帕金森病患者风险决策能力研究

目的 探讨帕金森病( Parkinson' disease,PD)患者在风险概率明确条件下的决策能力是否改变,进一步研究基底节与决策的关系.方法 采用风险概率明确的骰子博弈测试( Game of Dice Test,GDT)对25例PD患者(PD组)和25名健康被试者(HC组)进行风险决策能力研究.结果 与HC组(5.72±3.69)相比,PD组(10.88±5.58)更倾向于选择风险选项(t=3.86,P＜0.01).PD组(-3748.00±3923.87)的最后总资产通常是负值,而HC组(684.00±1764.62)都有盈利,两者的差异有统计学意义(t=-5.15,P＜0.01).PD组选择最多的是风险最大的选项即1个数字,而HC组选择最多的是3个数字的联合(1个数字:PD组:6.48±5.81;HC组:1.00±1.44;t=4.58,P＜0.01；3个数字:PD组:2.64±2.14;HC组:7.04±2.54；t=-6.62,P＜0.01),差异有统计学意义.此外,选择风险选项的次数与负反馈利用率(r=-0.59,P=0.003)和Stroop结果(r=0.55,P=0.004)的相关性显著.结论 研究表明PD患者在风险概率明确条件下存在明显的决策能力改变,并与执行功能和负反馈利用率相关.

Decision-making under risk condition in patients with Parkinson' s disease

Objective To investigate the ability of decision making under risk condition in patients with Parkinson' s disease (PD),and to explore the neural relationship between basal ganglia and the decision-making ability.Method Twenty-five PD patients and 25 healthy controls (HC) were investigated by Game of Dice Test (GDT) with explicit probability.Results PD patients performed poorly in the entire task,selecting more risky options ( PD:10.88 ± 5.58 ; HC:5.72 ± 3.69 ; t =3.86,P ＜ 0.01 ),compared with healthy controls.In general,the final asset of PD group was negative while the result of HC group was always profitable and the difference was significant ( PD:- 3748.00 ± 3923.87 ; HC:684.00 ± 1764.62 ; t =-5.15,P ＜ 0.01 ).The most frequent choice made by PD patients was one number,which is the most risky one.Accordingly,the most frequent choice made by HC group was three numbers (one number:PD:6.48 ±5.81;HC:1.00 ± 1.44;t =4.58,P ＜0.01; three numbers:PD:2.64 ±2.14;HC:7.04 ±2.54;t =-6.62,P ＜ 0.01 ).The frequency of choosing the risky options was correlated with the rate of using negative feedback( r =-0.59,P =0.003 ),and the result of Stroop test( r =0.55,P =0.004).Conclusion Present study has shown that PD patients have significant impairments in decision-making under risk condition,and the impairments are correlated with executive function and negative feedback.