients with PD and 12 healthy controls were tested on a modified, learning version of the Tower of London task while undergoing positron emission tomography at four different time points over the course of learning. Despite having less accurate problem solving abilities than controls, PD patients were able to acquire the skill learning task. However, as compared to controls, they maintained higher levels of cerebral blood flow activity in the dorsolateral prefrontal cortex and hippocampus and showed an increase in activity in the frontopolar cortex and posterior cingulate over the course of learning. These findings reflect a shift to the explicit memory system in PD patients, enabling them to learn this cognitive skill, which is normally acquired by control subjects using implicit learning strategies and frontostriatal circuitry. 相似文献
162.
Erin R. Foster Kevin J. Black Jo Ann V. Antenor-Dorsey Joel S. Perlmutter Tamara Hershey 《Brain and cognition》2008
Studies suggest motor deficit asymmetry may help predict the pattern of cognitive impairment in individuals with Parkinson disease (PD). We tested this hypothesis using a highly validated and sensitive spatial memory task, spatial delayed response (SDR), and clinical and neuroimaging measures of PD asymmetry. We predicted SDR performance would be more impaired by PD-related changes in the right side of the brain than in the left. PD (n = 35) and control (n = 28) participants performed the SDR task. PD participants either had worse motor deficits on the right (RPD) or left (LPD) side of the body. Some participants also had magnetic resonance imaging for measurement of their substantia nigra (SN) volumes. The LPD group performed worse on the SDR task than the RPD and control groups. Right SN volume accounted for a unique and significant portion of the variance in SDR error, with smaller volume predicting poorer performance. In conclusion, left motor dysfunction and smaller right SN volume are associated with poorer spatial memory. 相似文献
163.
The Clock Drawing Test (CDT) is a widely used instrument in the neuropsychological assessment of Alzheimer's disease (AD). As CDT performance necessitates several cognitive functions (e.g., visuospatial and constructional abilities, executive functioning), an interaction of multiple brain regions is likely. Fifty-one subjects with mild cognitive impairment, 23 with AD and 15 healthy controls underwent high-resolution magnetic resonance imaging. Optimized voxel-based morphometry (VBM) was performed to investigate the putative association between CDT performance and gray matter (GM) density throughout the entire brain. In the first step of analysis (p<.001, uncorrected), VBM revealed a reduced GM density in numerous cortical (temporal lobe, frontal lobe, parietal lobe, cerebellum) and subcortical (thalamus, basal ganglia) brain regions to be associated with poorer CDT performance. When corrected for multiple comparisons (p<.01), the associations remained significant predominantly in the left temporal and--less pronounced--the right temporal lobe. VBM demonstrated CDT performance to depend on the integrity of widely distributed cortical and subcortical areas in both brain hemispheres with accentuation in the left-sided temporal lobe region. 相似文献
164.
Rolstad S Nordlund A Gustavsson MH Eckerström C Klang O Hansen S Wallin A 《Scandinavian journal of psychology》2008,49(6):577-582
The purpose of this study was to construct a Swedish version of the National Adult Reading Test (NART-SWE), a test for assessment of premorbid IQ, and to investigate its validity and reliability on healthy controls and patients with mild Alzheimer's disease. As Swedish pronunciation rules are fixed, NART-SWE was constructed using loan words. NART-SWE has satisfactory psychometric properties: Inter-rater and retest reliability as well as internal consistency are very high. The NART-SWE demonstrates face validity. In addition, high correlation with IQ was obtained. A significant model emerged when using NART-SWE to predict IQ. Furthermore, no significant differences were observed when comparing performance for healthy controls' with that of patients with Alzheimer's disease on NART-SWE. It does appear that reading of irregular words is intact in mild Alzheimer's disease. 相似文献
165.
