| Prospective memory is a special form of memory pointing to the future.It not only plays an important role in daily life,but also plays an important part in Advanced cognitive activities.Prospective memory impairment is common in patients with mental disorders,which prevents them from successfully completing structured daily activities,thus hindering their cognitive recovery and social reintegration.Previous research on prospective memory has focused on patients with stroke,traumatic brain injury or healthy older adults,and some studies have focused on patients with schizophrenia,bipolar disorder,and other major mental disorders,the research on prospective memory impairment in patients with depression is divergent,and the research on the intervention of prospective memory in patients with depression is still at the initial stage.Therefore,it is urgent to fully understand the neural mechanism of prospective memory impairment in patients with depression,explore effective cognitive intervention methods,and promote cognitive rehabilitation.This study is divided into two parts: study 1 and study 2.In Study 1,42 patients with depression(MDD group)and 41 Healthy controls(HC)were enrolled according to DSM-5 diagnostic criteria,the event-based prospective memory and time-based prospective memory were tested by prospective memory task,in combination with1H-magnetic resonance spectroscopy(1H-MRS)technique,the brain functions of frontal lobe,cingulate gyrus and Thalamus in the two groups were examined,to analyze the relationship among prospective memory impairment,clinical features and brain dysfunction in MDD group.In study 2,43 patients with depressive episode were recruited and divided into intervention group(23 cases)and waiting group(20 cases).The cognitive function training system based on Virtual Reality(VR)was developed independently,before and after the intervention,the prospective memory task and the MCCB cognitive test were used to test the prospective memory function and the cognitive function in 7 domains of the two groups,the results of the two groups before and after intervention were compared and analyzed to explore the effective mechanism of cognitive rehabilitation training,in order to promote long-termprognosis to provide clinical evidence.Results:(1)the accuracy of event-based prospective memory in patients with depression was significantly lower than that in normal controls(p<0.01).(2)the correct rate of event-based prospective memory was negatively correlated with the severity of Depression(p<0.01).(3)the results showed that there were significant differences in NAA / CR of left frontal lobe white matter(p<0.05),Cho / CR of right cingulate gyrus and left Thalamus(p<0.01).(4)correlation between brain dysfunction of Mrs and prospective memory impairment in depressive patients: The correct rate of event-based prospective memory in MDD patients was negatively correlated with abnormal right cingulate gyrus(Cho / CR)(p<0.01),there was a significant negative correlation with Cho / CR in left Thalamus(p<0.05).(5)Using covariance analysis to analyze the prospective memory and cognitive function of the training group and the waiting group before and after the intervention,the working memory,reasoning,problem solving and total cognition of the training group were significantly improved(p<0.05),the score of event-based prospective memory in the training group was significantly higher than that in the waiting group(p<0.01).(6)the evaluation of social function before and after the intervention of the training group and the waiting group was studied by covariance analysis,the results showed that the CPFQ score and Wapi score in the training group decreased significantly(p<0.05).Conclusions:(1)There are differences in the impairment of prospective memory in patients with depression,there is impairment of event-based prospective memory,and there is no significant impairment of time-based prospective memory,it is suggested that there are different physiological mechanisms between the two kinds of prospective memory.(2)The impaired prospective memory of patients with depression is related to the severity of depression.(3)The impairment of event-based prospective memory in patients with depression is related to the dysfunction of right cingulate gyrus and left Thalamus,it can be used as clinical evidence to clarify the neural mechanism of prospective memory.(4)Using a cognitive training system based on virtual reality can improve event-based prospective memory,working memory,reasoning and problem-solving and general cognitive function in patientswith depressive episodes,and can reduce the disease to the patient daily life influence,promotes the patient to realize the cognition to heal.The results of this study are discussed and explained,which has certain theoretical significance and application value,and the shortcomings of the study and Future Research Direction are prospected. |
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