轻度认知功能障碍患者的语义记忆损害与神经调控

doi:10.3969/j.issn.2095-4344.2789

中国组织工程研究 ›› 2020, Vol. 24 ›› Issue (32): 5236-5242.doi: 10.3969/j.issn.2095-4344.2789

• 组织构建综述 tissue construction review • 上一篇下一篇

轻度认知功能障碍患者的语义记忆损害与神经调控

黎莹1，关汉添2，周钰1

¹广州医科大学附属第二医院康复医学科，广东省广州市 510260；²广州医科大学临床医学系，广东省广州市 511436

收稿日期:2019-12-28 修回日期:2020-01-04 接受日期:2020-02-19 出版日期:2020-11-18 发布日期:2020-09-26
通讯作者: 关汉添，广州医科大学本科在读，广州医科大学临床医学系，广东省广州市 511436
作者简介:黎莹，女，1990年生，广东省广州市人，2013年广州医科大学毕业，主管技师，主要从事卒中后康复方面的研究。
基金资助:
广东省大学生创新创业训练计划项目(S201910570004)

Semantic memory impairment and neuroregulation in patients with mild cognitive impairment

Li Ying1, Guan Hantian2, Zhou Yu1

¹Department of Rehabilitation Medicine, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, Guangdong Province, China; ²Department of Clinical Medicine, Guangzhou Medical University, Guangzhou 511436, Guangdong Province, China

Received:2019-12-28 Revised:2020-01-04 Accepted:2020-02-19 Online:2020-11-18 Published:2020-09-26
Contact: Guan Hantian, Department of Clinical Medicine, Guangzhou Medical University, Guangzhou 511436, Guangdong Province, China
About author:Li Ying, Technician in charge, Department of Rehabilitation Medicine, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, Guangdong Province, China
Supported by:
Guangdong University Student Innovation and Entrepreneurship Training Program Project, No. S201910570004

摘要/Abstract

摘要：

文题释义：

轻度认知障碍：是介于正常衰老与痴呆的过渡状态，是相对于年龄与教育程度的记忆或其他认知功能减退，记忆力、语言功能、注意力、执行能力等不同认知领域的减退，以记忆力减退为最常见的临床表现。国际轻度认知功能障碍工作组在2003年制定了轻度认知障碍的诊断标准：①有认知主诉，本人或知情者提供的认知功能障碍线索；②有认知功能损害的客观证据，选用蒙特利尔认知评估量表进行评分，高中及以上文化程度者≤26分，初中及以下文化程度者≤25分，且主要表现为记忆项异常者；③日常生活能力正常或仅有复杂日常能力轻度减退；④简易认知状态量表≥24分，不符合精神疾病的诊断和统计手册第四版诊断为痴呆的标准。

语义记忆：包括对词语的意义、概念与事实的记忆。语义记忆涉及概念和实际知识是储存。广义上语义记忆包括对世界的所有认识。严格意义上的语义记忆，则是根据命名、分类任务判定。语义记忆障碍的患者表现为对熟悉的物品命名障碍。轻度的可能表现为语义分类词生成的减少，而严重的语义记忆障碍则表现为告知物品用途也不能进行命名，或给予名称也不能说出物品的用途，严重者可能表现为常识的缺失。

背景：阿尔茨海默病是一种进行性神经系统退化疾病，以认知下降为主要特点。认知力下降会导致老年人逐渐失去自我照料的能力，影响日常生活和活动。轻度认知障碍作为阿尔茨海默病的前驱状态，尽早对轻度认知障碍进行诊断和治疗，对预防阿尔茨海默病发展有重大的意义。

目的：针对轻度认知障碍语义记忆障碍评估与治疗的发展及未来前景做一综述。

方法：应用计算机在PubMed、Web of Science和中国知网、万方等数据库检索轻度认知障碍语义记忆评估、治疗的相关研究，检索关键词为“mild cognitive impairment，semantic memory impairment，semantic memory deficit，语义记忆，轻度认知功能障碍，轻度认知损害”，检索时间为2009年1月至2019年11月。

结果与结论：语义记忆障碍为轻度认知障碍的主要临床症状之一，有一定的特异性。目前有不同类型的记忆量表可作为轻度认知障碍语义记忆障碍的神经心理学测量，颞叶、额叶和前运动区可能参与语义记忆环路。针对性的语义记忆神经生理学及辅助检查，靶向进行语义记忆康复训练，可利于早期识别轻度认知障碍的发生与转化。

ORCID: 0000-0002-2121-1523(关汉添)

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

关键词: 轻度认知障碍, 语义记忆, 功能性磁共振, 语义能力测试, 语义启动, 神经生理学测量, 重复经颅电刺激, 运动治疗

Abstract:

BACKGROUND: Alzheimer’s disease is a progressive neurological degenerative disease characterized by cognitive decline. Cognitive decline can make the elderly gradually losing their self-care ability, which eventually affects daily life and activities. Mild cognitive impairment is a precursor state of Alzheimer’s disease, and to diagnose and treat mild cognitive impairment as soon as possible has great significance in preventing the development of Alzheimer’s disease.

