摘要
目的:记忆是对新信息进行储存和回忆的能力,不同的记忆与不同的神经解剖结构相关联。综述与临床关系比较密切的4个记忆系统:情景记忆、语义记忆、程序记忆、工作记忆。概述不同记忆系统的相关神经解剖结构及临床表现,旨在于对临床诊断和治疗有所帮助。资料来源:应用计算机检索Medline数据库1996-01/2005-10相关文章,检索词“memorydisorder,episodememory,semanticmemory,workingmemory”,限定语言种类为英文。同时手工检索相关著作。资料选择:选取包含“情景记忆、语义记忆、程序记忆、工作记忆”4种记忆的文献,排除综述类文献和其他记忆分类文献,对符合条件的文献查找全文。资料提炼:符合与临床关系比较密切的情景记忆、语义记忆、程序记忆、工作记忆4个记忆系统的文献共183篇,从中选取相关文献23篇。排除重复研究和年代较久的文献160篇。资料综合:记忆障碍有不同的分类方法。传统的分类方法已为改进的与临床相关性好的方法取代。情景记忆、语义记忆、工作记忆均属外显记忆。程序记忆属非陈述性记忆,但在获得过程中既可以是外显的,也可以是内隐性的。其各自所涉及的脑区及临床表现不同。①与情景记忆系统有关的神经解剖结构包括内侧颞叶包括海马、鼻内侧和鼻周围皮层及额叶。左右半球前额叶参与情景记忆有一定分工,左半球主要负责编码,右半球主要负责提取。颞叶病变,表现为近记忆的再获得障碍。②根据命名、分类任务判定的语义记忆位于前外侧颞叶,语义记忆障碍的患者表现为命名障碍。③程序记忆属于非陈述性的,但在获得过程中既可以是外显的,也可以为内隐性的。严重情景记忆受损的患者其程序记忆可以完好无损,由此证实程序记忆所依赖的记忆系统有别于情景记忆和语义记忆系统。④工作记忆是传统的注意力、集中、短期记忆的结合,涉及短期保持和为记忆所需的信息操作。所有涉及工作记忆的任务都需要前额叶皮层的参与。研究显示语音工作记忆倾向于涉及脑左侧的更多区域,相反空间工作记忆则涉及右侧的更多区域。结论:记忆是由各自独特的系统组成的,一种疾病可能损伤多个记忆系统。记忆的分类改进有助于临床医师对患者记忆障碍的诊断和治疗,记忆障碍的治疗因原发病的不同而异。
OBJECTIVE: Memory is an ability to deposited and recall new information, Different memory systems depend on different neuroanatomical structures, This article aims to review four memory systems (episodic memory, semantic memory, procedural memory and working memory), which are closely related to clinic, and summarize the related neuroanatomical structures and the manifestations of different memory systems in order to aid the clinical diagnosis and treatment of memory disorders. DATA SOURCES: The related articles from January 1996 to October 2005 were searched in the Medline database by computer, with the key words of "memory disorder, episode memory, semantic memory, working memory" in English. Meanwhile, the related literatures were retrieved by handiwork. STUDY SELECTION: The articles including the four memory systems were selected to look up the full text, and those articles about reviews and other classification of memory were screened out. DATA EXTRACTION: A total of 183 articles of four memory systems closely related with clinic were collected, and 23 articles were included. Other 160 articles were excluded due to repetitive or outdated contents. DATA SYNTHESIS: There are various classifications for memory disorder. Traditional classifications have given way to the improved system, which is more correlated with clinic. Episodic memory, semantic memory and working memory refer to the explicit and declarative memory system. Procedural memory is nondeclarative but either explicit or implicit during acquisition. Different memory systems are associated with different brain areas and manifest different symptoms. ①There are some neuroanatomical structures related with episodic memory, such as temporal lobe, hippocampus, cortex and frontal lobe inside and around nose. And the anterior frontal lobes of left and right hemispheres have their own division of work: Left hemisphere is responsible for coding while right hemisphere is in .charge of extract. The lesion of temporal lobe is expressed as re-acquired disorder of recent memory. ②According to denomination and classification task, semantic memory is defined and located in anterior lateral temporal lobe, and the patients express amnesic aphasia. ③Procedural memory is nondeclarative but may be either explicit or implicit during acquisition. Procedural memory will be intact although episodic memory is severely injured, which confirms the memory system procedural memory depends on is different from those episodic memory and semantic memory depend on.④ Working memory is the traditional combination of attention, concentration and impermanent memory, and include the operations of remaining information for short term. All the tasks involved in the working memory can not be conducted without anterior frontal lobe cortex. The results of studies indicate the working memory of phone tend to deal with more areas of left brain, whereas the working memory of interspace tend to more areas of right brain. CONCLUSION: Memory consists of different specific systems, and several memory systems may be injured due to one kind of disease. It is helpful to improve the classification of memory for clinicians in the diagnosis and treatment of patients with memory disorder. In addition, there are different therapies for memory disorder according to different episodes.
出处
《中国临床康复》
CSCD
北大核心
2006年第22期122-124,共3页
Chinese Journal of Clinical Rehabilitation