{"id":8907,"date":"2020-12-11T23:14:35","date_gmt":"2020-12-11T20:14:35","guid":{"rendered":"http:\/\/blog.ulubat.org\/?p=8907"},"modified":"2020-12-11T23:14:37","modified_gmt":"2020-12-11T20:14:37","slug":"istem-disi-bellek-demans-tedavisinde-yeni-bir-yaklasim","status":"publish","type":"post","link":"https:\/\/blog.ulubat.org\/index.php\/genel\/istem-disi-bellek-demans-tedavisinde-yeni-bir-yaklasim\/","title":{"rendered":"\u0130stem D\u0131\u015f\u0131 Bellek: Demans Tedavisinde Yeni Bir Yakla\u015f\u0131m"},"content":{"rendered":"\n<p class=\"has-drop-cap\"><em>Bu yaz\u0131da hep birlikte Danimarka\u2019n\u0131n Aarhus kentinde yer alan, Alzheimer hastalar\u0131na \u00f6zel tasarlanm\u0131\u015f \u2018House of Memories\u2019 e do\u011fru bir yolculu\u011fa \u00e7\u0131kacak, bu yolculuk esnas\u0131nda House of Memories\u2019in ortaya \u00e7\u0131k\u0131\u015f hikayesinin arkas\u0131nda yatan \u0130stem D\u0131\u015f\u0131 Bellek (Involuntary Memory) kavram\u0131n\u0131 yak\u0131ndan tan\u0131maya \u00e7al\u0131\u015faca\u011f\u0131z.<\/em> <\/p>\n\n\n\n<p>House of Memories, Aarhus\u2019taki The Old Town Museum\u2019un bir par\u00e7as\u0131 olarak sadece Alzheimer hastalar\u0131na hizmet vermekte. Buras\u0131, 1950\u2019li y\u0131llarda orta s\u0131n\u0131f bir ailenin evinde olabilecek e\u015fyalarla d\u00f6\u015fenmi\u015f; bu d\u00f6nemi \u00e7a\u011fr\u0131\u015ft\u0131ran kokularla, m\u00fcziklerle hatta m\u00fcze \u00e7al\u0131\u015fanlar\u0131n\u0131n katk\u0131lar\u0131yla ortaya \u00e7\u0131kan baz\u0131 mizansenlerle zenginle\u015ftirilmi\u015f bir ev. 1950\u2019li y\u0131llara ait ortam\u0131n canland\u0131r\u0131lmak i\u00e7in uygun bulunmas\u0131n\u0131n sebebi ise Alzheimer hastalar\u0131n\u0131n genellikle 20\u2019li ya\u015flar\u0131na dair an\u0131lar\u0131 daha iyi koruduklar\u0131n\u0131n bilimsel ara\u015ft\u0131rmalarla ortaya \u00e7\u0131kar\u0131lmas\u0131. M\u00fczenin tasar\u0131m\u0131 i\u00e7in Alzheimer hastalar\u0131n\u0131n a\u011f\u0131rl\u0131kl\u0131 olarak i\u00e7inde oldu\u011fu ya\u015f grubu g\u00f6z \u00f6n\u00fcnde bulundurulup bu d\u00f6nem se\u00e7ilmi\u015f. M\u00fczeyi ziyaret eden hastalar\u0131n, gen\u00e7lik d\u00f6nemlerini an\u0131msatacak uyaranlar sayesinde \u0130stem D\u0131\u015f\u0131 Bellek arac\u0131l\u0131\u011f\u0131 ile an\u0131lar\u0131n\u0131 daha kolay hat\u0131rlayabilmelerini sa\u011flamak ama\u00e7lanm\u0131\u015f. Peki \u0130stem D\u0131\u015f\u0131 Bellek nedir, neden Alzheimer\u2019\u0131n tedavisinde bizlere yard\u0131mc\u0131 olabilece\u011fi d\u00fc\u015f\u00fcn\u00fclm\u00fc\u015ft\u00fcr?<\/p>\n\n\n\n<figure class=\"wp-block-image is-resized\"><img loading=\"lazy\" src=\"https:\/\/upload.wikimedia.org\/wikipedia\/commons\/thumb\/c\/c3\/Den_Gamle_By%2C_Aarhus%2C_Denmark_52.jpg\/800px-Den_Gamle_By%2C_Aarhus%2C_Denmark_52.jpg\" alt=\"\" width=\"527\" height=\"703\" \/><figcaption>KAYNAK: commons.wikimedia.org<\/figcaption><\/figure>\n\n\n\n<h3>\u0130stem D\u0131\u015f\u0131 Bellek Nedir?