•需要了解帕金森病的表型异质性。性别和遗传学决定帕金森病的表现和进展。•帕金森病中改变的情绪处理是男性患者特有的。•这受到两种性别的内分泌和遗传因素的影响。•这一发现可能会影响新出现的临床特征的诊断和治疗。
帕金森病(PD)被认为对男性和女性有不同的影响。神经精神症状在PD中常见且致残。然而,以往关注PD患者情绪识别的研究忽视了性别的混淆,缺乏关于潜在内分泌和遗传机制的证据.此外,虽然有许多关于PD情绪处理的影像学研究,性别相关的神经数据分析很少。因此,我们旨在探索命名因素对PD中情感识别和处理的相互作用。
对51名非痴呆的PD患者(26名男性)和44名年龄和性别匹配的健康对照(HC;25名男性)进行了临床和神经心理检查,包括情绪识别任务(Ekman60faces测试)。对25名患者和31名HC的子样本进行了基于任务的功能磁共振成像(fMRI),其中包括情绪面部表情的视频。为了研究激素和遗传学对情绪处理的影响,血液样本用于内分泌(睾酮,雌二醇,孕酮)和基因检测(5-HTTLPR,Val158MetCOMT多态性)。
在认知能力方面没有出现群体或性别差异。男性而非女性PD患者在识别情绪愤怒时表现出局限性障碍,伴随着对面部表情的神经反应减弱(例如,在壳核和脑岛中)。内分泌,女性患者的恐惧认知与雌激素水平呈正相关,而在遗传水平上,我们发现Val158MetCOMT基因型对PD患者的恐惧识别有影响。
我们的研究提供了证据表明,PD患者的情绪处理受损会特别影响男性患者,激素和遗传学有助于情绪识别表现。对潜在神经的进一步研究,PD中特定症状的内分泌和遗传机制具有临床意义,因为它可以提高我们对疾病的现象学和病理学的理解,并可能允许更个性化的医学。
•Understanding of the phenotypic heterogeneity of Parkinson\'s disease is needed.•Gender and genetics determine manifestation and progression of Parkinson\'s disease.•Altered emotion processing in Parkinson\'s disease is specific to male patients.•This is influenced by endocrinal and genetic factors in both genders.•This finding may impact the diagnosis and treatment of emerging clinical features.
Parkinson\'s disease (PD) has been suggested to affect males and females differently. Neuropsychiatric symptoms are common and disabling in PD. However, previous studies focusing on emotion recognition in PD have neglected the confounder of gender and lack evidence on the underlying endocrinal and genetic mechanisms. Moreover, while there are many imaging studies on emotion processing in PD, gender-related analyses of neural data are scarce. We therefore aimed at exploring the interplay of the named factors on emotion recognition and processing in PD.
51 non-demented PD patients (26 male) and 44 age- and gender-matched healthy controls (HC; 25 male) were examined clinically and neuropsychologically including an emotion recognition task (Ekman 60faces test). A subsample of 25 patients and 31 HC underwent task-based functional magnetic resonance imaging (fMRI) comprised of videos of emotional facial expressions. To examine the impact of hormones and genetics on emotion processing, blood samples were taken for endocrinal (testosterone, estradiol, progesterone) and genetic testing (5-HTTLPR, Val158Met COMT polymorphisms).
No group or gender differences emerged regarding cognitive abilities. Male but not female PD patients exhibited confined impairments in recognizing the emotion anger accompanied by diminished neural response to facial expressions (e.g. in the putamen and insula). Endocrinologically, fear recognition was positively correlated with estrogen levels in female patients, while on the genetic level we found an effect of Val158Met COMT genotype on the recognition of fear in PD patients.
Our study provides evidence that impaired emotion processing in PD specifically affects male patients, and that hormones and genetics contribute to emotion recognition performance. Further research on the underlying neural, endocrinological and genetic mechanisms of specific symptoms in PD is of clinical relevance, as it can improve our understanding of the phenomenology and pathobiology of the disease and may allow a more personalized medicine.