情境線索對額葉及顳葉型癲癇患者負向臉孔情緒辨識之影響

研究背景：過去研究指出額葉及顳葉型癲癇患者在負向臉孔情緒辨識的缺損，並可能造成患者在社會互動上的困難。在真實生活情境中，臉孔情緒通常伴隨背景情境線索一起存在，過去研究業已發現情境線索的有無對臉孔情緒的知覺與詮釋存在影響力。然而，情境線索與臉孔情緒辨識的相關研究，多以一般健康成人作為主要探討對象，在額葉型及顳葉型癲癇患者是否有相同影響或是其他效果，則鮮少有研究提及。本研究目的為探討：（1）相較健康對照組，癲癇組受試者在無情境線索下的負向臉孔情緒辨識表現；（2）相較健康對照組，癲癇組受試者在有情境線索情況下的負向情緒辨識表現；（3）健康組受試者在有、無情境線索下的負向臉孔情緒辨識表現；（4）癲癇組受試者在有、無情境線索下的負向臉孔情緒辨識表現；（5）癲癇相關風險因子與癲癇患者負向情緒辨識表現間的關係。研究方法：本研究經中區某醫學中心神經內科專科醫師轉介，排除曾接受過其他腦部手術、具物質濫用病史者，募得額葉型與顳葉型癲癇成年患者共26名，並根據患者的年齡、性別、教育程度等背景變項進行配對，募得健康對照組共30名。在研究流程中，每一位受試者會接受無情境線索之負向臉孔情緒辨識測驗、有情境線索之負向臉孔情緒辨識測驗、智力、精神症狀的評估，排除智能不足及嚴重精神症狀兩項因素對研究之干擾。結果與結論：（1）癲癇組受試者在沒有情境線索時，對害怕臉孔情緒辨識的正確率顯著低於健康對照組；（2）有情境線索時，癲癇組與健康對照組對各種負向臉孔情緒辨識的正確率皆無顯著差異（3）健康對照組受試者對於情境線索下的各種負向臉孔情緒辨識正確率皆顯著高於無情境線索；（4）癲癇組受試者對於情境線索下的各種負向臉孔情緒辨識正確率皆顯著高於無情境線索；（5）癲癇相關風險因子與癲癇患者的負向情緒辨識表現無顯著相關。

關鍵字

癲癇；臉孔情緒辨識；情境線索

並列摘要

Background: Previous studies have suggested that recognition of negative emotions is commonly impaired in patients with frontal lobe epilepsy or temporal lobe epilepsy. In real life, facial emotion usually appears along with situational background. It has been demonstrated that contextual cues could affect the perception of facial emotion. Most studies on contextual cues and facial emotion focus on healthy adults, but few studies focus on patients with frontal lobe or temporal lobe epilepsy. Research purpose: To investigate (1) the differences in negative emotion recognition in the absence of contextual cues between patients with epilepsy and healthy controls; (2) the differences in negative emotion recognition with contextual cues between patients with epilepsy and healthy controls; (3) the differences in negative emotion recognition with and without contextual cues in healthy controls; (4) the differences in negative emotion recognition with and without contextual cues in patients with epilepsy; (5) the relationship between seizure-related risk factors and negative facial emotion recognition. Method: Twenty-six patients with frontal or temporal lobe epilepsy who were referred by a neurologist in a medical center in middle district, excluding those who had undergone other brain surgeries and those with a history of substance abuse. A total of thirty matched controls were included. During the research process, each subject will receive a negative facial emotion recognition test without contextual cues, a negative facial emotional recognition test with contextual cues, selected subtests of the Mandarin version of the Wechsler Adult Intelligence Scale-III, the Social and Occupational Functioning Scale for Epilepsy, and the Symptom Checklist-90-Revised. Participants with mental retardation or severe psychiatric symptoms were excluded. Results and conclusion: The results showed that (1) in the absence of contextual cues, people with epilepsy were worse at recognizing the emotion of fearful faces than healthy controls; (2) in the case of situational cues, there was no significant difference in the recognition of negative emotions between epileptic patients and healthy controls (3) healthy controls have significantly higher emotion recognition accuracy when given contextual cues than those without;; (4) patients with epilepsy have significantly higher emotion recognition accuracy when given contextual cues than those without; (5) negative facial emotion recognition in patients with epilepsy was not significantly associated with seizure-related risk factors.