阿尔茨海默病和轻度认知障碍注意功能研究

摘要

Objective To investigate attention impairment in Alzheimer's disease (AD) and mild cognitive impairment (MCI). Methods Attention impairment was investigated in 16 patients with AD,in 12 patients with MCI and in 15 normal elderly participants using the modified behavioral attention network test (ANT) paradigm. The ANT was performed to investigate the reaction times for alertness,directional and executive control. Significant group effects of behavioral performance were calculated by analysis of variance (ANOVA). Results The reaction times of the three networks (alertness,directional and executive control) all showed significant differences between the three groups. Post hoc comparisons revealed that the reaction times of all the three networks were longer in AD group than in the normal control group and the MCI group. Compared with patients in the normal control group,patients in the MCI group presented selective attention impairment with preserved alertness effect (P = 0.26) and directional effect (P =0.11) but exhibited a significantly degenerated executive control effect (P<0.01). Conclusion AD and MCI patients show different patterns of behavior deficits,with total performance degeneration in the AD group and selective top-down attention deficits in the MCI group.%目的 研究阿尔茨海默病(Alzheimer's disease,AD)与轻度认知障碍(mild cognitive impairment,MCI)注意功能变化,进一步揭示AD认知功能减退规律.方法 选取济南军区总医院干部病房神经内科病房和门诊的患者43例,其中AD患者16例,MCI患者12例,正常对照15例.采用改良注意网络测试(ANT)范式进行注意功能测试,分别对人脑警觉能力、定向能力与执行控制能力反应时进行测试,通过方差分析进行组间行为效应比较.结果 三组间警觉、定向与执行控制3个子系统效应反应时均表现出显著差异,具有统计学意义(P<0.05).统计检验两两比较显示,AD组相对于正常对照组与MCI组3个子系统效应均表现为反应时延长;而MCI组相对正常对照组表现为选择性的注意功能受损,其中警觉效应(P=0.26)与定向效应(P=0.11)未发生显著性变化,而执行控制效应发生显著退化(P<0.01).结论 AD与MCI患者认知功能退变进程存在差异性,AD患者已出现全面注意功能减退,而MCI患者表现为选择性注意功能减退.