Drago Valeria, Foster Paul S, Skidmore Frank, Trifiletti Daniel, Heilman Kenneth M
Department of Neurology and Center for Neuropsychological Studies, University of Florida College of Medicine, Gainesville, FL 32610-0236, USA.
Cogn Behav Neurol. 2008 Jun;21(2):92-7. doi: 10.1097/WNN.0b013e31816bdfb2.
BACKGROUND/OBJECTIVES: Patients with Parkinson disease (PD) exhibit motor and frontal-executive dysfunction and often seem to be emotionally apathetic. We investigated whether PD patients have alterations in their emotional reactivity and how this might impact their proximal (avoidance) versus distal (approach) allocation of attention-intention.
Nine participants with PD and 9 normal controls were asked to judge the valence (pleasant-positive vs. unpleasant-negative) and arousal of 30 pictures from the International Affective Picture System. Participants were instructed to rate the pictures by marking 14-cm radial lines placed in front of them. On those lines where the subjects were going to rate emotional valence, the lines had a happy face at 1 end and a sad face at the other and when rating the arousal, they were presented with lines that had an "excited" and a "calm" face at opposite ends. For the emotional ratings, the dependent measures were the distances from the end of the line that had the "calm" or "sad" face to the participants' mark. For the approach-avoidance analysis, the dependent measure was the distance from the bottom of the line, regardless of the position of faces.
The PD patients did not differ from controls when judging valence, but their judgments of arousal was lower than that of the controls. In addition, in contrast to the controls when judging neutral pictures and arousal, the PD patients, independent of the proximal or distal position of the sad/happy faces or excited/calm faces, demonstrated an overall proximal bias. When presented with emotional versus neutral stimuli, the control group reduced their extrapersonal spatial bias, whereas the subjects with PD did not change their spatial bias.
The judgments of valence made by the subjects with PD were the same as that of the controls. These judgments might be based on cognitive decisions and as our PD subjects were not demented they could accurately determine valence. In contrast, judgments of arousal were reduced in the PD participants, and this result might reflect these patients impaired arousal-activation systems. Although emotional, versus neutral stimuli, induced a proximal deviation in the responses of the control subjects, the subjects with PD did not change their spatial bias. This Parkinsonian "emotional akinesia" might be related to either a reduced capacity to experience emotions or to an inability of emotional experiences to influence intentional and attentional systems.
背景/目的：帕金森病（PD）患者存在运动和额叶执行功能障碍，且常常表现出情感淡漠。我们研究了PD患者的情绪反应是否存在改变，以及这可能如何影响他们对注意力-意图的近端（回避）与远端（趋近）分配。
9名PD患者和9名正常对照者被要求判断来自国际情感图片系统的30张图片的效价（愉快-积极与不愉快-消极）和唤醒度。参与者被指示通过在他们面前放置的14厘米径向线上做标记来对图片进行评分。在那些用于评定情绪效价的线上，一端是笑脸，另一端是哭脸；而在评定唤醒度时，呈现的线两端分别是“兴奋”脸和“平静”脸。对于情绪评分，相关测量指标是从有“平静”或“悲伤”脸一端的线端点到参与者标记处的距离。对于趋近-回避分析，相关测量指标是从线底部的距离，而不考虑脸的位置情况。
在判断效价时PD患者与对照组没有差异，但他们对唤醒度的判断低于对照组。此外，与对照组在判断中性图片和唤醒度时不同，PD患者无论悲伤/快乐脸或兴奋/平静脸处于近端还是远端位置，都表现出总体的近端偏向性。当呈现情绪性刺激与中性刺激时，对照组减少了他们的个人空间外偏向性，而PD患者没有改变他们的空间偏向性。
PD患者对效价的判断与对照组相同。这些判断可能基于认知决策，并且由于我们的PD受试者没有痴呆，他们能够准确地确定效价。相比之下，PD参与者对唤醒度的判断降低了，这一结果可能反映了这些患者唤醒-激活系统受损。尽管情绪性刺激与中性刺激相比在对照组的反应中诱发了近端偏差，但PD患者没有改变他们的空间偏向性。这种帕金森氏“情感运动不能”可能与体验情绪能力降低或情绪体验无法影响意向和注意系统有关。