<\/h3>\n\n\n\n<p>Hepimizin bazen koklad\u0131\u011f\u0131m\u0131z eski bir parf\u00fcm, bazen de kar\u015f\u0131la\u015ft\u0131\u011f\u0131m\u0131z bir \u00e7ocukluk oyunca\u011f\u0131m\u0131z sayesinde aniden ge\u00e7mi\u015fteki spesifik bir an\u0131m\u0131za s\u00fcr\u00fcklendi\u011fimiz olmu\u015ftur. Haf\u0131zan\u0131n bir alt tipi olan bu kavram; g\u00fcnl\u00fck hayatta rastlad\u0131\u011f\u0131m\u0131z bu uyaranlar\u0131n, biz herhangi bir bilin\u00e7li geri \u00e7a\u011f\u0131rma davran\u0131\u015f\u0131nda bulunmadan haf\u0131zam\u0131z\u0131n tozlu raflar\u0131ndan kar\u015f\u0131m\u0131za baz\u0131 an\u0131lar\u0131m\u0131z\u0131 \u00e7\u0131karmas\u0131 durumunu tan\u0131mlamak i\u00e7in kullan\u0131l\u0131r. \u0130stemli Bellek \u00fczerine bir\u00e7ok \u00e7al\u0131\u015fma yap\u0131lm\u0131\u015f olsa da \u0130stem D\u0131\u015f\u0131 Bellek biraz daha az \u00e7al\u0131\u015f\u0131lm\u0131\u015f bir alan olarak kar\u015f\u0131m\u0131za \u00e7\u0131kmaktad\u0131r. Yap\u0131s\u0131 itibariyle, \u0130stem D\u0131\u015f\u0131 Bellek\u2019in ne zaman aktive olaca\u011f\u0131n\u0131 \u00f6ng\u00f6rmek g\u00fc\u00e7t\u00fcr. Bunun yan\u0131nda, ki\u015fiye \u00f6zel uyaranlarla ortaya \u00e7\u0131kan bir kavram oldu\u011fu ger\u00e7e\u011fi g\u00f6z \u00f6n\u00fcnde bulunduruldu\u011funda; \u0130stem D\u0131\u015f\u0131 Bellek, \u00fczerine \u00e7al\u0131\u015fman\u0131n zorlu oldu\u011fu bir aland\u0131r. Bu zorlu\u011fa ra\u011fmen ara\u015ft\u0131rmalarda kullan\u0131lmak \u00fczere baz\u0131 teknikler geli\u015ftirilmi\u015ftir. \u00d6rne\u011fin, deneye kat\u0131lan bireylerin ara\u015ft\u0131rmaya y\u00f6nelik bir g\u00fcnl\u00fck tutmas\u0131 ya da anket sorular\u0131na cevap vermesi gibi y\u00f6ntemler ara\u015ft\u0131rmac\u0131lar taraf\u0131ndan tercih edilebilmektedir. Bu \u00e7al\u0131\u015fmalar sonucunda bug\u00fcne kadar \u0130stem D\u0131\u015f\u0131 Bellek ile ilgili \u00f6\u011frendiklerimizi toparlayacak olursak:<\/p>\n\n\n\n<ul><li>Bu an\u0131lar zihnimizde dilsel uyaranlar sayesinde belirebilece\u011fi gibi ses, koku, g\u00f6r\u00fcnt\u00fc benzeri duyusal uyar\u0131lar da birer tetikleyici olabilirler. Zihnimizden ge\u00e7irdi\u011fimiz ba\u011f\u0131ms\u0131z bir d\u00fc\u015f\u00fcnce ya da i\u00e7inde bulundu\u011fumuz ortam \/ bu ortamda kar\u015f\u0131la\u015ft\u0131\u011f\u0131m\u0131z bir nesne de bizi haf\u0131zam\u0131zda ge\u00e7mi\u015fe do\u011fru ani bir yolculu\u011fa \u00e7\u0131karabilir.<\/li><\/ul>\n\n\n\n<ul><li>\u0130stem D\u0131\u015f\u0131 otobiyografik haf\u0131zam\u0131z genellikle su i\u00e7mek, y\u00fcr\u00fcmek gibi otomatikle\u015fmi\u015f ve y\u00fcksek odaklanma d\u00fczeyi gerektirmeyen davran\u0131\u015flar esnas\u0131nda aktifle\u015fir.<\/li><\/ul>\n\n\n\n<ul><li>Yap\u0131lan ara\u015ft\u0131rmalar sonucu \u2018Chaining\u2019 ad\u0131 verilen bir konsept fikir ortaya at\u0131lm\u0131\u015ft\u0131r. Bu konsepte g\u00f6re \u0130stem D\u0131\u015f\u0131 Bellek\u2019in aktifle\u015fmesi ile an\u0131msad\u0131\u011f\u0131m\u0131z bir an\u0131, kendisiyle ortak noktalara sahip ba\u015fka an\u0131lar\u0131m\u0131z\u0131 da beraberinde getirebilmektedir.