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  • 标题:記憶障害が遷延した右尾状核出血に対するリハビリテーション
  • 本地全文:下载
  • 作者:浦上 裕子 ; 山本 正浩 ; 北條 具仁
  • 期刊名称:高次脳機能研究
  • 印刷版ISSN:1348-4818
  • 电子版ISSN:1880-6554
  • 出版年度:2021
  • 卷号:41
  • 期号:1
  • 页码:45-53
  • DOI:10.2496/hbfr.41.45
  • 语种:Japanese
  • 出版社:Japan Society for Higher Brain Dysfunction ( Founded as Japanese Society of Aphasiology in 1977 )
  • 摘要:限局性の尾状核出血による記憶障害は予後良好とされているが, 遷延例を経験した.症例は 46 歳, 男性.右尾状核出血発症から 10 ヵ月目に当院を受診, 知的機能, 前頭葉機能や意欲は保たれ, 尾状核から前頭葉への投射線維は維持されていた.しかし短期記憶が重度に障害され, 訓練では時間間隔を延長しながら覚えたことを長期記憶に組み込む間隔伸張法を適応できなかった.「誤りなし学習」を取り入れ, 外的補助具を用いた代償手段を導入した.反復により一部手続き記憶の中に組み込まれるようになった. 展望記憶訓練では, 手がかりを呈示することで「存在想起」は一部改善したが, 「内容想起」は改善せず, 意図的想起には結びつかず, 側頭葉性健忘と似た回復経過をたどった.経過より, 尾状核と内側側頭葉との神経連絡の損傷により記憶の固定化 (memory consolidation) の過程に障害が生じ, 長期記憶に移行できなかったことが, 記憶障害が遷延した原因と考えられた.
  • 其他摘要:Patients with memory disturbance after hemorrhage of the caudate nucleus are known to have good prognosis ; however, we experienced a case in which memory disturbance was prolonged after hemorrhage of the right caudate nucleus. A 46-year-old male came to our hospital 10 months after onset of symptoms because he had difficulties in performing activities of daily living (ADL) and work. His intellectual ability, frontal lobe function, and motivation were preserved, and projection from the caudate nuclei to the frontal lobe was preserved. His short-term memory was severely disturbed, however, so that he was unable to adapt to spaced retrieval training. During rehabilitation, he underwent perspective memory training, and a compensation method was introduced using an external aid with errorless learning. Post-training, the patientʼs existence recall improved, although content recall and short-term memory were still disturbed, and he could not obtain intentional recall. His recovery process was similar to that of temporal lobe amnesia. Disturbance in the process of memory consolidation caused by damage to the projection from the caudate nucleus to the medial temporal lobe may be the reason why memory disturbance was prolonged.
  • 关键词:尾状核;遷延性記憶障害;側頭葉;記憶の固定化;リハビリテーション
  • 其他关键词:caudate nucleus;prolonged memory disturbance;temporal lobe;memory consolidation;rehabilitation
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