慢性疼痛对决策影响的脑电研究

发布时间：2018-01-04 23:26

本文关键词：慢性疼痛对决策影响的脑电研究　出处：《华东师范大学》2015年硕士论文　论文类型：学位论文

【摘要】：慢性疼痛是困扰人类的重要病症之一。慢性疼痛不仅会影响患者的日常生活,如工作、学习、睡眠,而且会进一步引发包括抑郁、焦虑等在内的一系列心理障碍,严重地损害了患者的身心健康。更重要的是,慢性疼痛也会对患者的认知能力造成损害。近年,大量的研究报道了慢性疼痛对决策会产生侵害。然而,慢性疼痛对决策反馈影响的脑机制研究依然鲜见,且这些仅有的研究中也存在不足。本研究旨在通过利用时间分辨率较高的事件相关电位技术,观测慢性疼痛患者(n=13)在完成爱荷华赌博任务时的脑电变化情况,并与健康被试(n=12)进行对比,从而探究慢性疼痛对决策反馈影响的神经机制。被试首先需要完成韦氏智力量表和Stroop色词的认知测评任务。随后的爱荷华赌博任务分为3个阶段(共6个Run)完成,被试须在在四堆获利和损失情况不相同的卡片堆(两堆长期来看会获利的好卡片堆,两堆长期来看会损失的坏卡片堆)中做出选择,以期获得最大收益。行为学上看,在阶段2和阶段3中,慢性疼痛病人的爱荷华赌博任务分数(选好卡片次数减去选坏卡片次数)显著低于健康被试(p0.05),表明慢性疼痛病人未能学习到选择卡片的正确策略。其次,在Stroop色词的认知测评中,慢性疼痛病人的正确率也显著地低于健康被试(p0.05),提示了慢性疼痛病人的认知控制能力可能存在异常。脑电结果关注了决策后的反馈脑电成分P200、 FRN(反馈负波,Feedback-Related Negativity)和P300。结果发现：1)两组被试的三个阶段的P200成分没有显著差异(p0.1),可能提示了慢性疼痛对于决策任务的影响并非由反馈刺激引起的感知觉介导；2)在阶段2中,慢性疼痛病人对惩罚卡片的FRN幅值显著高于获利FRN的幅值(p0.05),可能提示了慢性疼痛病人在这一阶段对惩罚反馈出现了更大的预期违背；3)对于P300成分,健康人对于奖惩反馈的显著差异出现在实验任务的阶段1(p0.01),而病人的这一显著差异出现在之后的阶段2(p0.05),这样的滞后暗示了慢性疼痛病人可能由于认知资源的调配受损,使得他们对奖励结果的认知性评估出现得较晚。通过分析慢性疼痛病人在执行爱荷华赌博任务时的行为学结果和决策后反馈阶段的脑电成分,本研究初步揭示了慢性疼痛病人情绪性决策的脑活动特点,为理解慢性疼痛病人决策异常的脑机制提供了实证研究证据。
[Abstract]:Chronic pain is one of the most important conditions that afflict human beings. Chronic pain not only affects patients' daily life, such as work, study, sleep, but also further causes depression. Anxiety, including a series of psychological disorders, seriously damaged the physical and mental health of patients. More importantly, chronic pain will also damage the cognitive ability of patients. A large number of studies have reported the impact of chronic pain on decision-making. However, the brain mechanism of the effect of chronic pain on decision-making feedback is still rare. This study aims to use event-related potentials with high temporal resolution. The changes of EEG in patients with chronic pain were observed when they completed the Iowa gambling task, and were compared with those of healthy subjects. In order to explore the neural mechanism of the influence of chronic pain on decision-making feedback, the subjects first need to complete the cognitive assessment of Wechsler Intelligence scale and Stroop color words. The subsequent Iowa gambling task is divided into three stages. A total of 6 Runs were completed. Participants were asked to choose between four piles of cards with different gains and losses (two piles of good cards that would benefit in the long run and two piles of bad cards that would lose in the long run). In order to get the most benefit. Behaviorism, in stage 2 and stage 3. Patients with chronic pain had significantly lower scores of Iowa gambling tasks (the number of cards selected minus the number of cards selected) than those of the healthy subjects (p0.05). The results showed that the patients with chronic pain could not learn the correct strategy of card selection. Secondly, the correct rate of the patients with chronic pain was significantly lower than that of the healthy subjects (p0.05) in the cognitive evaluation of Stroop color words. The results show that the cognitive control ability of patients with chronic pain may be abnormal. The EEG results focus on the feedback EEG components P200 and FRN (feedback negative wave) after decision-making. Feedback-Related Negativity) and P300.The results showed that there was no significant difference in P200 components in the three stages between the two groups (P 0.1). It may suggest that the effect of chronic pain on decision-making tasks is not mediated by the perception induced by feedback stimulation. 2) in stage 2, the FRN amplitude of the penalty card in the patients with chronic pain was significantly higher than that of the profit-making FRN (P 0.05). It may suggest that patients with chronic pain have a greater expected violation of punishment feedback at this stage; 3) for the P300 component, the significant difference of reward and punishment feedback in healthy people appeared at the stage of the experiment task (1 / p 0.01). This significant difference occurred at a later stage, indicating that chronic pain patients may be affected by the allocation of cognitive resources. The cognitive assessment of the reward results came later. By analyzing the behavioral results of patients with chronic pain while performing a gambling mission in Iowa and the EEG components of the post-decision feedback stage. This study preliminarily revealed the characteristics of brain activity of emotional decision making in patients with chronic pain and provided empirical evidence for understanding the brain mechanism of abnormal decision making in patients with chronic pain.
【学位授予单位】：华东师范大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R402

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