<\/li><\/ul>\n\n\n\n<ul><li>Mace; yapt\u0131\u011f\u0131 bir \u00e7al\u0131\u015fmada deneye kat\u0131lanlar\u0131n istem d\u0131\u015f\u0131 an\u0131lar\u0131n\u0131 2 hafta s\u00fcreyle bir g\u00fcnl\u00fc\u011fe kaydetmelerini istemi\u015f, bu s\u00fcre\u00e7te deneklerin her birine birka\u00e7 g\u00fcnde bir hayat\u0131n\u0131n spesifik bir zaman dilimi ile ilgili sorular y\u00f6neltmi\u015ftir. 2 hafta sonunda deneklere ait g\u00fcnl\u00fckleri inceledi\u011finde sorgulanan zaman dilimleri ile istem d\u0131\u015f\u0131 an\u0131lar\u0131n birbirleriyle ili\u015fkili oldu\u011funu ortaya koyarak istem d\u0131\u015f\u0131 bellek i\u00e7in ko\u015fulland\u0131rman\u0131n m\u00fcmk\u00fcn oldu\u011fu fikrini ortaya atm\u0131\u015ft\u0131r.<\/li><\/ul>\n\n\n\n<ul><li>Son y\u0131llarda baz\u0131 ara\u015ft\u0131rmac\u0131lar istemli ve istem d\u0131\u015f\u0131 belleklerin yap\u0131lar\u0131ndaki farkl\u0131l\u0131klar\u0131n beyinde uyar\u0131lan b\u00f6lgeleri ne \u015fekilde etkiledi\u011fini de merak etmeye ba\u015flam\u0131\u015flard\u0131r. Yap\u0131lan son \u00e7al\u0131\u015fmalar g\u00f6stermi\u015ftir ki bu iki haf\u0131za temel olarak ayn\u0131 yolaklar\u0131 payla\u015fsalar da dorsal frontal ve occipitotemporal b\u00f6lgeler istemli haf\u0131za faaliyetleri esnas\u0131nda daha fazla g\u00f6rev almaktad\u0131rlar. Bu alanda yap\u0131lan \u00e7al\u0131\u015fmalar hen\u00fcz emekleme d\u00f6neminde olsa da gelecekte bu farkl\u0131l\u0131klar daha s\u0131k dile getirilebilir.<\/li><li><\/li><\/ul>\n\n\n\n<figure class=\"wp-block-image is-resized\"><img loading=\"lazy\" src=\"https:\/\/cdn.pixabay.com\/photo\/2018\/04\/20\/20\/59\/mental-health-3337026_1280.jpg\" alt=\"\" width=\"534\" height=\"381\" \/><figcaption>KAYNAK: pixabay.com<br><br><\/figcaption><\/figure>\n\n\n\n<p>\u0130stem D\u0131\u015f\u0131 Bellek kavram\u0131n\u0131 irdeledikten sonra bu kavram ile\ndemans aras\u0131nda ne gibi bir ili\u015fki var gelin bir de buraya bakal\u0131m.<\/p>\n\n\n\n<p>Klinik \u00e7al\u0131\u015fmalara g\u00f6re, demans hastalar\u0131nda \u0130stem D\u0131\u015f\u0131 Bellek faaliyeti ile hastal\u0131\u011f\u0131n son evrelerine kadar ba\u015fl\u0131ca 20-30 ya\u015f aras\u0131 d\u00f6neme ait an\u0131lar olmak \u00fczere baz\u0131 an\u0131lar hat\u0131rlanabilmektedir. Her ne kadar di\u011fer kognitif faaliyetler gibi \u0130stem D\u0131\u015f\u0131 Bellek i\u015flevinin de ya\u015fla birlikte azald\u0131\u011f\u0131 ortaya konulsa da ya\u015fl\u0131 demans hastalar\u0131nda istem d\u0131\u015f\u0131 belle\u011fin istemli belle\u011fe g\u00f6re daha fonksiyonel oldu\u011fu g\u00f6r\u00fclmektedir.