| Objective:(1)To explore the characteristics of time perception changes and related factors under different levels of anxiety and depression in Wilson disease,so as to assist clinical application and diagnosis and treatment.(2)To explore the correlation between time perception changes and diseased brain regions in WD patients and their neural mechanisms.(3)WD patients who met the dialectical criteria of liver qi reversal and liver qi depression were included in the liver qi reversal group(37 cases)and liver qi depression group(33 cases),respectively.Meanwhile,The differences in general data,emotion-related scale test results and time perception-related indexes between the liver qi reversal group and the liver qi depression group were compared and analyzed.Methods:(1)Eighty-five WD patients who were hospitalized from June 2021 to April 2022 and met the enrollment criteria were selected as study subjects.Detailed records of general information of WD patients,TCM differential typing and WD patients’ Magnetic resonance imaging(MRI)results.The results of the Future time perspective(FTP)and Zimbardo time perspective inventory(ZTPI)and time-distance replication task test experiments were used as relevant indicators to evaluate the patient’s time perception.The Beck anxiety inventory(BAI),the Beck depression rating scale(BDI),the State trait anxiety in-ventory(STAI)and the PAD scale(Pleasure-Displeasure Arousal-Nonarousal)were used Dominance-Submissiveness,pleasure activation,dominance)assesses the patient’s emotional state.According to the score of the Baker Anxiety Scale,WD patients were divided into anxiety group(29 cases)and non-anxiety group(56 cases),and according to the score of Baker Depression Self-rating Scale,WD patients were divided into depression group(27 cases)and non-depressed group(58 cases).Comparing the results of emotion-related scale and the differences of time perception correlation indicators among different emotion groups,and analyze the correlation between time perception related indicators and general data and emotion correlation scale test results.(2)Multiple linear regression analysis was used to screen out the diseased brain regions that affected the relevant indicators of time perception.(3)WD patients with TCM differentiation as liver qi reversal and liver qi depression were screened and included in the liver qi reversal group(37 cases)and liver qi depression group(33 cases).Then,comparing and analyzing the differences in general data,emotion-related scale test results and time perception-related test results between the liver qi reversal group and the liver qi depression group.Results(1)Compared with the non-anxiety group,the anxiety group of WD patients had lower pleasure scores,and the scores of Baker anxiety,Beck depression,state anxiety and trait anxiety were higher and the differences were statistically significant(P<0.05).Compared with the non-depressed group,the depression group of WD patients had lower pleasure and dominance scores,and the scores of Baker anxiety,Beck depression,state anxiety and trait anxiety were higher(P<0.05).(2)The AEs of 4s,6s,8s and 12 s in the anxiety group of WD patients were significantly larger than those in the non-anxiety group(P<0.05).The 8s and 12 s ratios in the anxiety group were smaller than those in the non-anxiety group,and the difference was statistically significant(P<0.05).The 3s ratio in the depressed group of WD patients was smaller than that non-depressed group,and the difference was statistically significant(P<0.05).(3)The total FTP scores,future efficacy factor scores,purpose awareness factor scores,and future consciousness factor scores of WD patients were higher than those in the non-anxiety group,and the differences were statistically significant(P<0.05).The total FTP scores,behavioral commitment factor,future efficacy factor and purpose awareness factor scores of the depressed group of WD patients were higher than those in the non-depressed group,and the differences were statistically significant(P<0.05).(4)The anxiety group with WD had lower past positive scores and higher present fatality scores than the non-anxiety group,with a statistically significant difference(P<0.05).The depressed group had lower past positive scores,higher past negative scores,higher present fateful scores and present pleasure scores than non-depressed group,with a statistically significant difference(P<0.05).(5)The 1.5s AE of WD patients was positively correlated with trait anxiety(P<0.05).The 3s AE was negatively correlated with emotional dominance(P<0.05).The 4s AE was positively correlated with age and disease duration(P<0.05).The 6s AE was negatively correlated with emotional pleasure and dominance(P<0.05).and positively correlated with state anxiety and Baker anxiety(P<0.05).The 12 s AE was negatively correlated with emotional dominance(P<0.05).(6)The 1.5s ratio was negatively correlated with the number of years of education(P<0.05)and positively correlated with the emotional activation scores.The 2s ratio was negatively correlated with emotional pleasure(P<0.05).The 8s ratio was negatively correlated with age(P<0.05).The 12 s ratio was positively correlated with emotional dominance(P<0.05),and negatively correlated with Beck anxiety(P<0.05).