2008-08-012024-05-18https://scholars.lib.ntu.edu.tw/handle/123456789/714193摘要：行為測量如回憶、再認常被臨床用來評估中樞神經系統疾患(如：阿茲海默型失智症、輕度知能障礙)之記憶缺陷程度。但此類測驗表現通常不是單一認知歷程運作結果，而是經由一些認知歷程(如：記憶貯存與提取)共同運作所致。事實上，大部分此類研究仍只針對特定記憶功能(如：事件記憶、語意記憶、隱式記憶)作較深入分析。而少有學者嘗試區辨各類疾患記憶缺損的特定型式。此忽略極可能是因為傳統之統計方法無法有效區分不同臨床患者之分數表現究竟是哪一部份認知歷程(受損)所貢獻。 有鑑於此，本研究將用一種以資訊處理為基礎之多項歷程樹狀模式來評估記憶貯存與提取在中樞神經系統疾患(特別是阿茲海默型失智症及輕度知能障礙)行為測量表現中所扮演角色。我們將用一種階層性多項歷程樹狀結構來建構模式，因為其較能解決個人差異及小樣本等臨床上可能遇到的問題。希望藉由模式中不同參數之估計能幫助我們了解患者在認知歷程上之可能差異。我們用的行為測量資料來源為過去八年來中樞神經系統疾患被轉介至台大醫院神經科時所做之中文字詞序列學習測驗。此測驗包含十個序列的中文字詞學習、回憶、與再認，且是共同主持人花茂棽教授實驗室所執行之一系列的神經心理測驗其中一項。若能發現各類患者具有不同的記憶缺損型態，臨床上則將可更有效地幫助鑑別診斷不同類別的中樞神經系統疾患。 <br> Abstract: Behavioral measures like free recall, cued recall, or recognition are often used in clinical settings to assess memory deficits of patients with the central nervous system (CNS) diseases such as Alzheimer’s disease (AD) and amnestic mild cognitive impairment (MCI). However, scores of these measures typically are not results of a single cognitive process but are influenced by several cognitive processes such as storage and retrieval. In fact, most studies only focused on issues of different types of memory functions, such as episodic memory, semantic memory or implicit memory. Few studies explored the issue of whether there exist impaired memory function patterns that might be reflected by different test index scores in patients with different cognitive impairments. The negligence may be due to the fact that traditional statistical methods may not be powerful enough to help distinguish between different clinical groups in terms of contributions of underlying cognitive processes to the performance scores. The present study is to explore this issue. We propose to use an information-processing type of statistical/cognitive modeling approach, called multinomial processing tree (MPT) modeling, to assess the storage and retrieval deficits in clinical groups in Taiwan (especially for patients with MCI and with AD). We will focus on the construction of a (latent-class) hierarchical MPT model that has the advantage of allowing researchers to perform parameter estimation and hypothesis tests both within and between groups without worrying about the presence of individual differences. We will also study the goodness of fit of the model to existing data. The data, obtained from patients who visited the neurology clinics of National Taiwan University Hospital, are from the so-called Word Sequence Learning Test of learning of word lists (6 Chinese abstract words) in multiple trials (total 10 learning trials). This test is one of the tests in a battery of neuropsychological tests conducted in the co-PI, Professor Hua’s laboratory over the past 8 years from 2000 to 2007. The findings will further our understanding on different cognitive mechanisms underlying memory impairments observed in different CNS diseases. If executed successfully, the model may serve as a useful indicator to distinguish patients with amnestic MCI from patients with AD and/or other CNS diseases.阿茲海默型失智症記憶缺陷輕度知能障礙多項歷程樹狀模式Alzheimer`s diseasememory deficitsmild cognitive impairmentmultinomial processing tree modeling