臺灣博碩士論文加值系統

巴金森氏症患者除了主要的動作缺損之外，近年來發現有許多「非動作」的問題，例如巴金森氏症患者無法正確辨識負向情緒。由於能夠快速區辨臉部情緒具有生存上的價值，因此本研究採用快速情緒區辨作業，探討巴金森氏症患者是否有快速情緒區辨問題，並檢驗巴金森氏症患者的動作障礙程度是否與其情緒區辨能力有關。研究包含28位原發性巴金森氏症患者及28位年紀配對的健康對照組，均接受快速情緒區辨作業。由電腦螢幕呈現情緒刺激，包含高興、哀傷、害怕和生氣的情緒臉孔，受試者需判斷單一目標情緒臉孔為正向或負向情緒。結果顯示，相較於健康對照組，巴金森氏症患者反應時間比較長，且對高興和哀傷臉孔有較低的正確率。進一步依巴金森氏症患者的動作障礙評估分數將患者分為高、低動作障礙分數兩組，探討動作障礙程度與其情緒區辨力的關係，發現低動作障礙分數組(UPDRSIII分數低於35分)對哀傷情緒有較低的正確率，而高動作障礙分數組的患者則對生氣及高興臉孔有較低的正確率。由此可知，巴金甚症患者的快速情緒區辨能力有選擇性的缺損，動作障礙較嚴重的患者出現更廣泛的情緒處理問題。

Besides movement disorder, patients with Parkinson disease (PD) are revealed to have non-motor deficits. To fast detect or discriminate emotion stimuli is the basic ability of a human, and this ability implies adaptive value. There were two purposes in this study. The first goal was to investigate the discrimination of facial expressions in PD. The second goal was to investigate whether the fast discrimination of facial expressions in PD related to the level of their motor severities. 28 PDs and 28 age-matched healthy controls were recruited in this study, and they were asked to discriminate between positive (happiness) and negative (sadness, fear, anger) faces within the fast emotion discrimination task. The results revealed that PD discriminated all faces longer than healthy controls did, and PD also had less accuracy in the condition of happy and sad faces compared with healthy controls. Furthermore, PD was separated into two subgroups by the cut-off score “35” of UPDRS motor examination (part3). PD with lower level of motor score preformed worse in the condition of sad faces than healthy controls did, and the PD with higher motor score had dysfunctions in processing happy and angry faces. As previous findings, PD in the present study also showed selective deficits in fast emotion discrimination task, especially in processing happy and sad facial expressions. PD with severe motor deficits showed more impairment of discriminating facial expressions.

中文摘要 I
英文摘要 II
目次 III
表目次 V
圖目次 VI
附錄 VIII
第一章 前言 1
第二章 文獻回顧 3
第一節 巴金森氏症 3
第二節 巴金森氏症的神經病理 4
第三節 大腦皮質—基底核—大腦皮質迴路 7
第四節 巴金森氏症的非動作障礙 12
第五節 巴金森氏症的臉部情緒辨識問題 17
第六節 病程進展與大腦功能 21
第三章 研究方法 24
第一節 研究目的 24
第二節 研究方法 27
實驗材料與設備 27
基本實驗程序 27
第三節 實驗與結果 28
實驗一：快速情緒區辨作業—巴金森氏症患者組 28
受試者 28
作業內容 29
資料分析 30
結果 30
實驗二：情緒區辨作業—健康對照組受試者 33
受試者 33
作業內容 33
資料分析 34
結果 34
第四節 整體巴金森氏症患者與健康對照組的比較 35
第五節 高、低動作障礙巴金森氏症患者與健康對照組的比較 41
第四章 結果與討論 51
第一節 整體結果與討論 51
第二節 情緒訊息處理問題的神經機制 53
第三節 研究限制 60
第四節 結論、未來發展與貢獻 61
參考文獻 63
附錄 82

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