(7)The total FTP score of WD patients was negatively correlated with age,disease duration,emotional happiness score and dominance score(P<0.05),and positively correlated with state anxiety score,trait anxiety score,Baker anxiety score and Baker depression self-score(P<0.05).The behavioral commitment factor score was negatively correlated with age,disease duration and emotional dominance(P<0.05),and positively correlated with state anxiety score,trait anxiety score and Beck depression self-score(P<0.05).The future efficacy factor was negatively correlated with age,disease duration,emotional happiness and dominance(P<0.05),and positively correlated with state anxiety,trait anxiety,Baker anxiety and Baker depression self-score(P<0.05).The far-goal orientation factor score was negatively correlated with emotional dominance(P<0.05)and positively correlated with the score of Beck Depression Self-rating Scale(P<0.05).The goal consciousness score was negatively correlated with emotional pleasure and dominance(P<0.05),and positively correlated with state anxiety score,trait anxiety score,Baker anxiety score and Beck depression self-score(P<0.05).Future consciousness score was negatively correlated with age,emotional pleasure and dominance(P<0.05),and positively correlated with state anxiety,trait anxiety and Beck depression self-score(P<0.05).(8)The past negative scores of WD patients were negatively correlated with emotional pleasure scores(P<0.05),and positively correlated with state anxiety scores,trait anxiety scores and Baker depression self-scores(P<0.05).The past positive scores were positively correlated with emotional pleasure scores and dominance scores(P<0.05),and negatively correlated with state anxiety,trait anxiety,Baker anxiety and Beck depression self-rating(P<0.05).Now fatalism scores are negatively correlated with emotional pleasure and dominance(P<0.05),and positively correlated with state anxiety,trait anxiety,Baker anxiety and Beck depression self-score(P<0.05).The pleasure score was now negatively correlated with the duration of the disease(P<0.05),and positively correlated with state anxiety,Baker anxiety and Beck depression self-score(P<0.05).Future scores were positively correlated with age,years of education,emotional happiness and dominance(P<0.05),and negatively correlated with state anxiety(P<0.05).(9)The results of multiple linear regression analysis showed that the frontal lobe of WD patients was the influencing factor of the 1.5s AE(P<0.05),the widening of cerebral fissure was the influencing factor of the 4s AE(P<0.05),and cerebral atrophy was the influencing factor of 6s,8s,and 12 s AE(P<0.05).The thalamus is an influencing factor for the 16 s AE(P<0.05).(10)The results of multiple linear regression analysis showed that the frontal lobe was the influencing factor of the 1s ratio(P<0.05)and the corpus callosum compression part was the influencing factor of the 1.5s ratio(P<0.05).The brainstem is the influencing factor of 4s and 6s ratio(P<0.05),brain atrophy is the influencing factor of the 8s ratio(P<0.05),the frontal lobe and brain foot are the influencing factors of the12 s ratio(P<0.05),and the frontal lobe is the influencing factor of the 16 s ratio(P<0.05).(11)In WD patients,caudate nucleus,legume nucleus and brain stem were the influencing factors of the distant goal-oriented score(P<0.05),brain atrophy,legume nucleus and caudate nucleus were the influencing factors of future consciousness score(P<0.05),and caudate nucleus,legume nucleus and brain atrophy were the influencing factors of the total FTP score(P<0.05),and widening of sulcus fissure was the influencing factor of ZTPI’s current hedonic score(P<0.05).(12)The scores of PAD pleasure factor and dominance factor in the liver qi reversal group of WD patients were higher than those in the liver qi depression group,and the differences were statistically significant(P<0.05).The 4s ratio of WD patients was smaller than that in the liver qi depression group,and the difference was statistically significant(P<0.05).The future efficacy factor score of FTP in the liver qi reversal group of WD patients was lower than that in the liver qi depression group,and the difference was statistically significant(P<0.05).The positive factor scores of ZTPI in the liver qi reversal group were higher than those in the liver qi depression group,and the difference was statistically significant(P<0.05).Conclusions:(1)WD patients with anxiety and depression have changes in time perception,and the dimensions of patients’ age,disease duration,years of education,and emotional changes are all relevant factors of time perception changes.(2)Changes in time perception in WD patients are associated with frontal lobes,thalamus,brainstem,callosum pressure,cerebral feet,cerebral atrophy,widening of cerebral sulcus,caudate nucleus,and legumes.(3)There were different characteristics of time perception changes in WD patients with different TCM syndromes of liver qi reversal depression.(4)The neural mechanism of anxiety and depression in WD patients may be related to the change of time perception caused by the diseased brain region. |
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