摘要目的 探讨单一病灶皮层下脑梗死患者在发病后不同时间点分别从事特征工作记忆和整合工作记忆时的认知行为特点.方法 28例单一病灶皮层下脑梗死患者,25名年龄、性别及文化程度相匹配的健康志愿者为对照在实验期间进行一次相同任务测试.在发病基线(W1)、发病3个月(M3)以及发病6个月(M6)分别从事颜色、空间和颜色-空间整合3种工作记忆延迟匹配样本任务,计算机记录其行为反应时间和正确率,并统计学分析.结果 W1与M3比较,3种记忆任务的正确率[(61.06±7.78)％,(64.92±5.47)％；(90.59±2.95)％,(92.88±2.98)％；(77.06±5.58)％,(82.35±7.44)％]均有提高,其反应时间[(914.02±110.53) ms,(868.31±118.91) ms；(859.89±139.94)ms,(833.37±120.99)ms；(1150.17 ±92.02) ms,(918.72±101.28)ms]缩短,差异有统计学意义(P＜0.05)；M6与M3比较,空间任务的正确率[(93.91±2.86)％；(92.88±2.98)％]进一步提高,反应时间[(813.24±119.54)ms；(833.37±120.99) ms]缩短,而颜色任务的正确率[(64.50±4.49)％；(64.92±5.47)％]和反应时间[(866.47±123.87)ms; (868.31±118.91)ms]差异无统计学意义(P＞0.05),整合任务的正确率[(78.49±7.85)％；(82.35±7.44)％]却有显著性下降(P＜0.05),几乎降至发病基线水平[(77.06±5.58)％]；与对照组相比,除M6时空间记忆指标[(93.91±2.86)％；(813.24±119.54)ms]差异无统计学意义(P＞0.05),其余均差异有统计学意义.结论 单一病灶皮层下脑梗死患者在发病后特征及整合记忆均有不同程度损害,半年时空间记忆基本恢复至正常,但整合记忆存在继发性损害,这可能与脑梗死后神经纤维继发性损害有关.

abstractsObjective To investigate the cognitive behavioral characteristic longitudinally of the patients after subcortical infarction engaged in feature and binding working memory tasks.Methods The behavioral performances were recorded from 28 patients after subcortical infarction at the 1 st week (W1),3 rd moth (M3) and 6th month (M6) while performing color,location,and color-location binding delayed match-to-sample working memory task.25 healthy volunteers(controls) were investigated once using the same task protocol during the study period.Computer recorded the behavior reaction time and accuracy.Single factor variant analysis of repeated measurement was adopted.Results The accuracy of three memory tasks of M3 ((64.92 ± 5.47) ％ ; (92.88 ± 2.98) ％ ;(82.35 ±7.44)％) was improved than that of W1 ((61.06 ±7.78)％; (90.59 ±2.95)％; (77.06 ±5.58) ％) and the difference had statistically significant (P ＜ 0.05).But the reaction time of M3 ((868.31 ±118.91)ms; (833.37 ± 120.99) ms; (918.72 ± 101.28) ms) was shortened than that of W1 ((914.02 ±110.53) ms; (859.89 ± 139.94) ms; (1150.17 ± 92.02) ms) and the difference also had statistically significant (P ＜ 0.05).In the location-memory task,the correct rate of M6 ((93.91 ± 2.86) ％) was improved than that of M3 ((92.88 ± 2.98) ％) and the reaction time of M6 ((813.24 ± 119.54) ms) was shortened than M3 ((833.37 ±120.99) ms).M6 and M3 to be compared in the color memory task,the correct rate ((64.50 ± 4.49) ％ ; (64.92 ± 5.47) ％) and the reaction time ((866.47 ± 123.87) ms; (868.31 ± 118.91) ms) had no significant difference (P ＜ 0.05).But in the color-location binding task,the correct rate of M6 ((78.49 ± 7.85) ％) and M3 ((82.35 ± 7.44)％) to be compared had significant decreased nearly the level ((77.06 ± 5.58)％) of the stroke beginning.All behavioral performances of patients were worse than that of control subjects except the compare result of location-memory task in M6((93.91 ± 2.86) ％ ; (813.24 ± 119.54) ms).Conclusion Feature memory and binding memory had been damaged in different degrees in the patient after subcortical infarction.The binding memory had the secondary damage what might be related to the secondary nerve fiber degeneration after infarction.