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伴情感淡漠的帕金森病患者决策能力的研究*
杨静,王国平,汤其强
0
(中国科学技术大学附属第一医院神经内科)
摘要:
【摘要】 目的 探讨伴情感淡漠的帕金森病(PD)患者在风险不明确条件下的决策能力变化。 方法 纳入自2015年1月~2017年1月在中国科学技术大学附属第一医院神经内科病房住院的PD患者58例,根据情感淡漠量表将PD患者分为伴情感淡漠PD组(AP组)30例和不伴情感淡漠PD组(non—AP组)28例;同时纳入与之匹配的健康被试30例作为健康对照组。采用统一PD评定量表(UPDRS)及一般情况调查表对3组的神经功能状态、病情严重程度及人口学资料进行评估,应用神经心理学背景测试、爱荷华博弈任务(IGT)的实验范式分别对3组的认知功能及决策功能进行评定。比较3组上述测量评分。 结果 与健康对照组比较,AP组和nonAP组MoCA评分、额叶流畅性显著降低,而HAMA评分显著增加(P<0.05)。AP组HAMD评分高于健康对照组和non—AP组,数字广度倒背评分、再认记忆低于健康对照组和non—AP组,AP组延迟记忆评分低于健康对照组(P<0.05)。AP组和nonAP组患者在风险不明确条件下的IGT任务净得总分均低于健康对照组,AP组患者在风险不明确条件下的决策能力总净得分低于non—AP组和健康对照组(P<0.05)。结论 伴情感淡漠的PD患者在风险不明确条件下的决策功能受损明显,其机制可能与腹内侧前额叶皮层环路的功能受损相关。
关键词:  情感淡漠  帕金森病  神经功能  认知障碍  决策
DOI:
基金项目:国家自然科学基金面上项目(81573807)
The study of decision making under ambiguity in patients with emotional apathy for Parkinson′s disease
YANG Jing,WANG Guoping,TANG Qiqiang
(Department of Neurology, The First Affiliated Hospital of University of Science and Technology of China)
Abstract:
【Abstract】 Objective To investigate the ability of decision making under ambiguity condition in patients with emotional apathy for Parkinson′s disease. Methods 58 PD patients were included in the neurology ward of the first affiliated hospital of USTC From January 2015 to January 2017. According to the emotional apathy scale, PD patients were divided into PD group (30 cases) and nonAP group (28 cases). At the same time, 30 age and gender matched healthy controls were included in the present study.Neuropsychological background test and Iowa game task (IGT) experimental paradigm were used to evaluate the cognitive function and decisionmaking function under ambiguity, and the differences of the three groups in the above measurement scores were compared. Results Compared with the healthy control group, the MOCA score and frontal lobe fluency of AP group and non AP group decreased significantly, while the HAMA score increased significantly (P<0.05). The scores of HAMD in AP group were higher than those in healthy control group and non AP group. The scores of digit span reverse back and recognition memory were lower than those in HC group and non AP group. The scores of delayed memory in AP group were lower than those in HC group(P<0.05). The total score of IGT task in AP group and non AP group was lower than that in healthy control group, and the total score of decisionmaking ability in AP group was lower than that in non AP group and healthy control group (P<0.05). Conclusion The decisionmaking function of PD patients with emotional apathy is impaired obviously under the condition of uncertain risk, and the mechanism may be related to the functional impairment of ventromedial prefrontal cortex loop.
Key words:  Emotional apathy  Parkinson′s disease  Neural function  Cognitive impairment  Decision making under ambiguity

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