摘要目的:探讨视觉加工模式对阿尔茨海默病(Alzheimer's disease，AD)患者情绪面孔加工的影响。方法:2020年6月到2021年8月从安徽医科大学第一附属医院记忆障碍门诊的患者中选取符合本研究条件的22名AD患者(AD组)，从患者家属以及社区居民中选取人口统计学匹配的21名健康老年人(对照组)。两组被试在完成认知量表评估后进行情绪面孔视觉扫描及情绪面孔识别试验，同时在情绪面孔视觉扫描任务中记录眼动数据。使用SPSS 23.0 Windows版软件对所得结果进行统计分析。其中符合正态分布的数据采用独立样本 t检验及方差分析，对不符合正态分布的数据采用非参数检验。 结果:(1)在情绪面孔识别任务中，AD患者总的面孔情绪识别正确率[0.52(0.42，0.59)]低于正常对照组[0.67(0.64，0.69)]，差异具有统计学意义( Z＝-4.023， P<0.01)，且主要表现在对复杂面孔情绪的识别。(2)在情绪面孔视觉加工任务中，AD患者在眼区的眼跳次数[(1.96±0.97)次，(2.50±0.44)次]、注视次数[(3.93±2.58)次，(6.37±2.08)次]及注视时间[(1 205.89±727.32)s，(1 761.38±525.54)s]均低于对照组( t＝-2.314，-3.402，-2.880，均 P<0.05)，周围面部注视时间[384.95(276.51，587.78)s，276.06(190.03，384.55)s]高于对照组( Z＝-2.478， P＝0.013)；AD患者对惊讶[(3.76±2.90)次，(6.25±2.19)次]、愤怒[(4.48±2.72)次，(7.06±2.55)次]及厌恶[(4.10±2.45)次，(6.67±2.45)次]情绪眼区的注视次数均低于对照组，均差异具有统计学意义( t＝-3.164，-3.207，-3.436，均 P<0.05)；AD患者对惊讶[(1 150.26±753.22)s，(1 779.91±551.66)s]、愤怒[(1 430.85±869.52)s，(1 944.51±612.63)s]及厌恶[(1 266.14±765.67)s，(1 898.33±676.02)s]情绪眼区的注视时间低于对照组，均差异具有统计学意义( t＝-3.115，-2.247，-2.865，均 P<0.05)。(3)Spearman相关分析显示，AD整体情绪面孔识别正确率与眼区注视时间呈正相关( r＝0.429， P<0.05)。 结论:AD患者的视觉加工受损可能引起情绪面孔识别障碍。因此AD患者在情绪面孔加工上具有与年龄匹配的正常对照组不同的视觉加工模式，主要表现为对眼区的注视减少。

abstractsObjective:To explore the effect of visual processing patterns on emotional face processing in patients with Alzheimer's disease (AD).Methods:From June 2020 to August 2021, twenty-two AD patients (AD group) who met the conditions of this study were selected from the memory impairment clinic of the First Affiliated Hospital of Anhui Medical University, and demographically matched twenty-one elderly healthy people (control group) were selected from the patients' family members and community residents. The two groups of subjects performed emotional face visual scanning and facial recognition experiments after completing the evaluation of the cognitive scale and eye movement data were recorded in the emotional face visual scanning task. Statistical analysis of the obtained results was performed using SPSS 23.0 Windows version software. The data that conformed to the normal distribution were tested by independent samples t-test and variance analysis, and the data that did not conform to the normal distribution were tested by nonparametric test. Results:(1)In the emotional face recognition task, the total accuracy of facial emotion recognition of AD patients(0.52(0.42, 0.59)) was lower than that of the normal control group(0.67(0.64, 0.69)), and the difference was statistically significant( Z=-4.023, P<0.01), which was mainly manifested in recognizing complex facial emotion. (2) In the emotional face visual processing task, the saccade count ((1.96±0.97), (2.50±0.44)), fixation count ((3.93±2.58), (6.37±2.08))and fixation time ((1 205.89±727.32)s, (1 761.38±525.54)s)of AD patients were lower than those of the control group( t=-2.314, -3.402, -2.880, all P<0.05), and the surrounding facial fixation time (384.95 (276.51, 587.78)s, 276.06 (190.03, 384.55)s) was higher than that of the control group( Z=-2.478, P=0.013). Patients with AD had a lower fixation count than that in the control group on the eye area of surprise ((3.76±2.90), (6.25±2.19)), anger ((4.48±2.72), (7.06±2.55)) and disgust ((4.10±2.45), (6.67±2.45)), and the differences were statistically significant ( t=-3.164, -3.207, -3.436, all P<0.05). Patients with AD had a lower fixation time than those of the control group on the eye area of surprise ((1 150.26±753.22)s, (1 779.91±551.66)s), angry ((1 430.85±869.52)s, (1 944.51±612.63)s) and disgust ((1 266.14±765.67)s, (1 898.33±676.02)s), and the differences were statistically significant ( t=-3.115, -2.247, -2.865, all P<0.05). (3) Spearman correlation analysis showed that the accuracy of overall emotional face recognition was positively correlated with the fixation time in the eye area in AD patients ( r=0.429, P<0.05). Conclusion:The impaired visual processing of AD patients causes emotional face recognition disorders. Therefore, AD patients have different visual processing patterns in emotional face processing than age-matched normal controls, mainly manifested as the decreased fixation on the eye area.