伴情感淡漠的帕金森病患者前瞻性记忆研究

A study of prospective memory in patients with Parkinson＇s disease and emotional apathy

目的 探讨伴情感淡漠的帕金森病（PD）患者前瞻性记忆损害的特征。方法 纳入自2015年1月至2017年1月在中国科学技术大学附属第一医院神经内科门诊就诊的PD患者62例，根据情感淡漠量表将PD患者分为伴情感淡漠PD组和不伴情感淡漠PD组；同时纳入与之匹配的健康被试35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组被试的神经功能状态、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、基于事件前瞻性记忆（EBPM）和基于时间前瞻性记忆（TBPM）的实验范式分别对3组被试的认知功能及前瞻性记忆进行评定，比较3组被试在上述测量评分中的差异。同时采用相关分析观察3组被试前瞻性记忆与神经心理学评分之间的相关性。结果 （1）神经心理学测验结果提示，与健康对照组比较，2组PD患者MoCA评分均显著降低，HAMA和Stroop测验评分均显著增加，差异均有统计学意义（P〈0.05）。伴情感淡漠PD组HAMD、Stroop测验和数字连线任务评分显著高于不伴情感淡漠PD组，差异均有统计学意义（P〈0.05）。（2）EBPM任务中，伴情感淡漠PD组得分显著低于不伴情感淡漠PD组，且2组PD患者得分均低于健康对照组，差异均有统计学意义（P〈0.05）。TBPM任务中，伴情感淡漠PD组得分显著低于不伴情感淡漠PD组和健康对照组，差异均有统计学意义（P〈0.05）。（3）相关分析结果显示，伴情感淡漠PD组患者的EBPM评分与HAMD评分、Stroop测验和数字连线任务评分呈负相关关系（r=-0.352，P=0.048；r=-0.515，P=0.003；r=-0.524，P=0.002）。结论 伴情感淡漠的PD患者前瞻性记忆损害较不伴情感淡漠的PD患者更严重，情感淡漠对前瞻性记忆存在影响。

Objective To investigate the characteristics of prospective memory in patients with Parkinson＇s disease （PD） and emotional apathy.Methods Included in this study were 62 PD patients who had sought medical attention at our department from January 2015 to January 2017. They were divided into an emotional apathy group and a normal emotion group according to the emotional indifference scale. Also included in this study were another 35 healthy controls matched for demographic data. Their neurological function status, severity of illness and demographic data were assessed using the Unified Parkinson＇s Disease Rating Scale and the General Questionnaire. The neuropsychological tests and experimental paradigms of event-based prospective memory （EBPM） and time-based prospective memory （TBPM） were used to assess their cognitive function and prospective memory. Comparisons were done between the 3 groups in the above measurements.Results （1） Neuropsychological tests demonstrated that the 2 groups of PD patients had significantly lower MoCA scores and significantly higher HAMA and Stroop scores than the healthy control group （P〈0.05）. The emotional apathy group had significantly higher HAMA, Stroop and digit span test （DST） scores than the normal emotion group （P〈0.05）. （2） In EBPM task, the emotional apathy group scored significantly lower than the normal emotion group and the 2 groups of PD patients scored significantly lower than the healthy control group （P〈0.05）. In TBPM task, the emotional apathy group scored significantly lower than the normal emotion group and the healthy control group （P〈0.05）. （3） The correlation analysis showed that the EBPM scores were negatively correlated with the HAMD, Stroop and DST scores in the emotional apathy group （r=-0.352, P=0.048; r=-0.515, P=0.003; r=-0.524, P=0.002）.Conclusion Prospective memory impairment may be more severe in PD patients with emotional apathy, suggesting an impact of their emotional apathy on their prospective memory.