癫痫患者共情和情绪识别能力的神经心理学研究

发布时间：2018-06-11 13:43

本文选题：癫痫 + 脑电描记术　；参考：《安徽医科大学》2015年硕士论文

【摘要】：目的共情能力和情绪加工作为社会认知神经科学的重要组成部分,在人类社会交往和人际活动中扮演重要角色,对其研究有助于理解在复杂多变的环境下人脑的活动机制。当前有关癫痫的认知神经心理学研究表明,癫痫患者不仅在非社会认知成分如记忆、注意、执行功能等方面受损,同时社会认知作为独立的认知成分也愈发受到关注,癫痫患者的社会功能降低已成为影响其生活质量的重要因素,同时有研究认为额叶与社会认知密切相关。本研究一方面通过对癫痫患者共情和情绪识别能力的评估,研究癫痫患者是否存在以上认知障碍,另一方面探讨造成改变的可能相关影响因素,并进一步明确额叶与社会认知的关系。方法经神经心理学背景测试筛查后采用人际反应指针量表、眼区基本和复杂情绪识别任务,分别对62例动态脑电监测示不同脑区痫样放电的癫痫患者与80例健康对照者进行情绪识别和共情能力的评估和比较。结果癫痫病人组共情总分、认知共情、观点采择、想象得分均显著低于健康对照组(分别46.39±9.74、50.99±9.97,t=-2.893,P=0.004;23.31±7.10、27.24±6.22,t=-3.974,P=0.000;10.18±4.21、11.84±3.67,t=-2.838,P=0.005;13.13±4.46、15.40±3.84,t=-3.698,P=0.000)差异具有统计学意义;而情感共情、同情关心、个人痛苦得分与对照组相比差异均无统计学意义(P0.05)。额叶痫样放电组在共情总分、认知共情、观点采择得分上分别与额叶以外脑区痫样放电组、脑电图无异常的癫痫病人组、健康对照组相比差异都有统计学意义(P0.05),而情感共情、同情关心、个人痛苦得分在四组间差异尚不显著(P0.05)。共情得分与其他神经心理学背景测试无相关性。在眼区情绪识别得分上,癫痫组在六种眼区基本情绪识别正确数、总情绪识别正确数及眼区复杂情绪识别正确数[分别喜(19.3±2.0)分、怒(17.9±2.0)分、悲(18.1±2.3)分、恐(16.4±1.9)分、厌(17.6±2.1)分、惊(18.3±1.5)分、总基本情绪(107.7±8.1)分、复杂情绪(23.3±4.2)分]上均显著低于健康对照组[分别喜(19.9±0.2)分、怒(18.9±1.0)分、悲(19.2±1.0)分、恐(17.6±1.3)分、厌(18.6±1.2)分、惊(19.1±1.1)分、总基本情绪(113.4±3.4)分、复杂情绪(27.1±2.8)分],差异均有统计学意义(均P0.05);在男女性别判断任务上与健康对照组差异无统计学意义(P0.05)。癫痫组眼区基本情绪与眼区复杂情绪识别正相关(r=r=0.716,P=0.000)。癫痫组共情总分与眼区复杂情绪识别正相关(r=0.261,P=0.043)。结论癫痫病人存在分离性的共情障碍,认知共情损伤而情感共情保留,支持共情的两成分模型,认知共情和情感共情是可相互分离的两种成分。患者的共情能力和情绪识别所反映的心理理论能力存在关联。额叶痫样放电所致的额叶功能缺陷可能是影响癫痫患者社会认知的关键因素之一。
[Abstract]:Objective as an important part of social cognitive neuroscience, empathy and emotional processing play an important role in human social interaction and interpersonal activities. Current cognitive neuropsychological studies on epilepsy show that epileptic patients are not only impaired in non-social cognitive components such as memory, attention and executive function, but also increasingly concerned about social cognition as an independent cognitive component. The reduction of social function has become an important factor affecting the quality of life of epileptic patients, and it is believed that frontal lobe is closely related to social cognition. On the one hand, by evaluating the ability of empathy and emotion recognition in epileptic patients, we study whether the above cognitive impairment exists in epileptic patients, on the other hand, we discuss the possible related factors that cause the changes. The relationship between frontal lobe and social cognition was further clarified. Methods after neuropsychological background screening, interpersonal reaction pointer scale was used to identify basic and complex emotion in eye area. The emotional recognition and empathy ability of 62 epileptiform discharges in different brain regions and 80 healthy controls were evaluated and compared. Results the scores of total empathy, cognitive empathy, viewpoint selection and imagination in epileptic patients group were significantly lower than those in the healthy control group (46.39 卤9.74g / 50.99 卤9.97t ~ (-2.893) P 0.004t ~ (-2.893) P 0.004 ~ 23.31 卤7.1022 ~ 27.24 卤6.22 ~ t ~ (-3.974) P 0.00010.18 卤3.671 ~ (11.84) 卤3.637 ~ (th) P 0.00513.13 卤4.4615.40 卤3.84t ~ (-3.698t) P ~ (0.000), and the difference was statistically significant between the two groups. There was no significant difference in individual pain score between the two groups (P 0.05). There were significant differences in the total score, cognitive empathy, and point of view between the frontal lobe epileptiform discharge group and the frontal lobe epileptiform discharge group, the epileptic patients with no abnormal EEG, and the healthy control group (P 0.05). There was no significant difference in the score of personal pain between the four groups (P 0.05). There was no correlation between empathy score and other neuropsychological background tests. In the Epilepsy group, the correct number of basic emotion recognition, the total correct number of emotion recognition and the correct number of complex emotion recognition of eye region in six kinds of eye regions were correct [19.3 卤2.0), 17.9 卤2.0), 18.1 卤2.3), 16.4 卤1.9), 17.6 卤2.1), 18.3 卤1.5) in Epilepsy group, respectively. The scores of total basic emotion (107.7 卤8.1), complex emotion (23.3 卤4.2) were significantly lower than those of the healthy control group [19.9 卤0.2), 18.9 卤1.0), 19.2 卤1.0), 17.6 卤1.3), 18.6 卤1.2), 19.1 卤1.1), 113.4 卤3.4 卤3.4), respectively. The scores of complex emotions were 27.1 卤2.8), the differences were statistically significant (all P 0.05), and there was no significant difference between male and female in sex judgment task compared with the healthy control group (P 0.05). There was a positive correlation between the basic emotion of eye area and complex emotion recognition in epileptic group. The total score of empathy in epileptic group was positively correlated with complex emotion recognition in eye area. Conclusion Epilepsy patients have separate empathy disorder. Cognitive empathy injury and emotional empathy retention support the two component model of empathy. Cognitive empathy and emotional empathy are two kinds of components that can be separated from each other. There is a correlation between the empathy ability of patients and the psychological theory ability reflected by emotion recognition. Frontal lobe dysfunction caused by epileptiform discharge may be one of the key factors affecting social cognition of epileptic patients.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R742.1

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