帕金森病患者跨期决策能力障碍研究  

Intertemporal decision-making disorder in patients with Parkinson’s disease

作　　者：谢飞 刘秋皖 耿直 胡盼盼[3] 吴君仓[1] XIE Fei;LIU Qiu-wan;GENG Zhi;HU Pan-pan;WU Jun-cang(Department of Neurology,The Second People's Hospital of Hefei,Hefei 230011,Anhui,China;Department of Neurology,The Second Affiliated Hospital of Soochow University,Suzhou 215004,Jiangsu,China;Department of Neurology,The First Affiliated Hospital of Anhui Medical University,Hefei 230022,Anhui,China)

机构地区：[1]安徽省合肥市第二人民医院神经内科,230011 [2]苏州大学附属第二医院神经内科,215004 [3]安徽医科大学第一附属医院神经内科,合肥230022

出　　处：《中国现代神经疾病杂志》2022年第11期988-992,共5页Chinese Journal of Contemporary Neurology and Neurosurgery

基　　金：国家自然科学基金资助项目(项目编号:82171917)。

摘　　要：目的探讨帕金森病患者跨期决策能力障碍。方法纳入2020年1月至2021年8月在安徽省合肥市第二人民医院和苏州大学附属第二医院诊断与治疗的36例帕金森病患者以及性别、年龄、受教育程度相匹配的39例正常对照者,采用汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评价焦虑和抑郁症状,简易智能状态检查量表(MMSE)、词汇流畅性测验(VFT)、Stroop色词测验(SCWT)、数字广度测验(DST)评价认知功能,跨期决策范式的延迟折扣率K值评价跨期决策能力。结果与正常对照者相比,帕金森病患者MMSE评分(Z=-4.536,P=0.000)、VFT正确个数(Z=-4.555,P=0.000)、DST正序正确复述个数(Z=-4.696,P=0.000)和倒序正确复述个数(Z=-3.261,P=0.001)减少,HAMA评分(Z=-5.153,P=0.000)、HAMD评分(Z=-5.637,P=0.000)、Stroop C-A(Z=-7.105,P=0.000)、K值(Z=-3.209,P=0.004)增加;相关分析显示,帕金森病患者K值与MMSE评分、VFT正确个数、Stroop C-A、DST正序和倒序正确复述个数均无相关性(均P>0.05)。结论帕金森病患者存在跨期决策能力障碍,无法合理权衡延迟奖励的价值,更倾向即时奖励,决策行为更冲动。Objective To explore the intertemporal decision-making disorder in patients with Parkinson’s disease(PD).MethodsFrom January 2020 to August 2021,a total of 36 patients with PD(PD group)who diagnosed and treated in The Second People’s Hospital of Hefei and The Second Affiliated Hospital of Soochow University were selected,and 39 healthy controls(control group)with matched gender,age and eudcation were recruited.Hamilton Anxiety Rating Scale(HAMA),Hamilton Depression Rating Scale(HAMD),Mini-Mental State Examination(MMSE),Verbal Fluency Test(VFT),Digit Span Test(DST),and Stroop Color-Word Test(SCWT)were used to evaluate the neuropsychological characteristics,the delaydiscount rate K value in the intertemporal decision-making paradigm were used to evaluate the intertemporal decision-making ability.ResultsCompared with control group,the PD group had a decrease in MMSE score(Z=-4.536,P=0.000),correct number of VFT(Z=-4.555,P=0.000),correct repetition of DST-forwards(Z=-4.696,P=0.000)and DST-backwards(Z=-3.261,P=0.001),while had an increase in HAMA score(Z=-5.153,P=0.000),HAMD score(Z=-5.637,P=0.000),Stroop C-A(Z=-7.105,P=0.000)and K value(Z=-3.209,P=0.004).Correlation analysis showed that there was no correlation between K value and MMSE score,correct number of VFT,Stroop C-A,and correct repetition of DST-forwards and DST-backwards in PD patients(P>0.05,for all).ConclusionsPatients with PD have symptoms of intertemporal decision-making disorder.They can’t reasonably balance the value of delayed reward,prefer immediate reward,and have more impulsive decision-making behavior.

关 键 词：帕金森病 决策 延迟折扣(非MeSH词) 神经心理学测验 

分 类 号：R742.5[医药卫生—神经病学与精神病学]