从系统论看肿瘤的生物靶向性治疗 总被引:2,自引:0,他引:2
邓远美 《医学与哲学(人文社会医学版)》2008,29(1):66-67
肿瘤的生物靶向性治疗是恶性肿瘤治疗的新方法,其试图通过在基因水平上调节与肿瘤发生、发展有密切联系的生命物质来达到治愈肿瘤的目的。但临床运用中,生物靶向性治疗的疗效与我们的想象相去甚远。本文运用系统论的观点,分析目前生物靶向性治疗中存在的问题及寻求可能解决的方法。 相似文献
166.
揭开“看牙难、看牙贵”的面纱 总被引:12,自引:2,他引:10
患者对现有分科看牙模式的失望和对牙科医疗机构的商业化模式的疑问,产生了“看牙难、看牙贵”的感叹。通过14年的全科牙医诊疗体系的实践,从结构影响结果的哲学角度提出全科牙医教育培训体系的建立和牙科产业链调整的设想。通过对历史上全科牙医的回顾,推测全科牙医和专科牙医的互补形式,将成为中国牙科医疗体系的“新式样”。通过对牙科医疗机构运行机制的分析提出了改善的建议。 相似文献
167.
论医院实行单病种限价的伦理学价值 总被引:1,自引:0,他引:1
从单病种限价在医院内部管理机制等方面的作用出发,探讨了实施单病种限价的伦理价值基础和伦理学意义。认为单病种限价政策能促使医院形成“以人为本”的管理理念,切实维护患者利益,培养医务人员的医德素质,促使医院重视德源资产和品牌形象的建设,强化医务人员精益求精的科学精神,取信于民并帮助医院树立诚信的道德形象,是医院可持续发展的可取途径。 相似文献
168.
169.
Zuzana Skodova Iveta Nagyova Jitse P. van Dijk Adriana Sudzinova Helena Vargova Martin Studencan S. A. Reijneveld 《Journal of clinical psychology in medical settings》2008,15(3):204-213
Psychosocial factors have been shown to play an important role in the aetiology of coronary heart disease (CHD). A strong
association between CHD and socioeconomic status (lower-level education, poor financial situation) has also been well established.
Socioeconomic differences may thus also have an effect on psychosocial risk factors associated with CHD, and socioeconomic
disadvantage may negatively affect the later prognosis and quality of life of cardiac patients. The aim of this study was
to review the available evidence on socioeconomic differences in psychosocial factors which specifically contribute to CHD.
A computer-aided search of the Medline and PsycINFO databases resulted in 301 articles in English published between 1994 and
2007. A comprehensive screening process identified 12 empirical studies which described the socioeconomic differences in CHD
risk factors. A review of these studies showed that socioeconomic status (educational grade, occupation or income) was adversely
associated with psychosocial factors linked to CHD. This association was evident in the case of hostility and depression.
Available studies also showed a similar trend with respect to social support, perception of health and lack of optimism. Less
consistent were the results related to anger and perceived stress levels. Socioeconomic disadvantage seems to be an important
element influencing the psychosocial factors related to CHD, thus, a more comprehensive clarification of associations between
these factors might be useful. More studies are needed, focused not only on well-known risk factors such as depression and
hostility, but also on some lesser known psychosocial factors such as Type D and vital exhaustion and their role in CHD. 相似文献
170.
Karen B. Grothe Jamie S. Bodenlos Dori Whitehead Jake Olivier Phillip J. Brantley 《Journal of clinical psychology in medical settings》2008,15(2):163-169
The current study examined social support and stress as mediators of the hostility—coronary heart disease (CHD) relationship
as suggested by the psychosocial vulnerability model in a sample of low-income African Americans. Among 95 CHD patients and
30 healthy controls, hostility was negatively correlated with social support, but was not related to minor stress. CHD patients
endorsed higher levels of hostility; however, the relationship between hostility and CHD status was diminished once stress
and social support were included in the model. This study lends partial support for the psychosocial vulnerability model of
hostility in African Americans, but suggests that the relationship between hostility and stress may be impacted by socioeconomic
status. 相似文献