Memories defining the self in Alzheimer’s disease

ABSTRACT

There is a debate over the extent to which personal identity or the self is preserved in patients with Alzheimer’s disease (AD). Autobiographical memory deficits at early stages of AD could contribute to altering patients’ self. However, the nature of the relationship between autobiographical memory deficits and the self in AD has not been much investigated experimentally. In the present study, we aimed to investigate the integrative meaning of self-defining memories (SDMs) in early stages of AD and to analyse its relationship with the self-concept. The results showed that, when compared to the control group, AD patients less frequently extracted meaning from their SDMs and the meaning was less frequently tied to the self. Patients exhibited some altered aspects of the self-concept (i.e., complexity and strength), though some other components still persisted (i.e., valence and certainty). Correlation analyses showed that the impaired integrative meaning in the AD group was correlated with some changes in self-concept. We suggest that integrative meaning may act as a bridge between autobiographical memories and the self-concept, with reduced integration abilities appearing as a potential mechanism for the deterioration of the self-concept in AD.     

No dual-task practice effect in Alzheimer's disease

Diagnosis of Alzheimer's disease (AD) requires evidence of progressive decline in cognitive function. However, many tests used to assess cognitive function suffer from considerable practice effects, reducing their reliability. Several studies have reported that the ability to do two things at once, or dual tasking, is impaired in AD, but unaffected by healthy ageing. The apparent specificity of this impairment suggests that this assessment may be particularly useful in the early diagnosis of AD, but the reliability of this assessment remains unknown. Therefore, this study investigated simultaneous performance of digit recall and tracking tasks across six testing sessions in eight people with AD, eight healthy older adults and eight healthy younger adults. The results found that dual-task performance was unaffected by healthy ageing, but significantly impaired in AD, with no effect of repeated exposure. The absence of any improvements in performance despite increased familiarity with the task's demands suggests that not only is the dual-task assessment well suited for monitoring progression over time, but also that dual tasking involves a specific cognitive function which is impaired in the AD brain.     

阿尔茨海默病生物学标志物研究进展

阿尔茨海默病（AD）是常见的中枢神经系统变性疾病,是痴呆最常见的病因,发病率高.病理特征为老年斑及神经元纤维缠结.AD的确诊有赖病理学,临床诊断极其耗时.由于尚无准确的早期诊断方法,常使AD患者错过早期治疗的时机,这成为制约有效防控AD的瓶颈问题.因此寻找高敏感性、特异性、无创性的生物学标志物对AD的早期诊断至关重要.本文仅将目前较为广泛研究的生物学标志物及其研究现状作一概述.分别对脑脊液、血液、尿液及唾液中的AD标志物作逐一介绍.     

慢性心力衰竭患者临床管理与评估

尽管近年来在慢性心力衰竭(CHF)的治疗方面取得了较大的进展,但CHF患者仍有较高的住院率及病死率.CHF临床实践指南的发布促进了规范化治疗.为了取得良好的医疗效果,临床医生必须对心力衰竭患者提供一系列复杂的药物治疗及严格的自我控制措施.随着医学的不断发展,出现了包括心脏再同步化起搏、左心室辅助装置或心脏移植等治疗,而这些手段常需要在对患者进行危险性评估的基础上进行.严格遵循指南并使CHF患者出院后的教育与各种支持项目相结合才能够在一定程度上减低患者的再住院率及病死率.     

恐惧管理对道德五基准及道德判断的影响

本研究探讨恐惧管理理论对道德五种基本准则以及道德判断的影响。85名被试随机分配到实验组与控制组。全部被试首先完成道德五基准问卷。实验组被试接受死亡凸显提示后观看短片并完成一系列道德两难问题的判断;控制组接受一般负性事件提示。研究结果显示,相对于控制组而言,实验组被试倾向于作出直觉而非理性判断,并且死亡凸显对道德直觉判断的影响受到厌恶情绪的中介作用。同时,当故事情节发生转换时,实验组被试倾向于作出与原有道德直觉规范相一致的道德判断。本研究从恐惧管理理论出发,为道德判断的情理之争提供了启示。     

