Emotion Regulation, Executive Function, and Parkinson Disease

情绪调节、执行功能和帕金森病

• 批准号: 8356849
• 负责人: Dawn Bowers
• 金额: $ 21.51万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-06-01 至 2014-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8356849
• 关键词: Address; Affect; Amygdaloid structure; Anxiety; Arousal; Attention; Blinking; Clinical; Cognitive; Comorbidity; Complex; Descriptor; Disease; Elderly; Electroencephalography; Emotional; Emotions; Event-Related Potentials; Exhibits; Failure; Generations; Goals; Health; Husband; Impaired cognition; Impairment; Instruction; Intervention; Learning; Light; Measures; Mental Depression; Modeling; Motor; National Institute of Mental Health; Neurocognitive; Neurodegenerative Disorders; Parkinson Disease; Participant; Patients; Pharmaceutical Preparations; Physiological; Process; Psychophysiology; Regulation; Reporting; Research; Semantics; Severities; Severity of illness; Stimulus; Structure; Subgroup; Symptoms; System; Techniques; Testing; Up-Regulation; Woman; Work; base; emotion regulation; emotional stimulus; executive function; improved; indexing; meetings; neuropsychiatry; response; showing emotion; social; success; theories

DESCRIPTION (provided by applicant): The overarching goal of the current project is increased understanding of emotional processes in Parkinson's disease. Parkinson's disease (PD) is one of the most common neurodegenerative disorders of late life. It is caused by progressive dopaminergic depletion with motor, cognitive, and emotional changes. While advances have been made with respect to motor symptoms, emotional and neuropsychiatric changes (depression, apathy, anxiety) are prevalent and can be the some of the most disturbing, disabling, and complex aspects of the disorder. Findings from four recent studies of emotional responding have found that non-demented Parkinson patients without psychiatric co-morbidities exhibited blunted physiologic reactivity to aversive pictures as indexed by the startle eyeblink response (Bowers et al., 2006; Miller et al., 2009; Zahodne et al., 2011) or an event related potential component of motivated attention, the late positive potential, LPP (Dietz et al., 2011a). This reduced reactivity to unpleasant stimuli was not due to medication, depression, perceptual difficulties, or failure to generate basic startle or electrocortical activity. One interpretation of this emotional blunting relates to dopaminergic gating and inhibition of the amygdala, a key limbic structure in the emotion processing cascade. In light of these findings, the aims of the present study are to learn whether Parkinson patients can upregulate their responses to emotional stimuli and whether success in doing so is related to integrity of frontal-executive function. To address this aim, two approaches for amplifying emotional reactivity will be taken, one that is more active and self-directed (auto-evoked) and another that is more passive (exo-evoked). Both approaches have been associated with increased physiologic reactivity in healthy controls, as indexed by electrocortical responses (Moser et al., 2009, 2010; Foti & Hajcak, 2008; McNamara et al., 2009). In the current research, non-demented, non-depressed Parkinson patients and healthy controls will participate in two separate studies. Parkinson patients will be psychometrically classified into two cognitive subgroups based on neurocognitive measures: executively impaired (PD-exec) and cognitively normal (PD). During testing, participants will view standardized sets of neutral and emotional pictures while startle eyeblink responses and EEG are recorded. One study will involve use of self-directed regulation strategies to increase reactivity to emotional pictures, and the other study will involve passive listening to narratives that alter subsequent semantic meaning. Primary dependent variables will be amplitude of LPP, startle eyeblink and verbal ratings of valence and arousal. The major hypothesis is that effective regulation of physiologic reactivity to emotional stimuli by PD patients will depend on the integrity of frontal-executive systems. Parkinson patients in the cognitively normal subgroup will show changes in emotional reactivity regardless of active or more passive regulation approaches, whereas PD patients with executive disturbance will benefit only in the passive condition. Relationship to disease variables and neuropsychiatric factors (apathy, anxiety) will be examined. The proposed research will be the first to test whether Parkinson patients can benefit from techniques for bolstering their physiological and emotional reactivity. If predictions are met, the obtained findings may have broad implications for emotional enhancement in Parkinson disease. PUBLIC HEALTH RELEVANCE: This study examines emotional blunting in patients with Parkinson disease and focuses on nonpharmacologic techniques to bolster emotional reactivity. This study has potential treatment implications for improving apathy symptoms in Parkinson disease.

描述（由申请人提供）：当前项目的首要目标是增加对帕金森病情绪过程的理解。帕金森病（Parkinson's disease，PD）是老年人最常见的神经退行性疾病之一。它是由进行性多巴胺能耗竭引起的，伴有运动、认知和情绪变化。虽然在运动症状方面取得了进展，但情绪和神经精神变化（抑郁，冷漠，焦虑）普遍存在，并且可能是该疾病最令人不安，致残和复杂的方面。最近四项关于情绪反应的研究发现，没有精神病合并症的非痴呆帕金森患者对令人厌恶的图片表现出迟钝的生理反应，如惊吓指数 眨眼反应（Bowers等人，2006;米勒等人，2009; Zahodne等人，2011）或动机性注意力的事件相关电位成分，晚期正电位，LPP（Dietz等人， 2011年a）。这种对不愉快刺激的反应性降低不是由于药物、抑郁、知觉困难或无法产生基本的惊吓或皮层电活动。对这种情绪迟钝的一种解释与杏仁核的多巴胺能门控和抑制有关，杏仁核是情绪处理级联反应中的一个关键边缘结构。鉴于这些发现，本研究的目的是了解帕金森病患者是否可以上调他们对情绪刺激的反应，以及这样做的成功是否与额叶执行功能的完整性有关。为了实现这一目标，将采取两种方法来放大情绪反应，一种是更主动和自我导向的（自动诱发），另一种是更被动的（外部诱发）。这两种方法都与健康对照中增加的生理反应性相关，如通过皮层电反应所指示的（Moser等人，2009，2010; Foti & Hajcak，2008; McNamara等人，2009年）。在目前的研究中，非痴呆、非抑郁的帕金森病患者和健康对照者将参加两项独立的研究。帕金森患者将根据神经认知测量在心理测量上分为两个认知亚组：执行受损（PD-exec）和认知正常（PD）。在测试过程中，参与者将观看标准化的中性和情感图片集，同时记录惊吓眨眼反应和EEG。一项研究将涉及使用自我导向的调节策略，以增加对情感图片的反应，另一项研究将涉及被动倾听改变随后语义意义的叙述。主要因变量将是LPP的幅度，惊吓眨眼和言语评价的效价和唤醒。主要的假设是，PD患者对情绪刺激的生理反应的有效调节将取决于额叶执行系统的完整性。认知正常亚组中的帕金森患者将显示出情绪反应性的变化，无论是主动还是被动调节方法，而具有执行障碍的PD患者仅在被动条件下受益。将检查与疾病变量和神经精神因素（冷漠、焦虑）的关系。这项拟议中的研究将是第一个测试帕金森患者是否可以从增强其生理和情感反应的技术中受益的研究。如果预测得到满足，所获得的发现可能对帕金森病的情绪增强具有广泛的影响。 公共卫生相关性：本研究探讨帕金森病患者的情绪迟钝，并侧重于非药物技术，以加强情绪反应。这项研究对改善帕金森病的冷漠症状具有潜在的治疗意义。