Incidental and intentional memory in patients with neurodegenerative diseases

Doctoral Dissertation uoadl:2750887 517 Read counter

Unit:
Τομέας Κοινωνικής Ιατρικής - Ψυχιατρικής και Νευρολογίας
Library of the School of Health Sciences
Deposit date:
2018-05-04
Year:
2018
Author:
Kontaxopoulou Dionysia
Dissertation committee:
Στεφανής Λεωνίδας, Καθηγητής, Ιατρική ΕΚΠΑ
Βουμβουράκης Κωνσταντίνος, Καθηγητής, Ιατρική ΕΚΠΑ
Γεώργιος Γιαννής, Καθηγητής, Σχολή Πολιτικών Μηχανικών ΕΜΠ
Δουζένης Αθανάσιος, Καθηγητής, Ιατρική ΕΚΠΑ
Παπαγεωργίου Σωκράτης, Αν. Καθηγητής, Ιατρική ΕΚΠΑ
Οικονόμου Αλεξάνδρα, Αν. Καθηγήτρια, Ψυχολογία ΕΚΠΑ
Ζαλώνης Ιωάννης, Αν. Καθηγητής, Ιατρική ΕΚΠΑ
Original Title:
Ακούσια και εκούσια απομνημόνευση σε ασθενείς με νευροεκφυλιστικά νοσήματα
Languages:
Greek
Translated title:
Incidental and intentional memory in patients with neurodegenerative diseases
Summary:
Introduction: Incidental memory refers to the ability of memorizing information without specific intention. On the other hand, intentional memory refers to situations when individuals make a conscious effort to memorize the presented information. Incidental memory seems to play a very important role in everyday life, but is rarely being assessed during neuropsychological evaluation.
The goal of the present doctoral dissertation is the investigation of incidental and intentional memory in patients with neurodegenerative diseases (Alzheimer's disease, Parkinson's disease, Mild Cognitive Impairment) as well as their changes during normal aging. In addition, one of the objectives of the present research was to study the correlation between incidental/intentional memory with other cognitive functions as well as to investigate the association with the demographic characteristics of the sample. Finally, we investigated the association between incidental and intentional memory with patients' imaging findings.
Methodology: The sample of the present study consisted of 107 participants, 72 healthy participants and 65 patients with neurological conditions affecting cognitive functions (15 patients with Alzheimer's disease, 33 patients with Mild Cognitive Impairment and 17 patients with Parkinson's disease). All participants were examined by a special neurologist and neuropsychologist, and for their inclusion in the study they had to meet specific clinical and driving criteria.
Incidental memory evaluation was performed through a driving simulator experiment. More specifically, after completing the driving simulation, an incidental memory questionnaire, designed specifically for the needs of the experiment, was administrated to the participants. It consisted of questions about stimuli observed by the participants during the driving scenario either in the form of free recall or in the form of recognition task. In addition, intentional memory, verbal and visuospatial, was evaluated by two neuropsychological tests: (a) Hopkins Verbal Learning Test-Revised and (b) Brief Visuospatial Memory Test-Revised.
Results: The results of the analyses for the group of healthy participants revealed a greater impact of age on incidental memory tasks. On the contrary, gender did not appear to have such an effect on either incidental or intentional memory. In addition, attentional and executive functioning was more strongly associated with incidental memory than the intentional memory measures that were utilized in the current study.
The results of this study for patients with amnestic Mild Cognitive Impairment and mild Alzheimer's Disease indicated that: a) patients with mild Alzheimer's Disease performed worse than the amnestic Mild Cognitive Impairment group and the control group in incidental and intentional memory tasks, b) in comparison to the control group, patients with aMCI had a significant attenuation of performance only in intentional memory (verbal and visuospatial), c) when we separated the amnestic Mild Cognitive Impairment group patients with or without hippocampal atrophy, the only memory measure that appeared to differentiate the two subgroups was the incidental recognition task in which patients with hippocampal atrophy had a significantly lower performance than the patients without hippocampal atrophy, d) the incidental memory tasks, both free recall and recognition, were the only memory measures that strongly correlated with both right and left hippocampal atrophy but also with the overall atrophy of the temporal lobes.
The results for patients with Parkinson's disease, in comparison to the control group, revealed a significant impairment in intentional recall, both for verbal and visuospatial information. On the contrary, incidental memory seems to be better preserved in patients with Parkinson's disease. Our results revealed that compared to the control group, patients with Parkinson's disease had a significantly lower performance in neuropsychological tests evaluating attention and executive functions, which were significantly correlated with the intentional verbal and visuospatial memory tasks.
Discussion: The present doctoral thesis aims to the comprehensive evaluation of memory impairments, in order to contribute into the formulation of better diagnostic procedures and consequently to the implementation of better treatment plans.
Ageing appears to affect to a greater extent incidental rather than intentional memory. Healthy elderly seem to be able to retain adequately information that they have intentionally attempted to memorize while incidental encoding of information appears to be more affected during normal aging.
The present study also highlights the strong relationship between incidental memory and the volume of the hippocampus in patients with amnestic Mild Cognitive Impairment and mild Alzheimer's disease. Future studies could investigate the predictive value of incidental memory in detecting patients with amnestic Mild Cognitive Impairment who are at greater risk of developing Alzheimer's disease.
Patients with Parkinson's disease appeared to have significant deficits only in the intentional recall task whereas incidental memory was well preserved. Concerning that intentional memory is a more effortful and demanding cognitive process the significant difference in the intentional memory task between PD patients and the control group could be attributed to attentional frontal-related impairments that commonly appear in patients with Parkinson's disease. Finally, our findings indicated that PD patients performed worse only in the intentional recall task while their recognition performance was intact. This pattern of findings supports the view that the difficulties observed in intentional recall maybe explained by a frontal/executive dysfunction and not from a primary dysfunction of the medial temporal lobe structures.
Main subject category:
Health Sciences
Keywords:
Incidental memory, Intentional memory, Mild Cognitive Impairment, MCI, Alzheimer's disease, Parkinson's disease
Index:
No
Number of index pages:
0
Contains images:
Yes
Number of references:
524
Number of pages:
264
File:
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Dionysia Kontaxopoulou-Phd Thesis.pdf
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