Lou Lixia, Wang Yijie, Zhang Bingren, Jia Yanli, Wang Wei, Ye Juan
Eye Center, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
Department of Medical Psychology, College of Clinical Medicine, Hangzhou Normal University, Hangzhou, China.
Adv Ophthalmol Pract Res. 2022 Jul 19;2(3):100075. doi: 10.1016/j.aopr.2022.100075. eCollection 2022 Nov-Dec.
Phantom eye pain (PEP) is a major clinical problem after eye removal with no standard treatment protocol to date. As pain is a multidimensional experience associated with emotional and cognitive components, this study aimed to explore the possible neuropsychological mechanisms of PEP in a perspective of emotional cognition, in order to provide a basis for clinical treatment.
Visual oddball event-related potentials (ERPs) under different external emotional stimuli (Disgust, Fear, Sadness, Happiness, Erotica and Neutral) were tested in 12 patients and 12 healthy volunteers. Participants' affective states were measured with the Mood Disorder Questionnaire (MDQ), the Hypomania Checklist-32 (HCL-32), and the Plutchik-van Praag Depression Inventory (PVP). The amplitudes and latencies of N1, P2, N2 and P3 components were analyzed by three-way ANOVA, i.e., group (2) × emotion (6) × electrode (3). Multiple comparisons were performed using Bonferroni's test.
Longer N1 latencies, increased N1 amplitudes; shorter P2 latencies under Disgust and Happiness, decreased P2 amplitudes; shorter N2 latencies under Erotica, increased N2 amplitudes were found in patients compared with controls. There was no main effect of group or interaction effect on P3 latencies and P3 amplitudes. The MDQ and HCL-32 scores were lower, and the N1 latencies under Sadness were negatively correlated with PVP scores in patients.
PEP patients showed reversed patterns in exogenous attention allocation and enhanced involuntary attention to emotional stimuli compared with controls. This study demonstrated cortical processing of emotions in PEP patients and could provide a basis for developing emotional intervention therapy.
幻眼痛（PEP）是眼球摘除术后的一个主要临床问题，目前尚无标准的治疗方案。由于疼痛是一种与情感和认知成分相关的多维度体验，本研究旨在从情感认知的角度探讨PEP可能的神经心理学机制，为临床治疗提供依据。
对12例患者和12名健康志愿者在不同外部情感刺激（厌恶、恐惧、悲伤、快乐、色情和中性）下进行视觉oddball事件相关电位（ERP）测试。采用情绪障碍问卷（MDQ）、轻躁狂检查表-32（HCL-32）和普拉奇克-范普拉格抑郁量表（PVP）测量参与者的情感状态。通过三因素方差分析，即组（2）×情绪（6）×电极（3），分析N1、P2、N2和P3成分的波幅和潜伏期。使用Bonferroni检验进行多重比较。
与对照组相比，患者的N1潜伏期延长、N1波幅增加；在厌恶和快乐刺激下P2潜伏期缩短、P2波幅降低；在色情刺激下N2潜伏期缩短、N2波幅增加。组间因素和交互作用对P3潜伏期和P3波幅无显著影响。患者的MDQ和HCL-32评分较低，悲伤刺激下的N1潜伏期与PVP评分呈负相关。
与对照组相比，PEP患者在外源性注意力分配上表现出相反的模式，对情感刺激的非自愿注意力增强。本研究证明了PEP患者的情绪皮层加工过程，可为开发情感干预治疗提供依据。
