脑白质疏松患者情绪记忆的初步观察

发布时间：2018-07-03 07:36

本文选题：脑白质疏松症 + 情绪　；参考：《安徽医科大学》2017年硕士论文

【摘要】：研究目的脑白质疏松(LA)作为脑小血管病的一种,受到的关注及研究越来越多,目前大量研究证实LA影响认知功能。本研究利用不同效价的情绪图片学习-再认任务比较LA患者与正常老年人的情绪记忆改变的不同,初步比较不同情绪效价对LA患者的记忆的损害特点,并进一步探究其改变可能发生的神经机制。研究方法选取2015年7月至2016年2月在安徽医科大学第三附属医院神经内科就诊的门诊及住院的LA患者(LA组)和健康对照者(HC组)各24例,分别进行头颅MRI扫描及包括简易智能精神状态量表(MMSE)、词汇流畅性测试(Verbal fluency test,VFT)、数字广度测试(digital span,DS)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAND)测试等神经心理学测试,使用情绪图片学习-再认任务对两组进行情绪记忆测试,评估其认知功能状态,并按照Fazekas的评分标准将LA严重程度分为3级(轻、中、重),分析患者认知功能损害与LA疾病严重程度的相关性。研究结果脑白质疏松患者组与健康对照组在年龄、受教育程度、神经心理背景测试差异无统计学意义(p0.05)。在学习阶段中,LA组评分情绪图片的负性成绩评分与HC组相比有下降[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(p0.05);正性和中性成绩评分中HC组[分别为:正性(11.38±3.25)分;中性(12.75±2.86)分]与LA组[分别为:正性(10.42±2.30)分;中性(12.87±2.29)分]相比,差异无统计学意义(p0.05)。在情绪记忆测试的再认阶段,与HC组相比,LA组总情绪图片再认正确得分明显下降[分别为LA组:(33.67±7.10)分;HC组:(38.08+±5.45)分],差异有统计学意义(p0.05);LA组对不同效价情绪图片再认存在分离现象,相比于HC组[分别为: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[分别为: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(p0.05);而两组负性图片再认[分别为LA组:(13.20±1.86)分;HC组(12.20±2.65)分],差异无统计学意义(p0.05)。且在学习阶段,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);在再认阶段,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)。研究结论LA患者与认知功能密切相关,LA患者的情绪记忆损害中,主要表现为负性情绪记忆相对保留,而负性情绪评估、正性和中性情绪记忆受损,且情绪记忆的损害严重程度与LA程度相关,表明不同效价情绪记忆对LA的影响依赖不同的神经机制。
[Abstract]:Objective Leukoaraiosis (LA) has attracted more and more attention as a kind of small cerebral vascular disease. A large number of studies have confirmed that LA affects cognitive function. In this study, we compared the changes of emotional memory between LA patients and normal elderly patients by using different titer emotional picture learning and recognition task, and compared the damage characteristics of LA patients with different emotional titers to the memory of LA patients. And further explore the possible neural mechanism of its changes. Methods A total of 24 LA patients (LA group) and 24 healthy controls (HC group) from July 2015 to February 2016 in Department of Neurology, third affiliated Hospital of Anhui Medical University, were selected. Cranial MRI scans and neuropsychological tests were performed, including the mini-mental state scale (MMSE), the verbal fluency test (VFT), the number span test (digital Spanta-DS), the Hamilton anxiety scale (Hama), the Hamilton Depression scale (hand), and other neuropsychological tests. Emotional picture learning-recognition tasks were used to test emotional memory in two groups to assess their cognitive function, and to classify LA severity into three levels according to Fazekas score (mild, moderate, moderate). To analyze the correlation between cognitive impairment and the severity of LA disease. Results there was no significant difference in age, education level and neuropsychological background between patients with leukoaraiosis and healthy controls (p0.05). In the study stage, the scores of negative scores of emotional pictures in group A were lower than those in group HC [(12.75 卤2.02) vs (11.63 卤1.81) in group HC, respectively], the difference was significant (p0.05), the scores of positive and neutral scores in group HC [11.38 卤3.25] were significantly lower than those in group HC (P < 0.05), but in group A (12.75 卤2.02) and group LA (11.63 卤1.81), the scores of positive score and neutral score were (11.38 卤3.25), respectively. There was no significant difference between the neutral group (12.75 卤2.86) and the LA group [positive (10.42 卤2.30); neutral (12.87 卤2.29)] (p0.05). In the recognition stage of emotional memory test, the scores of recognition accuracy of total emotional picture in LA group were significantly lower than those in HC group [LA group: 33.67 卤7.10] and HC group: 38.08 卤5.45, respectively. The difference was statistically significant (p0.05). Compared with HC group (12.79 卤2.17) and neutral (12.08 卤2.59), the scores of positive and neutral picture recognition [11.04 卤2.40; neutral (10.42 卤2.93)] decreased significantly in LA group. The difference was statistically significant (p0.05), but there was no significant difference in negative picture recognition between the two groups [LA group: (13.20 卤1.86) points vs (12.20 卤2.65) points]. At the learning stage, negative scores were negatively correlated with the severity of leukoaraiosis (r-0.308p0. 033), and at the recognition stage, the recognition scores of the total emotional pictures were correct. The scores of positive and neutral emotional picture recognition were also negatively correlated with the severity of leukoaraiosis (r = 0.308). Conclusion the emotional memory impairment of LA patients is closely related to cognitive function. The main manifestation of emotional memory impairment is negative emotional memory, but negative emotional assessment, positive and neutral emotional memory impairment. The severity of emotional memory damage was related to the degree of LA, indicating that the effect of emotional memory on LA was dependent on different neural mechanisms.
【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】：R743

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