隨著人口結構老化，阿茲海默症 (Alzheimer’s disease; AD) 病人數急速攀升。記憶力障礙是AD的核心症狀，情節性失憶尤其明顯，這是海馬迴最重要的功能之一。針對情節性記憶，Tulving (1985) 提出時間旅行與重新體驗的概念，腦照影資料顯示，後視覺區與左側海馬迴可以推斷想像與記憶痕跡之間的互動；在核心細緻化聯想階段 (elaboration)，受測者真正要想像未來或回憶過去時所活化的腦區，彼此重疊部份相當多，例如precuneus以及附近的retrosplenial cortex；而且，想像未來發生情境或預想未來的能力，不論是可能發生的現實情境或為虛構，都需要有過去的經驗做為基礎。
目的：證明早期AD病人預想個人事件的能力、站在他人角度回憶事件和想像他人虛構經驗之能力皆比同齡正常老人 (cognitively healthy control; HC) 差。
方法：以圖片激發回想或預想的索引以刺激AD病人做想像未來及逆向回憶的時光之旅。訪談內容為回憶及想像個人經驗，以Autobiographical Memory Interview的計分標準分析兩組受試者對於各個時間距離事件的想像與回憶能力，並在計算正式實驗的資料之前，各評分者與國外的研究者以及評分者之間相互比對、進行信、效度檢驗。經由錄音將資料騰成逐字稿、並分析內部成份 (internal components) 與外部成份 (external components) 以定量未來記憶，從內部成份的豐富性可以推斷受測者是否真的「身歷其境」。評分者之間的總細節量、內外部細節量(內部細節為與索引相關的情節記憶、相對地外部細節則為無關的語意記憶)，皆與其他分析者高度相關 (r=0.91)。
結果：31位AD及31位HC完成所有流程，兩組在性別 (p = .86)、年齡 (p = .76) 與教育程度 (p = .106) 皆無差異，口語表現能力表現一致，HC的神經心理學測驗表現優於AD。兩組在內外部細節量與過去未來事件的2 (groups: AD, HC)× 2 (details: int., ext.)× 2 (time directions: past, future) ANOVA分析中，兩組在各實驗之總談話量皆無差異、回憶個人事件之能力較想像未來佳 (F(1,60) = 16.59, p < .005)，且AD不論在回憶過去 (t(60) = -3.224, p < .005) 或想像未來 (t(60) = -2.083, p < .05) 的情節記憶表現皆較HC差。再者，AD站在他人角度回憶事件的表現較HC組差 (F(1,60) = 5.261, p < .05)；AD想像虛構經驗之能力與HC組未達顯著差異 (F(1,60) = 2.849, p =.097)。
討論：由談話量可知AD與HC在語言表達的能力無異。AD回憶和想像個人事件之能力皆較HC差，符合想像未來需動用過去回憶之情節性模擬假說；另外，AD回憶個人事件能力仍較想像未來佳，與先前研究發現一致。此外，AD較難站在他人角度回憶生活事件，符合回憶他人經驗相較個人事件事件涉及更高階認知歷程而易毀損之假設。而兩組想像虛構經驗未達顯著，可能與AD涉及此能力之腦區尚未損壞，或HC原較難想像虛構經驗有關。
結論：本研究止於行為測量，未來可結合大腦造影術作為證據。

As the phenomenon of an aging demographic structure reveals a senile society, the population concerned with Alzheimer’s disease (AD) increases rapidly. The prevalent core syndrome of AD is the irreversible defect of the patients memory. According to long-term pathological development of AD, the episodic memory impairment in AD patients becomes more salient than other cognitive syndromes, it is a syndrome of early stage development. In 1985, Tulving proposed the terms “mental time travel” and “re-experience”, stating that episodic memory is strongly related to the hippocampus. According to the empirical research findings of neuro-imaging imagination is a result of a stimulated index in the posterior visual cortex interacting with the memory traces in the left parahippocampus. Besides, during the core network of elaboration/fMRI, brain images show that when AD patients proceed to imaging and recalling, the activation areas in human brains overlap. For instance, the activated precuneus areas are close to the activated retrosplenial cortex. To imagine future scenarios or to obtain the ability of future imagining of actual and imaginary events, one is required to think of ones individual past experiences.
This study was aimed to test mainly hypotheses for AD patients of different pathological stages against people of normal capability. First to examine the ability to simulate personal future events; Second, recalling events from alternative perspectives, Third, imagining imaginary events. Emulating past studies that use pictures as cues to remember former events or future thinking, this study adopted the same methodology. At some points after the first trial, participants were asked to recall events from the past. After these experiments, we categorized the contents of transcripts into internal and external components.
Participants were patients with very mild (CDR 0.5) and mild AD (CDR 1.0) from an Alzheimer’s Disease Research Center and the age-/sex-matched cognitively healthy controls (HC). 31 AD patients (15 males, mean age 72, education 10 years, MMSE 23, CASI 77) and 31 HC (16 males, mean age 69, education 11 years, MMSE 27, CASI 92) completed the study. No difference was detected between those two groups in terms of basic visual perceptual, verbal fluency and listening comprehension abilities, even though AD had a poorer semantic verbal fluency.
The interviews were segmented, categorized and then rated according to the AMI procedure. Subsequent analysis on inter-rater reliability of scoring indicated high agreement (Pearson’s r = .91). The number of internal and external details were counted and summed up across the three trials for each subject. All of events were analyzed using a 2 (group, AD and HC) × 2 (temporal direction, past and future) × 2 (details, internal and external) repeated factorial ANOVA. AD patients exhibited less internal episodic details as compared with HC, in both of the personal memory recollection (t(60)= -3.224, p < .005) and personal imagination (t(60)= -2.083, p < .005) experiments. Moreover, compared to the sum of internal and external details of both groups, the result for the experiment on memory recollection is higher than for imagination (F(1,60) = 16.559, p < .005). Otherwise, the results of AD were worse than HC for recalling events from alternative perspective (F(1,60) = 5.261, p < .05). By contrast, AD showed no significant difference with HC in imagining imaginary events (F(1,60) = 2.849, p =.097).
Compared to HC, AD reproduced more external semantic details when remembering personal past as well as imagining personal future events, and less internal episodic details in both remembering and imagination. It confirmed the hypothesis of episodic simulation. Moreover, both HC and AD produced more semantic and episodic details in remembering past events than in imagining the future, indicating that imagining is more difficult than recalling. AD, are unable recalling life events from alternative perspectives. It was parallel with recalling others experiences involved higher cognitive functions that have impaired in early AD apparently. Lastly, the ability of imaging imaginary events were no different, supposed that ageing HC also experienced difficulty in imagining and those brain locations in AD were complete.
Lastly, we lack brain scans of participants to assess the extent and the loss of relevant location.

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