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首页> 外文期刊>Neuropsychologia >Impaired context reversal learning, but not cue reversal learning, in patients with amnestic mild cognitive impairment.
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Impaired context reversal learning, but not cue reversal learning, in patients with amnestic mild cognitive impairment.

机译：遗忘性轻度认知障碍患者的情境逆转学习受损，但提示逆转学习不受影响。

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It has been proposed that reversal learning is impaired following damage to the orbitofrontal and ventromedial frontal cortex (OFC/VMFC) and to the medial temporal lobe (MTL), including the hippocampal formation. However, the exact characteristics of the MTL-associated reversal learning deficit are not known. To investigate this issue, we assessed 30 newly diagnosed patients with amnestic mild cognitive impairment (aMCI) and 30 matched healthy controls. All patients fulfilled the aMCI criteria of the Mayo Clinic Alzheimer's Disease Research Center and underwent head magnetic resonance imaging that confirmed MTL atrophy. Reversal learning was assessed using a novel reinforcement learning task. Participants first acquired and then reversed stimulus-outcome associations based on negative and positive feedback (losing and gaining points). Stimuli consisted of a cue (geometric shapes) and a spatial context (background color or pattern). Neuropsychological assessment included tasks related to the MTL (paired associates learning), dorsolateral prefrontal cortex (DLPFC) (extradimensional shift, One-touch Stockings of Cambridge), and OFC/VMFC (Holiday Apartment Task). Results revealed that, relative to controls, patients with aMCI exhibited a marked reversal learning deficit, which was highly selective for the reversal of context. The acquisition of stimulus-outcome associations and cue reversal learning were spared. Performance on the context reversal learning task significantly correlated with the right hippocampal volume. In addition, patients with aMCI had deficits on tests related to DLPFC but not to OFC/VMFC. However, DLPFC dysfunctions were not associated with context reversal learning. These results suggest that MTL deficits in aMCI selectively affect context reversal learning when OFC/VMFC functions are spared. This deficit is not influenced by the valence of the outcome (positive or negative feedback) and by executive dysfunctions.
机译：有人提出，对眶额和腹侧额叶皮层（OFC / VMFC）和内侧颞叶（MTL）（包括海马结构）的损害会损害逆向学习。但是，与MTL相关的逆向学习缺陷的确切特征尚不清楚。为了调查此问题，我们评估了30名新诊断的轻度认知障碍（aMCI）患者和30名匹配的健康对照。所有患者均符合梅奥诊所阿尔茨海默氏病研究中心的aMCI标准，并接受了头部磁共振成像，证实了MTL萎缩。使用新颖的强化学习任务评估了逆向学习。参与者首先根据负面和正面反馈（失去和获得的分数）获得了刺激－结果关联，然后将其反转。刺激由提示（几何形状）和空间背景（背景颜色或图案）组成。神经心理学评估包括与MTL（配对同伴学习），背外侧前额叶皮层（DLPFC）（超尺寸移位，剑桥一触式长袜）和OFC / VMFC（假日公寓任务）相关的任务。结果显示，相对于对照组，aMCI患者表现出明显的逆向学习缺陷，这对于逆境具有高度选择性。刺激结果结局的获得和线索逆转学习得到了保留。逆境学习任务的表现与右海马体积显着相关。此外，患有aMCI的患者在与DLPFC相关但与OFC / VMFC相关的检测方面存在缺陷。但是，DLPFC功能障碍与情境逆向学习无关。这些结果表明，在节省OFC / VMFC功能时，aMCI中的MTL缺陷会选择性地影响上下文反转学习。此缺陷不受结局效价（正反馈或负反馈）和执行功能障碍的影响。

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