遗忘型轻度认知功能障碍及阿尔茨海默病的社会认知研究

发布时间：2018-10-24 22:41

【摘要】：目的社会认知是指通过对社会信息的知觉分析从而理解他人的意图、想法等,同时用于指导自我的行为,是有效进行各项社会活动必不可少的一项重要技能,既往研究均表明遗忘型轻度认知功能障碍(amnestic mild cognitive impairment,aMCI)及阿尔茨海默病(Alzheimer’s disease,AD)存在社会认知功能域的损害,如面孔基本情绪识别,眼区情绪识别,风险决策等,本文拟进一步探讨aMCI及AD患者的生物运动感知能力及音乐情绪识别能力是否同样受损。方法实验一:采用时距辨别任务对17名aMCI患者及16名正常对照进行生物运动感知能力测试,包括完整和局部两个生物运动序列,分别记录两种序列主观相等点(point of subjective equality,PSE)。实验二:入选19名aMCI患者,16例AD患者,16例正常老年人,在特制的音乐播放器上分别播放能够表达快乐、平静、恐惧、悲伤四种情绪的音乐,并记录每种情绪回答的正确数。结果实验一:在完整生物运动序列的识别中,正常对照组的主观相等点(point of subjective equality,PSE)为负值(-0.50±0.51),与检验值“0”比较具有统计学差异(t=3.95;P=0.01),aMCI组的PSE值则为正值(0.08±0.41),两组间比较具有明显统计学差异(t=3.60;P=0.001);在局部生物序列识别中,aMCI组与正常对照组的PSE值均为负值,分别为(-0.10±0.35)及(-0.20±0.31),两者间比较无统计学差异(t=0.86;P=0.40),且均与检验值“0”比较无统计学差异(aMCI组,t=1.18,P=0.26;NC组,t=2.52,P=0.24)。实验二:正常对照组对恐惧情绪识别的表现明显好于aMCI及AD患者组,得分分别为(7.88±1.36),(5.05±2.34)及(3.69±2.02),三组间具有明显统计学意义(F=18.70;p0.001),但aMCI及AD组间比较则无差异(p=0.115),且恐惧情绪的识别得分与总体认知水平(mini-mental state examination,MMSE)呈明显正相关(r=0.578;p0.001);而快乐、平静、悲伤三种情感识别得分组间比较均无差异(p0.05).结论实验一:aMCI患者存在生物运动视知觉的加工障碍,主要是缺乏整合形状信息的能力,但识别局部运动信息的能力(运动的速度及轨迹等信息)仍然保存,这可能是患者社会交往能力下降的一个重要的潜在原因,根据视知觉加工的等级神经模型,可以推测在疾病的aMCI阶段,形状通路同样受损。实验二:aMCI及AD患者仍保存着对快乐、平静、悲伤音乐情绪的识别能力,但恐惧情绪的识别能力则明显受损,这可能与杏仁核的体积过早的发生萎缩或者功能发生异常,而控制其它情绪加工的脑区则相对完整有关,且总体认知水平的下降可能恐惧情绪识别受损的另一个潜在原因。
[Abstract]:Objective Social cognition refers to the understanding of other people's intentions and ideas through the perceptual analysis of social information, and the behavior used to guide oneself, which is an essential and important skill for the effective conduct of social activities. Previous studies have shown that amnesia mild cognitive impairment (amnestic mild cognitive impairment,aMCI) and Alzheimer's disease (Alzheimer's disease,AD) have impairment of social cognitive function domain, such as facial basic emotion recognition, eye area emotion recognition, risk decision making, etc. The purpose of this study was to explore whether the ability of motor perception and musical emotion recognition in patients with aMCI and AD were also impaired. Methods: in experiment 1, 17 patients with aMCI and 16 normal controls were tested with time distance discrimination task, including complete and local motion sequences, and recorded the subjective equal point (point of subjective equality,PSE of the two sequences. Experiment 2: 19 patients with aMCI, 16 patients with AD and 16 normal elderly were selected to play music on the special music player that could express four emotions: happiness, calm, fear and sadness, and recorded the correct number of responses to each emotion. Results experiment 1: in the recognition of complete biological motion sequences, The subjective equal point (point of subjective equality,PSE of the normal control group was negative (-0.50 卤0.51), which was significantly different from that of the test value "0" (the PSE value of the), aMCI group was positive (0.08 卤0.41), and there was significant difference between the two groups (t = 3.60, P 0.001), and in the recognition of local biological sequence, there was a significant difference between the two groups. The PSE values of aMCI group and normal control group were all negative. They were (-0.10 卤0.35) and (-0.20 卤0.31), respectively. There was no statistical difference between the two groups (t = 0.86, P < 0.40), and there was no significant difference compared with the test value "0" (aMCI group, t = 1.18, P ~ (0.26) N ~ +, t ~ (2.52) P ~ (0.24). Experiment 2: the normal control group had a better performance on the recognition of fear emotion than the patients with aMCI and AD. The scores of aMCI and AD were (7.88 卤1.36), (5.05 卤2.34) and (3.69 卤2.02), respectively, but there was no significant difference between aMCI group and AD group (p0.115). There was no difference among the three groups (p0.05). Conclusion experiment 1: aMCI patients have the processing obstacle of biological motion perception, mainly lack the ability to integrate shape information, but the ability of recognizing local motion information (such as speed and track of movement) is still preserved. According to the hierarchical neural model of visual perception processing, it can be inferred that the shape pathway is also impaired in the aMCI stage of the disease. Experiment two: patients with aMCI and AD still retain the ability to recognize the musical emotions of happiness, calm and sadness, but the ability of recognition of fear emotions is significantly impaired, which may be associated with premature atrophy or abnormal function of the amygdala. The brain regions that control other emotional processes are relatively intact, and a decline in the overall cognitive level may identify another underlying cause of impairment.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.16

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