目的：除了記憶上的缺損外，迷路也是許多早期阿茲海默氏症患者 (Alzheimer disease , AD) 的初發症狀之一。過去研究認為，認路至少有以自我中心和他中心兩種以上的認路策略。他中心認路策略是指，個體在特定環境下經過數次的認路學習後，會形成該環境的認知地圖，並可將其運用於認路上。本研究想探討早期AD患者認知地圖的存在情形與將其應用在虛擬環境認路中的表現。

方法：我們邀請早期輕微的AD患者與正常控制組 (Normal controls, NC) 參與研究，透過紙筆式測驗評估受試者對於其住家周圍熟悉環境的認知地圖，並使用虛擬環境軟體 (computer-generated arena, C-G Arena) 測量受試者在新環境中的學習情況，最後將認知地圖應用在模擬熟悉環境關係中測量受試者的運用。

結果：共有十九位早期AD患者與十八位NC組完成本實驗，在測量認知地圖的紙筆式測驗中，兩組的表現並無差異。而在虛擬的新環境學習與舊環境應用中，AD組在找到目標的時間較NC組長，但在移除目標的探測嘗試中，兩組在目標象限中徘徊的比例則無差別。

結論：早期AD患者仍然保有和NC組一樣的認知地圖，並且在虛擬環境中運用認知地圖的表現結果類似，兩組在日常生活認路表現的差異，可能受到其他因素所影響。

Objective In addition to memory impairment, getting lost is among initial symptoms in patients with early Alzheimer disease (AD). At least two kinds of wayfinding strategies, egocentric and allocentric, had been proposed. It is believed that people may form a cognitive map after having navigated a specific environment for several times, and are able to use it as an aid for navigation. We investigate the cognitive maps in early AD patients and their application in a computer-generated arena (CG-Arena).

Methods We invited mild AD (CDR 0.5 & 1) patients and normal controls (NC) to participate in the current study. We used pencil-paper tests to assessed their previously formed cognitive maps of familiar environments, and C-G Arena to measure their new environment learning as well as the application of the old map.

Results Nineteen patients (female 8, mean age 67.6 years old, education 9.7 years, and MMSE 24) and eighteen NCs (female 10, mean age 66.4 years old, education 8.8 years, and MMSE 27) completed the study. In the hand-drawing map part, the performance of both groups are equivalent. In the new environment learning, NCs found target faster than AD group in the third trial. As for old environment navigation experiment, AD group found target slower than the NCs did in finding target, but they had no difference in percentage of path on target quadrant.

Conclusion Early AD patients are still able to use cognitive map and keep pretty good allocentric representation of their familiar environments in C-G Arena as well as NC, the difference of daily navigation ability between two groups may contribute by other factors.

中文部分
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