Subjective states associated with retrieval failures in Parkinson’s disease

Instances in which we cannot retrieve information immediately but know that the information might be retrieved later are subjective states that accompany retrieval failure. These are expressed in feeling-of-knowing (FOK) and Tip-of-the-tongue (TOT) experiences. In Experiment 1, participants with Parkinson’s disease (PD) and older adult controls were given general questions and asked to report when they experienced a TOT state and to give related information about the missing word. The PD group experienced similar levels of TOTs but provided less correct peripheral information related to the target when in a TOT state. In Experiment 2, participants were given a Semantic (general knowledge questions) and an Episodic (word pairs) FOK task. PD patients failed to accurately predict their future memory performance (FOK) in response to both episodic and semantic cues. Results are interpreted in the context of recent frameworks of memory and metacognition.     

Sense of identity in advanced Alzheimer’s dementia: A cognitive dissociation between sameness and selfhood?

We looked at whether sense of identity persists in patients with Alzheimer’s disease (AD) and if its profile remains the same between two examinations. A specifically designed protocol was administered to 16 AD patients in the mild to severe stages of dementia and to 16 matched healthy controls, both living in the same institution. We showed that sense of identity was broadly preserved in AD patients. The patterns of their responses were similar to those of controls, and remained consistent over a two-week period. However, some qualitative characteristics of sense of identity in AD patients differed significantly from those of controls, suggesting that AD patients may not be able to update their self-knowledge, probably because of their episodic memory deficit. These results are discussed in the light of both current models of the self and philosophical concepts such as sameness and selfhood.     

Evidence of Incomplete Motor Programming in Parkinson's Disease

One of the essential questions regarding movement deficits in Parkinson's disease (PD) is whether they stem from impaired selecting and switching among movements, impaired use of predictive information to prepare movement, or impaired execution of movement. PD subjects (n = 9) and age-matched control subjects (n = 8) performed a cued, sequential-response RT task. The cue provided either no information, accurate information, or inaccurate information about the upcoming response. PD subjects used predictive information to prepare and to switch among movement sequences normally, but second and third key press latencies were prolonged in comparison with the first key press latency. In Experiments 2 and 3, the effects of choice set and sequence length on key press latencies were examined. These results provide evidence that PD subjects initiate movement before the entire response sequence is prepared. PD does not impair motor programming or execution processes themselves but impairs the smooth coordination of those processes.     

Handedness and Hemispheric Asymmetry in the Control Of Movements

This study investigated the influence of hemispheric specialization of function on the motor performance of the hands. Right-handed (n=17), ambidextral (n=21), and ambisinistral (n=12) subjects performed Fitts' (1954) reciprocal tapping task under two conditions with each hand. Conditions had the same index of difficulty but differed in movement precision. The left hand of righthanders was superior in the condition requiring the greatest amount of preprogramming. Conversely, the right hand was not superior in the condition having the greatest demand for feedback control. For ambidextrals, left-hand superiority in the relatively preprogrammed condition was also revealed. Ambisinistrals showed no significant difference between conditions with either hand. The results partially support the hypothesis that the motor performance of the hands mirrors the dominant processing mode of their contralateral hemisphere. Failure to find supportive evidence in ambisinistrals is consistent with the contention that they lack hemispheric specialization of function.     

Bilateral Transfer as a Function of Mental Imagery

Three experiments are reported which investigate the role of mental imagery in the bilateral transfer from right to left hand of rotary pursuit skill. In Experiment 1 both mental imagery and physical rehearsal showed significant positive transfer relative to a control condition. However, work decrement may have accumulated and transferred in the physical rehearsal group thereby depressing this group’s left-hand performance. Experiment 2 was conducted under conditions designed to allow work decrement to dissipate prior to transfer to the contralateral limb. The data still showed no difference between physical re-hearsal and mental imagery. One interpretation of these data is that work decrement was present under both the physical rehearsal and mental imagery manipulations in Experiment 1. The data from Experiment 3 confirmed this interpretation as well as replicated the positive transfer effects found for mental imagery in Experiments 1 and 2. The data are discussed in terms of central versus peripheral explanatory mechanisms.