对基底神经节在内隐启动中作用的再认识 来自1例遗忘症患者功能恢复期的动态观察

Recognition of basal ganglia in implicit priming: A dynamic study on an amnesic patient during his functional recovery

目的:通过对1例右侧颞叶和右基底神经节损伤而致健忘的患者在恢复期内记忆功能变化的检测,检验基底节的损伤是否会影响到知觉性与概念性内隐记忆任务,以及被试损伤部位功能的恢复对上述认知功能是否具有不同的影响,以揭示基底神经节在内隐启动中的作用。方法:以1例2003年12月外伤导致健忘症的解放军316医院的40岁男性患者(实验组)为对象,同等年龄与教育水平的5名健康被试(控制组1)和20名大学生分别为对照组(控制组2),于患者创伤后29d和34d,对患者一般认知能力、人格、自由回忆能力进行检测,并结合专业人员的主观观察基础上,于患者创伤后34d和80d,采用典型的内隐词干补笔测验、内隐图片偏好测验及外显再认测验,在患者认知功能恢复的不同时期分量词进行测验,考察被试的外显记忆、知觉性内隐记忆能力的变化。结果:所纳入的1名患者、5名健康被试和20名大学生均进入结果分析,无脱落者。①两次内隐词干补笔测验:患者第1次的成绩(补笔数为25)明显低于两个控制组(补笔数分别为46.0±3.7,54.6±1.8),第2次成绩(补笔数为67)与两个控制组接近。②在两次内隐图片偏好测验:患者第1次的成绩明显低于控制组(对新旧图片偏好之比分别为19∶41;38.4∶21.6),第2次成绩接近控制组(对新旧图片偏好之比为32∶28;38.4∶21.6)。③在两次外显语词再认测验:患者均表现出与控制组同等的再认水平(d'为1.08,-1.47,1.202±1.777)。结论:右侧颞叶的损伤对外显记忆产生明显的影响,右基底神经节的损伤不但影响知觉性内隐记忆,也影响概念性内隐记忆,还可能影响部分认知技能。表明基底神经节不但具有调节运动与技能学习的功能,还可能参与启动的调节,对右基底神经节的认知功能应该给予进一步的认识。

AIM：To examine whether there are different influences on the performance in explicit recognition task, and implicit memory tasks when the right temporal cortex and right basal ganglia is damaged by comparing a case of amnesic patient with normal controls. To observe effect of functional recovery of injured parts on above-mentioned cognition function to discover effect of basal ganglia on implicit priming.METHODS：A 40 years old amnesic patient from the 316 Hospital of Chinese PLA in December 2003 as experiment group, and two control groups were adopted, with the same age and educational level one consisted of 5 healthy participates （control group 1）, another consisted of 20 university students （control group 2）. After 29 days and 34 days injury,they were detected on cognitive ability, personality and free memory ability on the basis of professional suhjective observation. All the subjects were administrated after 34 days and 80 days injury by the explicit recognition test, implicit stem completion test, and implicit picture preference test respectively.RESULTS： All the 1 patient, 5 healthy participators and 20 university students were involved in the analysis of results. ① Twice implicit stem completion test： First result of patient was lower than that of control groupssignificantly （25, 46.0±3.7,54.6±1.8）. The patient showed the equivalent performance as that of control group in explicit recognition test for the second time （67）. ② Implicit picture preference test： First result of patient was lower than that of control groups significantly （The proportion between new picture and old picture was 19, 41 vs 38.4, 21.6, respectively）. The patient showed the equivalent performance as that of control group in the second time （the proportion between new picture and old picture was 32,28 vs; 38.4, 21.6, respectively）. ③ Explicit recognition test： The patient showed the equivalent performance as that of control group （1.08,-1.47,1.202± 1.777）.CONCLUSION：Explicit memory is significantly influenced hy the impairment of right temporal cortex, and both the implicit perceptual and conceptual tasks were influenced by the impairnlcnt of right basal ganglia,and some cognitive skills possihly were partially affected. This means that not only is the basal ganglia involved in the modulation of movement and learning skill, hut also is involved the modulation of initiation. The cognitive function of basal ganglia needs to be explored further.