脑白质疏松患者情绪记忆的初步观察

A primary study on the emotional memory in patients with leuloaraiosis

目的研究脑白质疏松（LA）患者的情绪记忆改变，初步探讨不同情绪效价对LA患者记忆损害的特点及可能的神经机制。方法使用不同效价的情绪图片学习一再认任务，对24名LA患者（LA组）和24名同期就诊的健康对照者（HC组）进行情绪记忆测试。结果在学习阶段，与HC组情绪图片的负性成绩评分相比，LA组评分有下降[分别为HC组：（12．75±2．02）分；LA组：（11．63±1．81）分]，差异有统计学意义（火0．05）；在正性和中性成绩评分中，Hc组[正性（11．38±3．25）分；中性（12．75±2．86）分]与LA组[正性（10．42±2．30）分；中性（12．87±2．29）分]相比，差异无统计学意义（P〉0．05）。在再认阶段，LA组总情绪图片再认正确得分较Hc组明显下降[LA组：（33．67±7．10）分；HC组：（38．08±5．45）分]，差异有统计学意义（P〈0．05）；LA组对不同效价情绪图片再认存在分离现象，相比于HC组[正性（12．79±2．17）分；中性（12．08±2．59）分]，LA组在正性和中性图片再认[正性（11．04±2．40）分；中性（10．42±2．93）分]中，正性和中性情绪图片再认正确得分显著下降，差异有统计学意义（P〈0．05）；而两组负性图片再认[LA组：（13．20±1．86）分；HC组（12．20±2．65）分]，差异无统计学意义（P〉0．05）。学习阶段，负性成绩评分与脑白质疏松严重程度呈负相关（r=-0．308，P=0．033）；再认阶段．总情绪图片再认正确得分、正性以及中性情绪图片再认正确得分与脑白质疏松的严重程度亦呈负相关（r=-0．308，P=0．033；r=-0．426，P=0．003；r=-0353，P=0．014）。结论LA患者存在情绪记忆损害，且病变越严重情绪记忆损害越严重，主要表现为负性情绪评估、正性和中性情绪记忆受损，而负性情绪记忆相对保留，提示LA患者对不同效价情绪记忆的影响可能依赖不同的神经机制。

Objective To investigate the emotional memory characteristic in patients with leuloarai- osis （LA） and explore the neurobiological mechanisms through observing the changes of emotional memory. Methods Different valence images （including positive, neutral and negative pictures） were used to test twenty-four patients with Leuloaraiosis （ LA group） and twenty-four healthy colhrols （ HC group） at the same time.The emotional memory was evaluated by the recognition of emotional pictures. Results In appraisal of the emotional pictures, there was no significant difference between patients with LA （positive （ 10.42± 2.30） and neulral （ 12.87±2.29）, respectively） and healthy controls （ positive （ 11.38 ± 3.25 ） and neutral （ 12.75±2.86）, respectively） in positive and negative appraisal （all P〉 0.05 ）. But the negative appraisal decreased between LA group （11.63± 1.81 ） and HC group （12.75±2.02） （/9〉0.05）.Compared with healthy controls （38.08±5.45）, patients with LA（33.67±7.10） showed sharply decline in the emotional images memorizing task（P〈0.05）. And the accuracy in recognizing positive and netural valence pictures in patients with LA （（ Positive（11.04±2.40） and neulral （10.42± 2.93 ）） was significantly lower than that in healthy controls （ （positive（ 12.79±2.17 ） and neutral（ 12.08±2.59 ） ） （P〈0.05）.But in negative stimulus, there was no signif- icant difference between LA group（ 13.20± 1.86）and HC group（ 12.20±2.65 ） （P〉0.05）.In addition the total correct recognition, positive and neutral valence in pictures recognition were negativly correlated with the se-verity of white matter lesions in the LA patients group （ r = - 0.308, P= 0.033 ; r = - 0.462, P = 0.003 ; r = -0.352, P=0.014）. Conclusion The emotional memory is impaired in patients with LA,and the degree of damage is aeeompornied with the severity degree of LA.The emotional memory for positive and neutral van- lenee pictures is impaired but the emotional memory for neutral is relatively reserved in patients with LA in pictures recognition phase.It suggests that impaired emotional memory with different valences may be related to different neuromeehanisms.