OBJECTIVE: To summarize the development and future prospects of the assessment and treatment of semantic memory disorders due to mild cognitive impairment.

METHODS: A computer-based retrieval of PubMed, Web of Science, CNKI, and WanFang was performed for related studies on the evaluation and treatment of mild cognitive impairment in semantic memory. The keywords were “mild cognitive impairment, semantic memory impairment, semantic memory deficit” in English and Chinese, respectively. The retrieval time was from January 2009 to November 2019.

RESULTS AND CONCLUSION: Semantic memory disorder is one of the main clinical symptoms of mild cognitive impairment, and has certain specificity. At present, there are different types of memory scales that can be used as neurophysiological measures of semantic memory disorder due to mild cognitive impairment. The temporal lobe, frontal lobe, and premotor region may participate in the semantic memory loop. Targeted semantic memory neurophysiology and auxiliary examinations, and targeted semantic memory rehabilitation training can be helpful for early identification of the occurrence and transformation of mild cognitive impairment.

Key words: mild cognitive impairment, semantic memory, functional magnetic resonance imaging, semantic ability test, semantic initiation, neuropsychological measurement, repetitive transcranial electrical stimulation, exercise therapy

中图分类号:

黎莹, 关汉添, 周钰. 轻度认知功能障碍患者的语义记忆损害与神经调控[J]. 中国组织工程研究, 2020, 24(32): 5236-5242.

Li Ying, Guan Hantian, Zhou Yu. Semantic memory impairment and neuroregulation in patients with mild cognitive impairment[J]. Chinese Journal of Tissue Engineering Research, 2020, 24(32): 5236-5242.

图/表（结果） 2

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引言

材料方法

1.1 资料来源

检索人及检索时间：第一作者检索“mild cognitive impairment， semantic memory impairment，semantic memory，语义记忆，轻度认知功能障碍，轻度认知损害”等关键词，于2019年7月1日至2019年11月30日进行检索，检索结果包括中文文献与英文文献。

检索文献时限：2009年1月至2019年11月。

检索数据库：①PubMed(www.ncbi.nlm.nih.gov/ pubmed)是美国国家医学图书馆提供的一个免费信息检索系统，主要提供生物医学方面的论文检索；②Web of Science(login.webofknowledge.com/)支持自然科学、社会科学、艺术与人文学科的文献检索，数据来源于期刊、图书、专利、会议录、网络资源(包括免费开放资源)等；③中国知网(www.cnki.net/)是目前世界上最大的连续动态更新的中国期刊全文数据库，收录国内8 200多种重要期刊；④万方数据库(www.wanfangdata.com.cn)是由万方数据公司开发的，涵盖期刊、会议纪要、论文、学术成果、学术会议论文的大型网络数据库；也是和中国知网齐名的中国专业的学术数据库。

检索途径：包括关键词检索、主题词检索、摘要检索、全文检索等。

检索方法：由第一作者用广州医科大学图书馆电子资源数据库中的PubMed、中国知网及万方资源数据库检索发表在2009年至2019年的文章，检索词分别为“semantic memory impairment；semantic memory”和“轻度认知功能障碍；轻度认知损害；语义记忆”。从轻度认知功能障碍语义记忆临床表现，语义记忆损害神经生理学测量，轻度认知功能障碍可能神经环路，轻度认知功能障碍语义记忆治疗等4方面进行总结。共检索到1 572篇文章，按纳入和排除标准对文献进行筛选，共纳入78篇文章。

检索文献类型：包括研究原著，综述，述评，经验交流，病例报告，荟萃分析等。

1.2 入选标准

纳入标准：①涉及轻度认知障碍语义记忆的相关研究；②涉及语义记忆损害神经生理学测量的相关研究；③涉及语义记忆治疗的相关研究；④纳入文献中的引用文献。

排除标准：①与研究目的不相关的文献；②内容重复的文献。

1.3 文献筛选流程通过PubMed、Web of Science、中国知网和万方数据库检索关键词在2014年到2019年所发表相关中英文文献1 572篇，使用NoteExpress软件排除重复后，纳入非重复文献101篇，浏览全文后排除与研究目的不相关的文献，最终纳入文献78篇。其中9篇介绍了轻度认知障碍语义记忆障碍的临床特征，43篇语义记忆的各种神经生理学测量应用，14篇介绍了语义记忆可能相关神经环路，12篇介绍了语义记忆各种康复手段的研究进展。

轻度认知功能障碍患者的语义记忆损害与神经调控

Semantic memory impairment and neuroregulation in patients with mild cognitive impairment

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