Prostorová orientace při fyziologickém a patologickém stárnutí

Spatial Navigation in Physiological and Pathological Ageing

Spatial navigation is a process of determining and maintaining a course or trajectory from one place to another. There is a mild progressive decline of spatial navigation in the course of physiological ageing. Nevertheless, severe spatial navigation deficit might be the first sign of incipient Alzheimer’s disease at the stage of mild cognitive impairment, before the full dementia syndrome develops. Patients with mild cognitive impairment with memory deficit of hippocampal type, manifested by encoding and retrieval impairment, are at very high risk of Alzheimer’s disease. These patients have the same pattern of spatial navigation impairment as patients with mild Alzheimer’s disease. Spatial navigation testing in older patients and a development of computerized tests for routine clinical use thus represent a possibility to further investigate this cognitive domain as well as an opportunity of an early diagnosis of Alzheimer’s disease. Spatial navigation in humans is of great significance for translational research as spatial navigation tests form a major part of basic cognitive research and are also used in preclinical testing of cognitive drugs in laboratory animals.

Key words:
spatial navigation – physiological ageing – pathological ageing – mild cognitive impairment – Alzheimer’s disease

Autoři: I. Gažová; K. Vlček; Z. Nedělská; I. Mokrišová; E. Hynčicová; J. Laczó; J. Hort
Působiště autorů: Kognitivní centrum, Neurologická klinika, UK v Praze, 2. LF a FN v Motole, Praha ¹; Mezinárodní centrum klinického výzkumu, FN u sv. Anny v Brně ²; Oddělení neurofyziologie paměti, Fyziologický ústav AV ČR ³
Vyšlo v časopise: Cesk Slov Neurol N 2012; 75/108(4): 411-414
Kategorie: Přehledný referát

Souhrn

Prostorová orientace je schopnost určování a udržování trasy z jednoho místa do druhého. V průběhu fyziologického stárnutí dochází k postupnému mírnému zhoršování prostorové orientace. Nicméně výrazné postižení prostorové orientace může být první známkou počínající Alzheimerovy choroby, ještě před plným rozvojem syndromu demence, ve stadiu mírné kognitivní poruchy. Především pacienti, kteří mají velmi vysoké riziko rozvoje Alzheimerovy choroby, pacienti s mírnou kognitivní poruchou s postižením paměti hipokampálního typu projevující se poruchou ukládání a vybavování informací mají výrazně porušenu prostorovou orientaci podobného charakteru jako pacienti s lehkou Alzheimerovou chorobou. Testování prostorové orientace u starší populace a vývoj počítačových testů pro rutinní klinické použití tedy představují nejen možnost dále prozkoumat tuto kognitivní doménu, ale zejména možnost velmi časné diagnostiky Alzheimerovy choroby. Jelikož velká část základního výzkumu kognice a preklinického zkoušení kognitiv u laboratorních zvířat je prováděna testy prostorové kognice, má výzkum prostorové orientace u lidí velký význam i z hlediska translačního výzkumu.

Klíčová slova:
prostorová orientace – fyziologické stárnutí – patologické stárnutí – mírná kognitivní porucha – Alzheimerova choroba

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