帕金森病患者音乐情绪认知特点及其影响因素研究

Characteristics and correlative factors of musical emotion recognition in patients with Parkiuson＇ s disease

目的探讨帕金森病患者音乐情绪认知的特点、与执行功能的关系及其影响因素。方法采用24首表达高兴、悲伤、恐惧、愤怒情绪的音乐节选对2014年1月至6月在北京医院神经内科就诊的24例帕金森病患者和24名健康对照进行测试。两组均采用一个简化了的连线测验和画钟测验进行执行功能检查。对所有患者应用Hoehn-Yahr（H-Y）分期、统一帕金森病评定量表第三部分（UPDRSⅢ）、汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）及左旋多巴等效剂量（LDE）等对临床特点进行评定。结果帕金森病患者的连线时间[（51．58±33．14）s]较对照组[（34．46±19．64）s]明显延长（t=2．178，P=0．036），中位连线错误次数[0（QL=0，QU，=2．5）]较对照组[0（QL=0，Qu=0）]明显增加（Z=-2．372，P=0．018），画钟测验分数（2．63±0．65）较对照组（2．96±0．20）明显降低（t=-2．407，P=0．023）。帕金森病组在识别高兴、悲伤、恐惧和愤怒音乐时与对照组差异没有统计学意义（均P〉0．05）。帕金森病组识别高兴、悲伤音乐情绪得分以及总分均与连线时间存在明显相关性（r=-0．560、-0．572、-0．530，P=0．004、0．003、0．008），而与年龄、病程、受教育时间、简易精神状态量表评分、UPDRSⅢ评分、H．Y分期、HAMA评分、HAMD评分、LDE、画钟测验得分和音乐背景均无明显相关性（均P〉0．05）。结论本组帕金森病患者的音乐情绪认知未受损；音乐情绪认知与执行功能之间的关系尚不确定。

Objective To investigate emotion recognition in music in patients with idiopathic Parkinson＇ s disease （ PD ） , and to further explore its relationship with executive function and related factors. Methods Twenty-four PD patients enrolled from the Department of Neurology, Beijing Hospital between January and June 2014 and 24 matched healthy controls were tested using 24 musical excerpts that expressed happiness, sadness, fear or anger. The two groups were tested for executive function using a simplified trail making test and a clock drawing test. All the patients were rated on the Hoehn-Yahr stage, the Unified Parkinson＇ s Disease Rating Scale （UPDRS） Ⅲ, the Hamilton Rating Scale for Anxiety （HAMA） and the Hamilton Rating Scale for Depression （HAMD）. Results In trail making test, PD patients worked slower （ （51.58 ±33. 14） s） than controls （ （34.46 ± 19. 64） s） （t =2. 178, P =0. 036）. PD patients got more errors （0 （ QL = 0, Qu = 2. 5 ） ） than controls （0 （ QL = 0, Qu = 0） ; Z = - 2. 372, P = 0.018 ）. In clock drawing test, PD patients got lower score （2. 63± 0. 65 ） than controls （2. 96± 0. 20） （t = - 2. 407, P = 0. 023 ）. The difference between two groups was not statistically significant in the recognition of happy, sad, fear or anger music （ all P 〉 0. 05）. In PD group, the scores of the recognition of happy, sad music and the total score of musical emotion recognition were associated with the time of trail making test （ r = - 0. 560, - 0. 572, - 0. 530, P = 0. 004, 0. 003, 0. 008 ）, while not related to age, disease duration , education duration, the scores of Minimum Mental State Examination, the scores of UPDRS 111, Hoehn-Yahr stage, the scores of HAMA, the scores of HAMD, LDE, the scores of clock drawing test or musical background （ all P 〉 0. 05）. Conclusions PD patients are not impaired in emotionrecognition in music in this study. The relationship between musical emotion recognition and executive function is unclear.