\u00a0 Yaz\u0131n\u0131n ba\u015f\u0131nda bahsedilen House of Memories de i\u015fte bu bilginin \u0131\u015f\u0131\u011f\u0131nda, istem d\u0131\u015f\u0131 belle\u011fi stim\u00fcle edecek \u015fekilde dizayn edilmi\u015ftir. M\u00fczenin y\u00f6neticileri bir r\u00f6portajda; eve baston ile giren hastalar\u0131n baston kullanmadan \u00e7\u0131kt\u0131klar\u0131na, y\u0131llard\u0131r konu\u015fmayan ki\u015filerin i\u00e7eride konu\u015ftuklar\u0131na defalarca \u015fahit olduklar\u0131n\u0131, bu dramatik sonu\u00e7lar\u0131n kulaktan kula\u011fa yay\u0131lmas\u0131 sayesinde bir\u00e7ok farkl\u0131 \u00fclkede buna benzer projelerin y\u00fcr\u00fcrl\u00fc\u011fe sokulmas\u0131 i\u00e7in \u00e7al\u0131\u015fmalar ba\u015flat\u0131ld\u0131\u011f\u0131n\u0131 bildirmi\u015fler. Bu ev her ne kadar ki\u015fiselle\u015ftirilmi\u015f \u00f6\u011feler bar\u0131nd\u0131rmasa da \u0130stem D\u0131\u015f\u0131 Belle\u011fin aktive edilmesi ile ba\u015fta Alzheimer olmak \u00fczere farkl\u0131 varyasyonlardaki demans hastalar\u0131n\u0131n klinik progresyonlar\u0131n\u0131n iyiye gidebilece\u011fi konusunda t\u0131p d\u00fcnyas\u0131na bir \u00f6rnek te\u015fkil etmektedir. G\u00fcn\u00fcm\u00fczde m\u00fczik ve koku kullan\u0131m\u0131 ile Alzheimer hastalar\u0131n\u0131n tedavisine destek olma \u00e7al\u0131\u015fmalar\u0131 yap\u0131ld\u0131\u011f\u0131 gibi House of Memories modelinden yola \u00e7\u0131karak m\u00fcze d\u0131\u015f\u0131nda da hastalar\u0131n rehabilitasyon s\u00fcrecine daha ki\u015fiselle\u015ftirilmi\u015f bir yakla\u015f\u0131mla \u0130stem D\u0131\u015f\u0131 Belle\u011fin stim\u00fclasyonunu entegre etmeye y\u00f6nelik \u00e7al\u0131\u015fmalar da yap\u0131lmaktad\u0131r.<\/p>\n\n\n\n<p>\u0130stem d\u0131\u015f\u0131 belle\u011fi, hala hakk\u0131nda olduk\u00e7a az bilgiye sahip oldu\u011fumuz bir kapal\u0131 kutu olarak nitelendirebiliriz. Belki de gelecekte bu alanda yap\u0131lacak \u00e7al\u0131\u015fmalar haf\u0131zan\u0131n gizemlerini ayd\u0131nlatma yolunda bize bir \u0131\u015f\u0131k olacak, demans\u0131n tedavisinde yeni bir yol a\u00e7acakt\u0131r.<\/p>\n\n\n\n<h3>KAYNAK\u00c7A<\/h3>\n\n\n\n<p>Overgaard, S. (2016, September\n13). Denmark&#8217;s &#8216;House Of Memories&#8217; Re-Creates 1950s For Alzheimer&#8217;s Patients.\nRetrieved December 10, 2020, from\nhttps:\/\/www.npr.org\/sections\/parallels\/2016\/09\/13\/493744351\/denmarks-house-of-memories-recreates-1950s-for-alzheimers-patients<\/p>\n\n\n\n<p>&nbsp;Involuntary memory. (2020, October 23).\nRetrieved December 10, 2020, from\nhttps:\/\/en.wikipedia.org\/wiki\/Involuntary_memory<\/p>\n\n\n\n<p>Involuntary autobiographical\nmemories. (n.d.). Retrieved December 10, 2020, from\nhttps:\/\/thepsychologist.bps.org.uk\/volume-26\/edition-3\/involuntary-autobiographical-memories<\/p>\n\n\n\n<p>Hyman, I., Phd. (2016). For Those\nWith Alzheimer\u2019s, a Place to Remember. Retrieved 2020, from\nhttps:\/\/www.psychologytoday.com\/us\/blog\/mental-mishaps\/201608\/those-alzheimer-s-place-remember<\/p>\n\n\n\n<p>Leggieri, M., Thaut, M. H., Fornazzari,\nL., Schweizer, T. A., Barfett, J., Munoz, D. G., &amp; Fischer, C. E. (2019).