精神分裂症共情缺陷及其rTMS干预研究

发布时间：2018-01-14 17:12

本文关键词：精神分裂症共情缺陷及其rTMS干预研究　出处：《安徽医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的目前研究证明精神分裂症存在广泛的社会认知缺陷,此障碍是导致社会功能衰退的重要原因。共情是社会认知的重要成分,研究精神分裂症及其一级亲属的共情能力有助于理解精神分裂症社会功能障碍的神经心理机制,同时为进一步探究共情缺陷是否能成为精神分裂症认知障碍内表型提供依据。共情能力可以通过物理、认知行为训练等干预技术得到改善,经颅磁刺激(transcranial magnetic stimulation,TMS)技术作为一种新型无创的物理治疗方法成为越来越重要的治疗手段,本研究探讨低频r TMS干预对精神分裂患者共情能力的影响。方法研究一:对35个精神分裂症患者,教育年限、年龄相匹配的33个一级亲属以及34个正常对照组施以认知测试、人际反应指针量表(The Interpersonal Reactivity Index,IRI)、疼痛共情范式,并统计各项任务的指标,分析比较三组的差异。研究二:对22个精神分裂症患者采用c TBS刺激模式精准定位左侧颞顶联合区连续进行15天的低频r TMS干预,在干预前后施以认知测试、IRI-C量表、疼痛共情范式,并将干预前后的各项任务指标与性别、年龄、教育年限相匹配的22个对照组进行分析比较,观察干预前后患者共情能力与对照组的差异,同时比较患者自身干预前后的差异。结果研究一:患者组IRI-C总分(p=0.006)、观点采择(perspective taking,PT)(p=0.037)、想象(fantasy,FS)(p=0.001)、共情性关心(empathy concern,EC)(p=0.015)得分显著低于对照组;患者组的EC(p=0.029)得分显著低于亲属组;亲属组的FS(p=0.013)得分显著低于对照组;患者组疼痛图片的正确率显著低于对照组(p=0.005);患者组对中性图片(p=0.001)及疼痛图片的反应时(p=0.006)均显著长于对照组;患者组临床阴性症状得分与对疼痛图片判断的正确率(p=0.020)和评级得分(p=0.049)呈负相关。研究二:患者干预前后IRI-C量表总分(p=0.004)、PT(p=0.000)、EC(p=0.015)、对疼痛图片判断的正确率(p=0.000)、临床评估(positive and negative syndrome scale,PANSS)总分(p=0.000)、阳性症状得分(p=0.000)、阴性症状得分(p=0.001)存在显著差异。结论精神分裂症患者共情能力及疼痛共情能力显著差于对照组,一级亲属的FS能力低于对照组;对精神分裂症患者进行r TMS干预能够改善其共情能力。
[Abstract]:Objective to prove that schizophrenia has a wide range of social cognitive defects, which is an important factor leading to the decline of social function. Empathy is an important component of social cognition. To study the empathy ability of schizophrenia and its first-degree relatives is helpful to understand the neuropsychological mechanism of social dysfunction of schizophrenia. At the same time, it provides a basis for further exploring whether empathy defects can become the phenotype of schizophrenia cognitive impairment. Empathy ability can be improved through physical, cognitive behavior training and other intervention techniques. Transcranial magnetic stimulation. As a new non-invasive physiotherapy technique, TMS320T has become more and more important. The purpose of this study was to investigate the effect of low frequency r TMS intervention on the empathy ability of schizophrenic patients. Methods study 1: 35 schizophrenic patients, education years. Cognitive tests were performed on 33 first-degree relatives matched with age and 34 normal controls. The Interpersonal Reactivity Index, the pain empathy paradigm, and the indicators of each task were evaluated by the interpersonal response pointer scale. Analysis and comparison of the differences among the three groups. Study 2: 22 patients with schizophrenia using c TBS stimulation mode to accurately locate the left temporoparietal joint area for 15 days of low-frequency r TMS intervention. Before and after intervention, IRI-C scale and pain empathy paradigm were used to analyze and compare 22 control groups whose task indexes matched with gender, age and education years before and after intervention. Observe the difference between the patients before and after intervention and the control group, and compare the differences before and after intervention. Results 1: the total score of IRI-C in the patients group was 0.006). Take a perspective on your point of view (P0.037). Imagine a fantasy (P0. 001). The score of empathy was significantly lower than that of the control group. The score of ECP 0.029 in the patients group was significantly lower than that in the relatives group. The scores of the relative group were significantly lower than that of the control group. The correct rate of pain pictures in the patients group was significantly lower than that in the control group (P 0.005). The response time of the patient group to both the neutral image and the pain picture was significantly longer than that of the control group. Scores of clinical negative symptoms and correct judgment of pain pictures in the patients group (p0.020) and rating scores (p0.049). There was a negative correlation. Study 2: the total score of IRI-C scale before and after intervention was 0.004). The correct rate of judging pain picture was 0.000 ~ (0.000)% (P = 0.000). The total score of positive and negative syndrome scaleSSS was 0.000). There was significant difference between positive symptom score and negative symptom score (P < 0. 001). Conclusion the empathy ability and pain empathy ability of schizophrenia patients are significantly lower than those of the control group. The FS ability of first-degree relatives was lower than that of control group. R TMS intervention in schizophrenic patients can improve their empathy ability.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.3;B842.6

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