背景與目的 除了記憶和其他認知功能之退化，迷路和認人困難也是阿茲海默症 (AD) 患者的常見症狀。根據過去影像和個案研究，人類負責處理臉孔和景象之區域可能重疊或相當接近。因此，本研究以事件相關電位探討極輕度阿茲海默症患者在此二功能之退化是否平行一致，進而推論大腦之認知成分與腦部運作歷程。
方法 研究對象為極輕度阿茲海默症患者和其配偶。給受試者熟悉臉孔、陌生臉孔、熟悉景象和陌生景象的圖片，受試者看到刺激圖片後，必須判斷該圖片為熟悉或陌生，紀錄和分析受試者做作業之錯誤率、反應時間和腦波反應。事件相關電位之腦波分析則著重於N170之結構編碼歷程和N250r之熟悉感及使用儲存結構表徵歷程。
結果 共分析極輕度阿茲海默症患者20人，控制組受試者17人。P7和P8電極之N170振幅對「臉孔」特別敏感，且極輕度阿茲海默氏症病人與控制組受試者於P7和P8電極之N170振幅無差異；P3和P4電極之N170振幅對「景象」特別敏感，且極輕度阿茲海默氏症病人於P3和P4電極呈現較小的N170振幅。極輕度阿茲海默氏症病人和控制組受試者辨識臉孔和辨識景象的外顯行為錯誤率均沒有差異；但ERP於F3電極反應熟悉感和使用儲存結構表徵歷程之N250r振幅中，兩組受試者均可熟悉臉孔反應出應有的熟悉感，對陌生臉孔產生比熟悉臉孔大的N250r振幅，但極輕度阿茲海默氏症病人的N250r振幅卻未對熟悉景象反應出應有的熟悉感。
結論 人類由不同的神經機制來處理辨識臉孔和辨識景象之結構編碼，極輕度阿茲海默症病人之熟悉景象再認退化時間早於熟悉臉孔再認歷程。

Background and objective Besides amnesia and other cognitive dysfunctions, getting lost and inability to recognize people are common in patients with AD, even in the early part of the disease. Based on the fact that the brain regions responsible for face and scene recognition are overlapped, we used ERP to examine whether the deterioration in the recognition of familiar faces and scenes is unparallel in patients with very mild AD.
Methods The visual stimulate used for ERP included pictures of familiar faces, novel faces, familiar scenes and novel scenes. Participants were asked to make a judgment if the picture displayed was familiar or not. We recorded their behavioral responses as well as electrophysiological signal at the same time. We focused on N170, reflecting the structural encoding process, and N250r which reflects the stored representation and the familiarity.
Results 20 very mild AD patients and 17 normal controls completed the study. The largest N170 waves to FACES come from P7 and P8, while the largest N170 waves to SCENES are from P3 and P4, at which NC produced larger N170 than the AD group. In addition, participants had similar errors rate when judging pictures of faces and scenes as familiar or not, but failed to be detected the familiarity effect in AD patients from the N250r when familiar scenes were provided.
Conclusion The study clearly demonstrates that different neural regions are responsible for early visual process in the structure encoding of scenes and faces. As compared with face recognition, scene recognition is impaired earlier in the course of AD.

中文部分
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