The Concept of Psychological Syndrome Analysis (Vygotsky-Luria-Zeigarnik School) in the Study of Neurodinamic and Motivational Impact on Memory Efficiency in Elderly Patients with Essential HypertensionстатьяТезисы
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Дата последнего поиска статьи во внешних источниках: 8 января 2017 г.
Аннотация:Background.
Vascular (or subcortical) dementia is most frequent among the patients with essential hypertension (EH). Memory disorders, especially that embracing current events, without clinically apparent signs of amnesia, is a distinctive feature of this type of dementia. The worst impact reveals itself in active reproduction of material, while the more elementary recognition stays relatively undamaged. Present research aims to assess the role of neurodinamic and motivational factors on memory efficiency in elderly EH patients.
Methods.
The assessment of memory embraced an investigation into qualitative features of cognitive processes with Luria's neuropsychological assessment scheme (Luria, 1980) and Zeigarnik’s procedure of pathopsychological study (Zeigarnik, 1972).
25 patients with EH took part in the study, stage 1-2, mean age was 67.6±6.1. Antihypertensive therapy with a fixed dose combination of amlodipine 5 mg/lisinopril 10 mg (with dose titration if necessary) was prescribed for all of them during 24 weeks.
Results.
Study of the short-term memory revealed a degradation of capacity for memorization (68 % of the patients), contraction of reproduction volume (48%) and retardation of memory traces with interfering impacts (54%). Data of the first and second examination, when compared, indicate reliable quantitative decrease of paraphasias (56% vs 32%; p<0.05) and contaminations (16% vs 12%; р<0.05), and improvement in the quality of memorization (32% vs 52%; р<0.05).
The study of mediated memorization (the “Pictogram” method) showed that only 16% of participants reproduced 75% of the material correctly. Efficiency in reproduction of emotionally negative stimuli turned out to be 2.5 times lower than reproduction of emotionally neutral ones. At that, we revealed no direct correlation between degradation of reproduction and cognitive complexity of the stimulus (r=0.27, p˃0.05).
But there was revealed a positive correlation between degradation of reproduction and decline in motivation of the patients (r=0.44, р<0.01).
Discussion.
It is mostly decline in the level of energetic and neurodynamic maintenance of mental activity that lies at the heart of such memory derangements; it is caused by poor functioning of deep brain structures (Luria, 1974; Korsakova, Moskovichyute, 2003). However, correlation analysis data show the interconnection between frequency of motivation disturbances and frequency in occurrence of various signs of memory decline, such as low efficiency in memorization (r = 0.39, р<0.01). and delayed recall (r = 0.46, р<0.001).
Conclusion.
The data provide a strong arguments to support the hypothesis of particular importance of motivational factor (along with the neurodynamic one) in memory efficiency in elderly EH patients.