Brain, Vol 120, Issue 11 2039-2058, Copyright © 1997 by Oxford University Press
L Pelosi, JM Geesken, M Holly, M Hayward and LD Blumhardt
Auditory and visual event-related potentials were recorded during a
short-term memory task in 24 patients who had recently presented with
symptomatically and clinically isolated spinal cord syndromes suspected to
be due to multiple sclerosis, and in 24 matched control subjects.
Event-related potentials (ERPs) were recorded during two sequential
components of the working memory task, first the temporary active
memorizing of sets of digits and secondly, their subsequent manipulation,
namely digit-probe recognition and matching. The patients' reaction times
were slower and showed larger increments than those of the control subjects
as the number of items to be memorized was increased. The patients' ERPs
during both memorizing and probe matching/recognition phases differed
significantly from control subjects for both auditory and visual
presentations. The more marked changes were seen in a subgroup of eight
patients who had the lowest levels of performance on a battery of general
tests of memory and who also made significantly more errors in the working
memory task as the memory load increased. In this subgroup, the
abnormalities of the ERPs during recognition and matching tests occurred in
the component of the response that has been shown to be sensitive to memory
loading in healthy control subjects. This study provides objective evidence
of subclinical working memory dysfunction in patients at an early stage of
demyelinating disease, i.e. when they first present with clinically
isolated spinal cord lesions and before they have developed symptoms of
cognitive or memory dysfunction. The defect at this early stage is either
restricted to processes involved in the formation of a memory trace or,
more probably, involves both trace formation and the mechanisms that
underly recognition ('retrieval') and matching of memory traces in working
memory.
ARTICLES
Working memory impairment in early multiple sclerosis. Evidence from an event-related potential study of patients with clinically isolated myelopathy
Department of Clinical Neurophysiology, University Hospital, Queen's Medical Centre, UK.
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