健康与遗传心理学研究室知识库

摘要： 对于自发性虚构病人的神经解剖基础，尚缺乏详细精确的解剖定位；对于其认知神经心理学的机制，也还没有一个统一的广为接受的理论；而且，自发性虚构的症状非常多样和异质，这提示其本身可能还有亚型，这也是一个未明的问题。 研究从神经科临床中筛选脑受损区域合适的病人，进行神经影像学及神经心理学的测量，来探索上述问题的答案。研究中使用的标准测验包括：简易智能精神状态量表, 神经精神科问卷，韦氏记忆量表中国修订版，言语流畅性测验，威斯康星卡片分类测验等等。研究中还使用了实验神经心理学方法、临床访谈方法等。另外，为了本研究的需要，对国外的神经心理学相关量表进行了中国本土化的修订。 研究结果提示，基于神经解剖基础、症状、认知神经机制等方面的不同，自发性虚构可以分为三种亚型：顺行性自发虚构、逆行性自发虚构、顺行和逆行合并型自发虚构。 在认知神经机制上，一个 “what、where、when、logic and transfer模型（简称WWWLT模型）”被提出，用以解释自发性虚构的机制。 本研究编制了中国版的虚构量表，可以作为进一步研究的工具。对自发性虚构的神经解剖受损部位提出了更详细的定位，首次提出了自发性虚构的亚型分类，并且，建立了WWWLT模型，用于解释自发性虚构的认知神经机制。

Abstract: The exact neuroanatomical area for spontaneous confabulation was elusive, and the cognitive neuropsychological mechanism for it was still controversial. Furthermore, the diversity of symptoms of spontaneous confabulation suggested that it should have the subtypes. The patients who had proper brain injuries were selected with the computerized tomography and the magnetic resonance imaging from neurological departments in the hospitals. The standardized neuropsychological assessments were employed: Mini-mental state examination (MMSE), neuropsychiatric inventory (NPI), Wechsler memory scale of Chinese version (WMS-C), verbal fluency test, Wisconsin card sorting test (WCST), stroop color and word test, and so on. The experimental neuropsychological methods and clinical interviews were also carried out. The relevant foreign neuropsychological batteries were revised and employed for the Chinese patients. The results suggested that spontaneous confabulations should have three subtypes: the anterograde spontaneous confabulation, the retrograde spontaneous confabulation, and ‘the anterograde & retrograde combined spontaneous confabulation’. Furthermore, the ‘what, where, when, logic and transfer’model (WWWLT model) was suggested to explain the cognitive neuropsychological mechanisms of the subtypes of spontaneous confabulation. The Chinese confabulation battery which was constructed in the research could be a useful instrument for the further study. The exact neuroanatomical areas for spontaneous confabulation were defined. The subtypes of spontaneous confabulation were suggested firstly, and the WWWLT model was made to explain the three subtypes.