Takizawa Hirokazu, Ishioka Toshiyuki, Koizumi Kohei, Tayama Jun, Suzuki Makoto, Nakaya Naoki, Hamaguchi Toyohiro
Department of Rehabilitation, Graduate School of Health Sciences, Saitama Prefectural University, Saitama, Japan.
Faculty of Human Sciences, Waseda University, Saitama, Japan.
Int J Behav Med. 2021 Aug;28(4):511-522. doi: 10.1007/s12529-020-09940-2. Epub 2020 Dec 1.
Post-stroke depression increases the likelihood of adverse physical symptoms. Attentional bias (AB) for negative stimuli is important in depression onset, maintenance, and remission. Stroke is more likely in older adults, who can have reduced cognitive function. Individuals with mild cognitive impairment (MCI) can have delayed reaction times (RTs). We hypothesized that RT to select neutral facial expression is affected by depressive symptoms and cognitive function in patients with stroke.
This study analyzed 61 patients with stroke. Beck Depression Inventory-Second Edition (BDI-II) and Profile of Mood States (short version) scores were determined. Task stimuli comprised eight pairs of facial expressions containing affective (angry) and neutral faces. AB was measured as the RT to select the neutral face in two simultaneously presented images using attention bias modification (ABM) software. Patients were grouped according to depressive symptoms using BDI-II scores. Between-subject factors of depressive symptoms and cognitive function were determined by ANCOVA.
No significant interaction was found between depressive symptoms and cognitive function on RT. There was a main effect of cognitive function, but not depressive symptoms. In patients with hemiparesis and depressive symptoms, RT was significantly shorter in patients without MCI compared with patients with MCI.
People with stroke and elevated depression symptoms with hemiparesis but without MCI quickly selected neutral facial expressions from neutral and aversive expressions, and thus do not need ABM to escape aversive stimuli. ABM in response to aversive stimuli may be useful in evaluating negative emotions in individuals with post-stroke depression without MCI.
中风后抑郁会增加出现不良身体症状的可能性。对负面刺激的注意偏向（AB）在抑郁症的发作、维持和缓解中起重要作用。中风在老年人中更为常见，而老年人的认知功能可能会下降。轻度认知障碍（MCI）患者的反应时间（RT）可能会延迟。我们假设，中风患者选择中性面部表情的反应时间受抑郁症状和认知功能的影响。
本研究分析了61例中风患者。测定了贝克抑郁量表第二版（BDI-II）和情绪状态量表（简版）得分。任务刺激包括八对包含情感（愤怒）和中性面孔的面部表情。使用注意偏向矫正（ABM）软件，将选择两张同时呈现图像中中性面孔的反应时间作为注意偏向进行测量。根据BDI-II得分，将患者按抑郁症状分组。通过协方差分析确定抑郁症状和认知功能的组间因素。
在反应时间上，未发现抑郁症状和认知功能之间存在显著交互作用。存在认知功能的主效应，但不存在抑郁症状的主效应。在有偏瘫和抑郁症状的患者中，与患有MCI的患者相比，未患有MCI的患者的反应时间显著更短。
患有中风且抑郁症状加重、有偏瘫但无MCI的患者能够迅速从中性和厌恶表情中选择中性面部表情，因此不需要注意偏向矫正来逃避厌恶刺激。针对厌恶刺激的注意偏向矫正可能有助于评估无MCI的中风后抑郁患者的负面情绪。
