摘要： 目的 探讨帕金森病患者跨期决策能力障碍。方法 纳入2020年1月至2021年8月在安徽省合肥市第二人民医院和苏州大学附属第二医院诊断与治疗的36例帕金森病患者以及性别、年龄、受教育程度相匹配的39例正常对照者，采用汉密尔顿焦虑量表（HAMA）和汉密尔顿抑郁量表（HAMD）评价焦虑和抑郁症状，简易智能状态检查量表（MMSE）、词汇流畅性测验（VFT）、Stroop色词测验（SCWT）、数字广度测验（DST）评价认知功能，跨期决策范式的延迟折扣率K值评价跨期决策能力。结果 与正常对照者相比，帕金森病患者MMSE评分（Z=-4.536，P=0.000）、VFT正确个数（Z=-4.555，P=0.000）、DST正序正确复述个数（Z=-4.696，P=0.000）和倒序正确复述个数（Z=-3.261，P=0.001）减少，HAMA评分（Z=-5.153，P=0.000）、HAMD评分（Z=-5.637，P=0.000）、Stroop C-A（Z=-7.105，P=0.000）、K值（Z=-3.209，P=0.004）增加；相关分析显示，帕金森病患者K值与MMSE评分、VFT正确个数、Stroop C-A、DST正序和倒序正确复述个数均无相关性（均P>0.05）。结论 帕金森病患者存在跨期决策能力障碍，无法合理权衡延迟奖励的价值，更倾向即时奖励，决策行为更冲动。

关键词: 帕金森病, 决策, 延迟折扣（非MeSH词）, 神经心理学测验

Abstract: Objective To explore the intertemporal decision-making disorder in patients with Parkinson's disease (PD).Methods From January 2020 to August 2021, a total of 36 patients with PD (PD group) who diagnosed and treated in The Second People's Hospital of Hefei and The Second Affiliated Hospital of Soochow University were selected, and 39 healthy controls (control group) with matched gender, age and eudcation were recruited. Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD), Mini-Mental State Examination (MMSE), Verbal Fluency Test (VFT), Digit Span Test (DST), and Stroop Color-Word Test (SCWT) were used to evaluate the neuropsychological characteristics, the delay- discount rate K value in the intertemporal decision-making paradigm were used to evaluate the intertemporal decision-making ability.Results Compared with control group, the PD group had a decrease in MMSE score (Z=-4.536, P=0.000), correct number of VFT (Z=-4.555, P=0.000), correct repetition of DST-forwards (Z=-4.696, P=0.000) and DST-backwards (Z=-3.261, P=0.001), while had an increase in HAMA score (Z=-5.153, P=0.000), HAMD score (Z=-5.637, P=0.000), Stroop C-A (Z=-7.105, P=0.000) and K value (Z=-3.209, P=0.004). Correlation analysis showed that there was no correlation between K value and MMSE score, correct number of VFT, Stroop C-A, and correct repetition of DST-forwards and DST-backwards in PD patients (P>0.05, for all).Conclusions Patients with PD have symptoms of intertemporal decision-making disorder. They can't reasonably balance the value of delayed reward, prefer immediate reward, and have more impulsive decision-making behavior.

Key words: Parkinson disease, Decision making, Delay-discount (not in MeSH), Neuropsychological tests