帕金森病患者的社会认知功能损害的研究

A study of social cognition deficits in patients with parkinson disease

目的通过对帕金森病（parkinsondisease，PD）患者社会认知情况的研究，探讨PD患者是否存在社会认知能力下降，进一步验证基底节参与社会认知加工的假说。方法选取确诊的PD患者30例（服用美多巴0．5～3年）和年龄、教育程度相匹配的健康成人36例，采用非言语的（眼区情绪识别）和言语的（失言觉察）社会信息感知测验，对其社会认知能力进行神经心理学研究。结果PD组与对照组在失言觉察总分上的差异有统计学意义（PD组，对照组分别为：27．03±6．11，36．89±3．81，Z=一5．79，P〈0．001），提示PD患者的心理状态的理解能力低于正常人；而PD组的眼区情绪识别能力与对照组的差异无统计学意义，可能与美多巴的替代治疗有关（PD组，对照组喜、惊、恐、悲、厌、怒的正确识别得分分别为：19．33±1．06，17．90±1．90，15．67±2．45，16．23±2．60，15．80±2．07，15．93±2．80；19．22±0．87，17．80±1．45，15．36±1．76，16．27±2．08，15．94±1．80，15．97±1．82；Z分另0为-0．85，-0．67，-0．42，-0．19，-0．39，-0．23；P分另0为0．395，0．500，0．676，0．850，0．694，0．820）。Pearson相关分析显示，Hoehn-Yahr分级与眼区情绪识别中的6种基本情绪、失言觉察任务得分均无明显相关性（均有P〉O．05）。结论PD患者存在社会认知功能损害，PD的主要病变在基底节，提示基底节参与了社会认知的加工。

Objective To explore the relationship between social cognition and social functioning of parkinson disease, and to test the hypothesis that the basal ganglia is involved in the network of social cognition. Methods 30 PD patients and 36 age- and education-matched healthy controls were enrolled in the social cognition tests. Social cognition abilities were measured with two neuropsychological tasks： eye emotion recognition （happy, surprise, fear, sad, disgust, anger） and faux pas recognition task. Results Patients with parkinson diseases showed a large and highly significant deficit in the faux pas task （PD, Controls： 27.03 ＋ 6.11,36.89 ＋ 3.81, Z = - 5.79, P 〈0.001 ）. There was no significant difference between parkinson diseases group and control group in eye emotion recognition （happy, surprise, fear, sad, disgust, anger： Z = - 0.85, - 0.67, - 0.42, - 0.19, - 0.39, - 0.23, P = 0. 395,0. 500,0. 676,0. 850,0. 694, 0. 820, respectively）. Correlation analysis revealed no relation among Hoehn-Yahr stage, eye emotions and faux pas. Conclusions The results confirm that there are deficits of social cognition in parkinson diseases, and the basal ganglia may play an important role in social cognition.