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Medial Temporal Lobe Atrophy is Related to Learning Strategy Changes in Amnestic Mild Cognitive Impairment

Published online by Cambridge University Press:  26 April 2019

Liling Zhang
Department of Neurology, Tianjin Medical University General Hospital, Tianjin Neurological Institute, 154, Anshan Road, Tianjin 300052, China Department of Neurology, Heji Hospital Affiliated to Changzhi Medical College, 271, Taihang East Street, Changzhi, Shanxi 046000, China
Wen-hao Sun
Department of Neurology, Tianjin Medical University General Hospital, Tianjin Neurological Institute, 154, Anshan Road, Tianjin 300052, China
Mengya Xing
Department of Neurology, Tianjin Medical University General Hospital, Tianjin Neurological Institute, 154, Anshan Road, Tianjin 300052, China
Yue Wang
Department of Neurology, Tianjin Medical University General Hospital, Tianjin Neurological Institute, 154, Anshan Road, Tianjin 300052, China
Yuanyuan Zhang
Department of Radiology, Tianjin Medical University General Hospital, 154, Anshan Road, Tianjin 300052, China
Qingna Sun
Department of Neurology, Baoding No. 1 Central Hospital, 320, Changcheng Bei Street, Baoding, Hebei 071000, China
Yan Cheng
Department of Neurology, Tianjin Medical University General Hospital, Tianjin Neurological Institute, 154, Anshan Road, Tianjin 300052, China
Chuan Shi
Psychological Assessment Center, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health, Ministry of Health (Peking University), The National Clinical Research Center for Mental Health Disorders (Peking University Sixth Hospital), 51, Hua Yuan Bei Road, Beijing 100191, China
Nan Zhang*
Department of Neurology, Tianjin Medical University General Hospital, Tianjin Neurological Institute, 154, Anshan Road, Tianjin 300052, China Department of Neurology, Tianjin Medical University General Hospital Airport Hospital, 85, Dongliu Road, Airport Economic Area, Tianjin 300308, China
Correspondence and reprint requests to: Nan Zhang, Department of Neurology, Tianjin Medical University General Hospital, 154, Anshan Road, Tianjin 300052, China. E-mail:


Objective: Deficits in the semantic learning strategy were observed in subjects with amnestic mild cognitive impairment (aMCI) in our previous study. In the present study, we explored the contributions of executive function and brain structure changes to the decline in the semantic learning strategy in aMCI. Methods: A neuropsychological battery was used to test memory and executive function in 96 aMCI subjects and 90 age- and gender-matched healthy controls (HCs). The semantic clustering ratio on the verbal learning test was calculated to evaluate learning strategy. Medial temporal lobe atrophy (MTA) and white matter hyperintensities (WMH) were measured on MRI with the MTA and Fazekas visual rating scales, respectively. Results: Compared to HCs, aMCI subjects had poorer performance in terms of memory, executive function, and the semantic clustering ratio (P < .001). In aMCI subjects, no significant correlation between learning strategy and executive function was observed. aMCI subjects with obvious MTA demonstrated a lower semantic clustering ratio than those without MTA (P < .001). There was no significant difference in the learning strategies between subjects with high-grade WMH and subjects with low-grade WMH. Conclusion: aMCI subjects showed obvious impairment in the semantic learning strategy, which was attributable to MTA but independent of executive dysfunction and subcortical WMH. These findings need to be further validated in large cohorts with biomarkers identified using volumetric brain measurements. (JINS, 2019, 25, 706–717)

Regular Research
Copyright © INS. Published by Cambridge University Press, 2019. 

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