\nMusic Intervention Approaches for Alzheimer\u2019s Disease: A Review of the\nLiterature. <em>Frontiers in Neuroscience,<\/em> <em>13<\/em>.\ndoi:10.3389\/fnins.2019.00132<\/p>\n\n\n\n<p>Haj, M. E., Gandolphe, M. C., Gallouj,\nK., Kapogiannis, D., &amp; Antoine, P. (2017). From Nose to Memory: The\nInvoluntary Nature of Odor-evoked Autobiographical Memories in Alzheimer\u2019s\nDisease. <em>Chemical Senses,<\/em> <em>43<\/em>(1), 27-34. doi:10.1093\/chemse\/bjx064<\/p>\n\n\n\n<p>Hall SA, Rubin DC, Miles A, Davis\nSW, Wing EA, Cabeza R, Berntsen D. The neural basis of involuntary episodic\nmemories. J Cogn Neurosci. 2014 Oct;26(10):2385-99. doi: 10.1162\/jocn_a_00633.\nEpub 2014 Apr 4. PMID: 24702453; PMCID: PMC4149828.<\/p>\n\n\n\n<p>Mole C. (2017). Are there Special\nMechanisms of Involuntary Memory?.&nbsp;<em>Review of philosophy and psychology<\/em>,&nbsp;<em>8<\/em>(3),\n557\u2013571. <a href=\"https:\/\/doi.org\/10.1007\/s13164-016-0326-z\">https:\/\/doi.org\/10.1007\/s13164-016-0326-z<\/a><\/p>\n\n\n\n<p>Hall NM, Gjedde A, Kupers R. Neural\nmechanisms of voluntary and involuntary recall: a PET study. Behav Brain Res.\n2008 Jan 25;186(2):261-72. doi: 10.1016\/j.bbr.2007.08.026. Epub 2007 Aug 26.\nPMID: 17913256.<\/p>\n\n\n\n<p>Schlagman, Simone &amp; Kvavilashvili, Lia &amp; Schulz, Joerg.\n(2008). Involuntary Memory. (p.87,112) p10.1002\/9780470774069.ch5.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Bu yaz\u0131da hep birlikte Danimarka\u2019n\u0131n Aarhus kentinde yer alan, Alzheimer hastalar\u0131na \u00f6zel tasarlanm\u0131\u015f \u2018House of Memories\u2019 e do\u011fru bir yolculu\u011fa \u00e7\u0131kacak, bu yolculuk esnas\u0131nda House of Memories\u2019in ortaya \u00e7\u0131k\u0131\u015f hikayesinin arkas\u0131nda yatan \u0130stem D\u0131\u015f\u0131 Bellek (Involuntary Memory) kavram\u0131n\u0131 yak\u0131ndan tan\u0131maya \u00e7al\u0131\u015faca\u011f\u0131z. <\/p>\n","protected":false},"author":390,"featured_media":8913,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[1,19,165],"tags":[57,249,1493,1492,84],"acf":[],"views":650,"_links":{"self":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/8907"}],"collection":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/users\/390"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/comments?post=8907"}],"version-history":[{"count":2,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/8907\/revisions"}],"predecessor-version":[{"id":8911,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/posts\/8907\/revisions\/8911"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/media\/8913"}],"wp:attachment":[{"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/media?parent=8907"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/categories?post=8907"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.ulubat.org\/index.php\/wp-json\/wp\/v2\/tags?post=8907"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}