| Objectives(1)To investigate the features of attention bias and related factors in Wilson’s disease in negative emotional information processing,so as to provide a reference for further guiding clinical treatment and improving quality of life.(2)To explore the cognitive neural mechanisms of attention bias in individuals with Wilson’s disease.(3)To probe the features of attention bias in Traditional Chinese Medicine syndrome types in Wilson’s disease individuals,and to provide theoretical basis for TCM clinical syndrome differentiation and treatment.Methods(1)70 cases of WD patients hospitalized in Affiliated Hospital of Institute of Neurology of Anhui College of Chinese Medicine from May 2021 to September 2021 were selected as the research object,negative emotions was assessed by using the State-Trait Anxiety Inventory and Beck Depression Inventory.Among these,49 eligible patients with Wilson ’ s disease(WD)were grouped according to the State-Trait Anxiety Inventory,trait(state)anxiety inventory score more than 40 points to determine the positive cut-off value,the participants were divided into high trait anxiety group(25cases)and low trait anxiety group(24 cases).Similarly,they can be divided into high state anxiety group(25 cases)and low state anxiety group(24 cases).Emotional Stroop paradigm was used to conduct emotional processing experiment,and the reaction time of different emotional word stimuli was evaluated.According to Beck Depression Scale,40 cases of WD patients were divided into depression group(14 cases)and nondepression group(26 cases).The discrepancies were compared respectively between the two groups,and the pertinence among rumination and negative emotion and attention bias was analyzed.At the same time,model of multiple linear regression was applied to evaluate the contributing factors of attention bias response.(2)Based on laboratory test results of the brain MRI,49 eligible cases of WD patients were divided into normal MRI group(14 cases)(28.6%)and abnormal MRI group(35cases)(71.4%).There were brain lesions involved 26 cases of lentiform nucleus,4 cases of caudate nucleus,4 cases of corpus callosum pressure,14 cases of brainstem,8 cases of thalamus,12 cases of cerebrum,14 cases of frontal lobe,5 cases of parietal lobe,and20 cases of cerebral atrophy in the abnormal MRI group.The Stroop paradigm was used to conduct the emotion processing experiment,and the Flashing Fusion Frequency was further devoted to assess the attention persistence experiment.The critical value of Flashing Fusion Frequency was measured,and the differences between the two groups in different emotional words and critical value of Flashing Fusion Frequency were compared,and by using multivariate linear regression model,the affecting elements of attention bias were assessed.(3)According to the theory of "Liver dysfunction" dialectical classification method,49 cases of WD patients were divided into two types: Liver-qi inverse syndrome(26 cases)and Liver-qi Depression syndrome(23 cases).To analyze the characteristics and related factors of attention bias between Liver-qi inverse syndrome group and Liver-qi Depression syndrome group in WD patients.Results(1)In WD patients,there were significant differences in the reaction times of the positive,negative and neutral terms between the high trait anxiety group and the low ones(all P<0.05);At the same time,the high state anxiety group also had higher responses to the three emotional words than the low state anxiety group,there were significant differences.(all P<0.05).(2)Analysis of multiple linear regression indicated that the meant score of trait anxiety(P=0.020,0.015,0.008)and age(P=0.002,0.008,0.014)were the influencing factors for the measured responses to positive,negative and neutral emotion words(P < 0.05).(3)In WD patients,the depression group had higher responses to the positive,negative and neutral words than the nondepression group,and the differences with significance(all P<0.05).(4)Correlation analysis expressed that the mean score of Beck Depression Inventory and in WD patients were positively correlated with the mean score of rumination(38.0±11.2),symptom rumination(19.8±6.4),obsessive thinking(10.0±3.4)and introspection(8.0±2.9)(r =0.750,0.766,0.686,0.324,all P<0.001),in addition,the reaction times of negative and neutral words were positively associated with rumination and symptom rumination(P<0.05).(5)Multivariate linear regression model indicated that the average score of Beck Depression Inventory were the influencing factors for the measured responses to positive,negative and neutral emotion words(P<0.05).(6)In WD patients,the reaction time measured in the abnormal brain MRI groups was significantly higher than the normal brain MRI groups under the positive,negative and neutral words respectively,there were remarkable differences.(all P<0.05).Significant difference of the three bright spot colors(red,green and yellow,respectively)between the normal brain MRI groups and abnormal groups(P <0.05).(7)Multivariate linear regression model expressed that the focal lesions in the splenium of the corpus callosum(P=0.000,0.000,0.001)and the lenticula(P=0.005,0.000,0.014)were the influencing factors for the measured responses to positive emotional words,negative emotional words and neutral words(P<0.05),and the injury of the parietal lobe was also the influencing factors for the measured responses to negative emotional words(P<0.05).In addition,brain stem injury and age were factors influencing CFF measured under both red and yellow tonal visual stimuli(P<0.05).(8)In WD patients,the reaction times measured under the positive,negative and neutral words in the Liver-qi inverse syndrome group were significantly higher than the Liver-qi Depression syndrome group,there were remarkable differences.(all P<0.05).(9)Model of multiple linear regression proclaimed that the age(P= 0.002,0.018,0.012)were the influencing factors for the measured responses to positive,negative and neutral emotion words(P<0.05).In addition,TCM syndrome(P=0.025)was also an influential factor for the measured responses to negative words(P<0.05).Conclusions(1)Anxiety will cause WD patients to show negative attention bias,and the more serious trait anxiety is,the more negative attention bias will be generated.And depression can lead them to pay too much attention to negative emotions,showing that the more serious the depression,the more likely the individuals will show attention bias to negative emotions,and the attention bias is the cognitive mechanism of rumination.(2)In Wilson’s disease,brain structural injury can lead to more negative attention bias.Among which,the damage of corpus callosum pressure,lentiform nucleus and parietal lobe are influencing factors of negative attention bias in WD patients.In addition,according to CFF value,WD patients’ attention bias may be characterized by regulating strong negative stimuli through avoidance strategies and reducing visual exploration of emotional cues and attention span,resulting in abnormal emotional regulation of the body and a repeated and involuntary negative thinking,which further interferes with emotions and aggravates negative cognitive bias.(3)In WD patients,the liver-qi inverse syndrome have more negative attention bias than those with liver-qi depression syndrome.At the same time,age can significantly predict the characteristics of attention bias,and different TCM syndrome types are the influencing factors of the reaction time of negative words. |
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