高海拔低氧环境与工作记忆损伤
记忆相关脑区对缺氧特别敏感。通过对动物缺氧实验和人类临床缺氧病例(如,慢性阻塞性肺病、阻塞性睡眠呼吸暂停综合征)的观察发现,缺氧会导致海马、小脑和边缘系统损伤[21]。急性高海拔暴露影响记忆功能,包括工作记忆、短时记忆和长时记忆。Garrido与同事(1995)分别在海拔3 750 m、4 400 m和8 000 m报告了与急性高原反应(AMS)相关的脑水肿和短暂广泛性记忆障碍的个案。在海拔5 000 m,35天的登山过程中,Nelson(1982)发现20名登山者空间记忆改变,Crow和Kelman(1971)在也发现了86名被试明显的短期记忆损伤。在自由回忆任务中,72名飞行员在不同海拔高度执行无线电传呼任务,记忆损伤发生在海拔4 545 m处,说明高海拔对记忆有更高的要求[22]。Virués-Ortega等人(2002)采用数字广度任务在海拔4 800 m和4 600 m处发现了短期记忆损伤。在高海拔环境下(4 500 m和5 050 m)成年人(29~37岁)出现词语序列回忆困难,尤其对先出现的词语回忆更加困难[23]。
Yan等人(2011)用fMRI测查了生长在高海拔的汉族人的空间工作记忆,高海拔组的平均反应时比低海拔组略长,但在精确性方面两组无差异。与空间工作记忆有关的脑区在两组均有激活。高海拔组左侧枕中回激活下降,而左侧锥体和左颞上回的激活增加。尽管高海拔组前额叶的灰质体积下降,但是额叶BOLD信号没有显著下降,这表明高海拔组更大范围地利用了额叶,维持了更高的注意水平。高海拔组小脑锥体和颞叶的激活增加,表明高海拔组在完成空间工作记忆任务时利用了更多注意资源,以维持更高的注意水平来补偿视觉空间结构的缺损。
工作记忆是信息临时加工的中转站,它容量有限,但是与众多认知功能关系密切,它是知觉、长时记忆和动作之间的接口,是思维过程的基础。高海拔缺氧对工作记忆影响的研究可以帮助我们更好地了解在高海拔缺氧环境下认知功能的改变。目前,空间和言语工作记忆受高海拔影响的机制还不明确,所以我们采用反映工作记忆刷新功能的n-back范式和反映工作记忆保持能力的延迟匹配范式对高海拔地区的移居者进行系统研究,探索高原低氧环境对言语和空间工作记忆的刷新和保持功能的影响,并通过对三个海拔地区的世居居民的研究来确定高海拔造成认知功能损伤的海拔阈限。(https://www.daowen.com)
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