面肌痉挛患者决策能力的初步研究

目的 探讨面肌痉挛患者在风险明确情境下的决策功能.方法 采用风险明确的骰子投掷实验(GDT)对面肌痉挛患者进行决策能力评估.收纳了28例门诊诊断明确的面肌痉挛患者,并与性别、年龄、教育程度相匹配的30例健康对照组进行对比.同时完成了神经心理学背景测试,比较两组被试在这些测试的差异性.结果 与健康对照组相比,面肌痉挛组存在风险明确情境下的决策功能受损,表现为面肌痉挛组净得分低于健康对照组,两组差异有统计学意义(t=-3.491,P=0.001);两组被试在GDT 4个选项中也存在差异:单个数目的组合(F=13.059,P=0.001)及3个数目的组合(F=6.599,P=0.013)的差异有统计学意义;两组被试在Stroop色词测试、数字广度(倒序)中差异无统计学意义;而两组被试在数字广度(正序)(t=-2.839,P=0.006)、词汇流畅性(t=-2.193,P=0.032)、负反馈利用率(t=-3.368,P=0.001) 存在显著差异.结论 面肌痉挛患者在风险明确情境下的决策功能受损,可能与执行功能及负反馈利用率受损有关.

A preliminary study of decision making under risk in patients with hemifacial spasm

Objective To explore the decision making under risk in patients with hemifacial spasm.Methods Using the Game of Dice Task(GDT,decision making under risk) to assess the decision-making ability of patients with hemifacial spasm.Twenty-eight patients with hemifacial spasm were recruited from outpatient service,and thirty-nine control subjects matched for gender,age,education performed the GDT,as well as a series of neuropsychological tests.The difference between the two groups was compared.Results Compared with healthy controls,the decision making function under risk was impaired with hemifacial spasm patients.The net score on GDT was significantly low in patients with hemifacial spasm than healthy control(t=-3.491,P=0.001).The difference on single comparisons in the different choices was found between two groups: single number(F=13.059,P=0.001) and triple number(F=6.599,P=0.013) had significant difference.Among the results of the background tests,stroop color-word test,the digit span test (backward) were observed no difference between two groups.The digit span test(forward)(t=-2.839,P=0.006),verbal fluency tests(t=-2.193,P=0.032) and use of negative feedback(t=-3.368,P=0.001) in hemifacial spasm group had significant difference compared to healthy group.Conclusion The patients with hemifacial spasm have impairment in decision making under risk,which may relate to the defect of executive function and the use of negative feedback.