Effect Of Attention Impairment On Facial Emotional Recognition And Event Related In Patients With Parkinson’s Disease

Objective:To investigate the characteristics of facial emotional cognitive impairments and its relationships with attention and event related potentials in patients with Parkinson’s disease (PD). Methods:Sixty patients diagnosed as PD in department of emergency, affiliated hospital of Sichuan Medical University were included in the PD group, while 30 healthy patients matched with PD group in age, sex and education degree during the same period were included in the normal control group (NC). Two groups completed the following tests:1. Neuropsychological scale tests:Mini-Mental State Examination (MMSE), Montreal cognitive scale (MoCA), Clinical dementia rating scale (CDR), Aactivities of Daily Living Scale (ADL), Hamilton Depression Scale (HAMD); and according to the results of attention from MoCA, PD group was divided into attention intact groups (Attention score is full marks, namely six points) and attention impaired group (Attention score is not full marks), referred to as PDa, PDb group, respectively.2. Computer auxiliary tests:Continuous Performance Test (CPT), face emotional cognitive tests; 3. Event related potentials (ERPs):P300, mismatch negative wave (MMN). Finally, correlation analyses were performed between face emotional recognition and CPT, ERPs. All statistical analyses were performed using SPSS 17.0 software. Results:1. There were no significant differences in sex, age, education degree and other baseline characteristics among PDa, PDb and NC group (P>0.05).2. there was no statistically significant difference in the overall cognitive function using MMSE test among three groups (P>0.05). In MoCA test, compared with NC group, test scores were lower in the PDa, PDb group, with statistically significant difference (P<0.01); scores in PDa group was different from those in PDb group (P<0.01). While the rest of the single test comparison, PDa group compared with NC group, there were significant differences in executive function, delayed memory and visual space cognitive function level(P<0.01), but language features, naming, directional force, the level of abstraction and attention were no significant differences(P>0.05) between PDa and NC group; PDb group compared with NC group, visual space function, delayed memory and attention were significant differences(P<0.01), language features, naming, directional force and abstract cognitive level were no significant differences(P>0.05); PDa and PDb group for comparison, attention level was significant difference(P<0.01), the rest of the items were no significant differences (P>0.05).2, computer auxiliary testing results show that: (1) in CPT tests, PDa group compared with NC group, the average reaction time and non-response rates are higher than that of the NC group, but no significant difference (P>0.05), the PDb group compared with NC and PDa group, the average reaction time and non-response rates are increasing, the differences were significant(P<0.01). (2) face emotional recognition test:PDa group compared with NC group, emotion recognition total scores were decreased, with statistically significant differences (P<0.05), dominated by the scores of facial emotions including "disgust" and "fear"(P<0.05), the rest of the emotional faces declining scoring, there were no significant difference(P>0.05). PDb group compared with NC group, the "nuitral" face emotional score was no difference, the scores of "disgust" and "fear" facial emotions were significantly decreased(P<0.01), and the scores of other facial emotions and the total emotional cognitive score were all decreased (P<0.05); PDb group compared with the PDa group, the total score and the scores of "disgust" and "fear" facial emotions were significantly decreased, with statistically significant differences (P<0.01), however, no significant difference was found in the scores of other facial emotions between the two groups. (P>0.05).3, ERPs measurement:PDa group compared with NC group, the latency periods of P300 and MMN were prolonged and the amplitude was decreased, with statistically differences(P<0.05), PDb group compared with NC group, the latency period of P300 and MMN were significantly prolonged, amplitude was decreased, with statistically significant differences(P<0.01); PDa group compared with PDb group, the latency period of P300 was significantly prolonged and the amplitude was significantly decreased, with statistically significant differences(P< 0.01), MMN latency period, amplitude has no obvious difference (P> 0.05).4, the correlation analysis:face emotions "disgust", "fear", and the total score of cognitive were negatively correlated with CPT non-response rates and the average reaction time; and positively correlated with P300 and MMN amplitude, negatively correlated with P300 and MMN latency period. Conclusion:1, Recognitive impairment in patients with Parkinson’s disease mainly presented with visual space, executive function and delay memory impairments, also attention impairment, especially obviously damaged sustained attention; 2, Facial emotional recognition disorders mainly manifested "disgust", "fear" in patients with PD; 3, Facial emotional recognition disorder may be affected by the attention function, possibly sustained attention function; 4, A good correlation was found between the events related potentials including P300 and MMN and emotional recognition, thereby P300 and MMN could be used to detect emotional recognition impairment in Patients with Parkinson’s Disease.