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Associative Learning, Acquired Equivalence, and Flexible Generalization of Knowledge in Mild Alzheimer Disease

Bódi, Nikoletta MD*; Csibri, Éva MD*; Myers, Catherine E. PhD; Gluck, Mark A. PhD; Kéri, Szabolcs MD, PhD, DSc*

Cognitive and Behavioral Neurology: June 2009 - Volume 22 - Issue 2 - p 89-94
doi: 10.1097/WNN.0b013e318192ccf0
Original Studies

Background Acquired equivalence is a phenomenon in which prior training to treat 2 stimuli as equivalent increases generalization between them. Previous studies demonstrated that the hippocampal complex might play an important role in acquired equivalence associative learning. In this study, we tested the possibility that acquired equivalence learning is a sensitive marker of mild Alzheimer disease (AD).

Methods In the associative learning test, antecedent stimuli were cartoon faces and consequent stimuli were different colored cartoon fishes. Each cartoon character had some pet fish and the task was to learn these face-fish associations using feedback provided after each decision. In the transfer phase, knowledge about face-fish pairs had to be generalized to new associations.

Results AD patients exhibited mild impairments in the training phase, whereas they were profoundly impaired on the acquired equivalence test. Associative knowledge could not be transferred to a more flexible retrieval condition.

Conclusions These results suggest that acquired equivalence learning is specifically impaired in early AD, which may indicate the pathology of the hippocampal complex.

*Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary

Department of Psychology

Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark

Reprints: Szabolcs Kéri, PhD, Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest H1083, Balassa u. 6., Hungary (e-mail:

Received for publication July 23, 2008; accepted October 19, 2008

© 2009 Lippincott Williams & Wilkins, Inc.