[关键词]
[摘要]
目的 评估长期情志不畅社区中老年人群的肝失疏泄证候表现并探讨其总体认知功能和前瞻记忆下降的神经电生理机制。方法 使用艾森克人格问卷和一般情况调查表等筛选符合高、低神经质标准的46-65岁社区中老年人群对应纳入长期情志不畅组和情志畅达对照组,按照性别、年龄(±2岁)和受教育年限(±2年)相匹配的原则纳入两组各60例被试,借助中医肝脏象情绪量表检测两组被试的中医肝经证候、焦虑因子、抑郁因子得分和三因子总分,并分别进行总体认知功能、前瞻记忆总体水平和事件性前瞻记忆双任务范式的行为学评估及事件相关电位成分检测。结果 与情志畅达对照组相比,长期情志不畅组被试的中医肝脏象情绪量表总分及肝经证候因子、焦虑情绪因子和抑郁情绪因子得分均显著升高(P<0.05),MoCA量表总分(校正后)及视空间与执行功能、注意和延迟回忆3个认知域水平得分均显著降低(P<0.05),且其前瞻记忆问卷总分显著降低(P<0.05)。长期情志不畅组被试完成事件性前瞻记忆双任务范式中进行中任务和前瞻记忆任务的正确率均降低、反应时均显著延长(P<0.05)。长期情志不畅组被试的进行中任务和前瞻记忆任务P200波幅均增加呈边缘显著性(0.05<P<0.10),且前瞻记忆任务N300和PP潜伏期均显著延长(P<0.05)。结论 46-65岁长期情志不畅特质的社区中老年人群具有明显的肝失疏泄证候表现,存在总体认知功能和前瞻记忆总体水平的显著下降,在进行中任务和前瞻意向形成阶段消耗的注意加工资源较多、对前瞻靶线索的觉察和识别速度减慢、前瞻意图提取及意向执行速度减慢是其可能的部分机制。
[Key word]
[Abstract]
Objective To explore the neuroelectrophysiological mechanism of the decline of overall cognitive function and prospective memory, the syndrome manifestation of liver failing to govern conveyance and dispersion of the middle-aged and elderly people in the community with long-term emotional disturbance were evaluated. Methods Eysenck personality questionnaire (EPQ) and general condition questionnaire were used to screen the middle-aged and elderly people from 46 to 65 years old in the community who met the high and low neuroticism criteria, which were included in the long-term emotional disturbance group and the control group. According to the principle of matching sex, age (±2 years) and years of education (±2 years), 60 subjects in each group were included. The scores of livers meridian syndrome, anxiety factor, depression factor and the total scores of three factors in the two groups were detected with the emotion rating scale for Ganzangxiang of traditional Chinese medicine. The overall cognitive function, the overall level of prospective memory and the dual-task paradigm of event-related memory were evaluated and event-related potential components were detected. Results Compared to the control group, the total scores of emotion rating scale for Ganzangxiang of traditional Chinese medicine and the scores of liver meridian syndrome factor, anxiety factor and depression factor all increased in the long-term emotional disturbance group significantly (P<0.05). The total scores of MoCA scale (after correction) and the level scores of visual space and executive function, attention and delayed recall decreased significantly (P<0.05), and the total scores of prospective memory questionnaire decreased significantly (P<0.05). The correct rates of ongoing tasks and prospective memory tasks in the event-based prospective memory dual task paradigm were decreased, and the reaction time was prolonged in the long-term emotional disorder group significantly (P<0.05). The amplitude of P200 of ongoing task and prospective memory task were increased in the long-term emotional disorder group (0.05<P<0.10). The latencies of prospective memory task N300 and PP were prolonged significantly (P<0.05). Conclusion The middle-aged and elderly people aged 46-65 years old with long-term emotional disturbance have obvious syndrome symptoms of liver failing to govern conveyance and dispersion, and a significant decline in the overall level of cognitive function and prospective memory occurred. The possible mechanisms mentioned above are that more attention processing resources are consumed in the ongoing task and prospective intention formation stage. The speed of detection and recognition of prospective target clues is slower, and the speed of prospective intention extraction and intention execution is slower.
[中图分类号]
[基金项目]
国家自然科学基金委员会面上项目(81873208):肝失疏泄对正常人群和MCI患者认知功能衰退进程的影响及机制研究,负责人:詹向红;河南省“双一流”创建学科中医学科学研究专项(HSRP-DFCTCM-2023-1-02):负性情绪积累对aMCI患者执行功能的影响及疏肝法干预机制,负责人:詹向红;河南省自然科学基金面上项目(242300420106):基于“脑-肠轴”理论探讨逍遥散调节AD海马炎症微环境改善空间工作记忆的作用机制