The Neuropsychological Study On Memory Monitoring And Moral Judgment In Patients With Wilson’s Disease

Objective Memory monitoring is the overall grasp of an individual’s own memory situation. Moral judgment refers to people evaluating the behavior of individual based on their own moral principles in mind, according to good moral characters which a particular cultural or sub-cultural environment regulated. The aim of this paper is to investigate the ability of memory monitoring and moral judgment situation in patients with Wilson’s disease(hepatolenticular degeneration)，andto further explore its possible mechanism.Methods We choice30patients who was diagnosed HLD in Institute of Neurology of Anhui TCM University and30healthy control participants to test theirfeel of knowing and judgment in moral dilemma. We use SPSS17.0statistical analyze the data by two independent samples t test and Pearson correlation analysis, taking P <0.05was considered statistically significant. Experiment1:The feeling-of-knowing(FOK) paradigm of episodic memory(EM) and semantic memory(SM)were established and subsequently administered in30HLD patients and30healthy control(HC) participants who were matched in age and educational level. Experiment2: We translate Joshua D. Greene’s moral dilemmas questionnaire which including50assumptions.30patients and30healthy control participants in experiment1made judgment of "willing to do" or "unwilling to do so" after reading. Results Experiment1: Compared with healthy control group(FOK-EM recall64.17%±29.21%;FOK-SM recall84.72%±11.44%),the FOK-EM recall(26.55%±20.92%) and FOK-SM recall(53.93%±28.42%) in HLD patients were significantly low(t=-5.140,p<0.01;t=-5.123,p<0.01).The correct judgment and correct recognition of FOK-EM(50.64%±29.43%) and the false judgment and correct recognition of FOK-EM（12.80%±18.32%）in the HLD group were significantly different with the HC group(the correct judgment and correct recognition of FOK-EM:75.15%±31.73%and the false judgment and correct recognition of FOK-EM:1.81%±5.41%;t=-2.693,p<0.05;t=3.026,p<0.01).Most importantly,the stroop effect was positively correlated with thefalse judgment and correct recognition of FOK-EM in HLD group(r=0.601，p<0.01). Experiment2:We used three classes of stimuli: non-moral scenarios(n18), impersonal moral scenarios (n11), and personal moral scenarios (n21). On personal moral scenarios, the frequency of endorsing‘yes’ responses was significantly greater in the HLD group than in HC group(P values,0.01, corrected,t=3.908).Conclusions The results show that the HLD group made less accurate metamemory monitoring than the healthy control group by underestimating their memory performance on episodic FOK,whereas the semantic metamemory monitoring is not impaired.Moreover,the impairment of memory monitoring was positively correlated with the deficit of executive function,indicate that the impairment in PFC could be an influential factor of memory disorder in HLD.It’s also indicates the episodic and semantic metamemory monitoring depending on differentneural network. Paients being highly inclined to the utilitarian choice in "personal" moral judgments may caused by the disorder of negative emotional processing which leaded by the damage in PFC.The mechanism of the HLD paient’s performance above could be the thedamage in direct and indirect loop between PFC and basal ganglia.