首发重度女性抑郁症患者对负性情绪图片刺激的fMRI研究

发布时间：2018-03-20 04:33

本文选题：重度抑郁症　切入点：功能性磁共振　出处：《天津医科大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的通过国际情绪图片视觉刺激模式诱发情绪,分别比较正常对照与首发重度女性抑郁症患者,应激组与非应激组在负性情绪图片刺激下脑激活区的异同,探讨抑郁症患者负性认知模式的神经病理机制及应激因素对抑郁症的影响。方法对20名女性正常志愿者和33名首发重度女性抑郁症患者进行中性和负性情绪图片的交叉视觉刺激,刺激过程中进行功能磁共振成像。采用基于MATLAB平台的SPM8软件包进行功能数据预处理、统计分析和结果显示。统计分析中,采用SPM8基本模式中的单样本t-检验进行组分析,独立双样本t-检验进行组间分析。结果 1、正常对照组面对负性情绪图片刺激时平均激活的脑区为：两侧颞中回、右颞下回、右枕中回、右角回、左岛叶及双侧小脑。 2、抑郁症患者面对负性情绪图片刺激时平均激活的脑区为：双侧颞中回、左颞下回、左枕下回、左枕上回、双侧舌回、双侧梭状回、左额上回、右楔前叶、双侧角回、左小脑、脑干。 3、与正常对照组相比,面对负性情绪图片刺激时,抑郁症患者的双侧海马、双侧楔前叶、双侧后扣带回、右角回、右枕中回、右颞上回、右岛叶及右侧小脑激活程度显著增加；未见明显激活减低区。 4、与非应激组相比,在负性情绪图片刺激下,应激组激活显著增加的脑区有：双侧颞上回、左颞中回、左枕中回、左额内侧回、右额下回、双侧中央前回、双侧中央后回、双侧额中回、右楔前叶、左中央旁小叶、双侧丘脑、双侧海马、左小脑；未见明显激活减低区。结论 1.抑郁症患者在负性情绪图片刺激下存在着与情绪处理相关脑区的激活异常。结果显示,抑郁症患者和正常对照相比较,在负性情绪图片刺激时表现为双侧海马、双侧楔前叶、双侧后扣带回、右角回、右枕中回、右颞上回、右岛叶及右侧小脑激活程度显著增加；而未见激活显著减低区。提示抑郁症患者对负性情绪刺激的神经反应增强,存在负性认知模式。 2.应激组在负性情绪图片刺激时,多个脑区的激活较非应激组增强,包括双侧颞上回、左颞中回、左枕中回、左额内回、右额下回、双侧中央前回、双侧中央后回、双侧额中回、右楔前叶、左中央旁小叶、双侧丘脑、双侧海马、左小脑。提示发病前存在应激性生活事件的患者对负性情绪刺激的感知判断可能存在更大的偏倚,及存在更为明显的负性认知。
[Abstract]:Objective to compare the differences and similarities between the normal control group and the first-episode severe female depression patients, the stress group and the non-stress group under the negative emotional picture stimulation in the brain activation region by the visual stimulation mode of the international emotional picture, and to compare the difference between the normal control group and the first-episode severe female depression group. To explore the neuropathological mechanism of negative cognitive model and the effect of stress factors on depression. Methods Twenty normal female volunteers and 33 first-episode patients with severe female depression were subjected to cross-visual stimulation of neutral and negative emotional images. Functional magnetic resonance imaging (fMRI) was performed during stimulation. SPM8 software package based on MATLAB platform was used for functional data preprocessing, statistical analysis and results showed. In the statistical analysis, a single sample t-test in the basic SPM8 model was used for group analysis. Independent double-sample t-test was used for inter-group analysis. Results. 1. In the normal control group, the average activation areas of the brain were: bilateral middle temporal gyrus, right inferior temporal gyrus, right middle occipital gyrus, right angle gyrus, left island lobe and bilateral cerebellum. 2. The average activation areas of depression patients in the face of negative emotional picture stimulation were: bilateral middle temporal gyrus, left inferior temporal gyrus, left inferior occipital gyrus, left superior occipital gyrus, bilateral lingual gyrus, bilateral fusiform gyrus, left superior frontal gyrus, right anterior wedge lobe, bilateral angular gyrus, left cerebellum, left cerebellum, left superior occipital gyrus, bilateral fusiform gyrus, left superior frontal gyrus. Brain stem. 3Compared with the normal control group, the activation degree of bilateral hippocampus, bilateral anterior cuneate lobe, bilateral posterior cingulate gyrus, right angle gyrus, right middle occipital gyrus, right superior temporal gyrus, right insular lobe and right cerebellum were significantly increased in patients with depression. No significant activation decreased area was found. 4Compared with the non-stress group, under the stimulation of negative emotional picture, the activation of bilateral superior temporal gyrus, left middle temporal gyrus, left middle occipital gyrus, left medial frontal gyrus, right inferior frontal gyrus, bilateral precentral gyrus and bilateral posterior central gyrus were significantly increased in the stress group. Bilateral middle frontal gyrus, right anterior cuneate lobe, left paracentral lobule, bilateral thalamus, bilateral hippocampus, left cerebellum; Conclusion. 1. There were abnormal activation in the brain regions associated with emotion processing in patients with depression under negative emotional picture stimulation. The results showed that the depression patients showed bilateral hippocampal activity and bilateral anterior wedge lobe during negative emotional picture stimulation compared with normal controls. The activation degree of bilateral cingulate gyrus, right angle gyrus, right middle occipital gyrus, right superior temporal gyrus, right insular lobe and right cerebellum increased significantly, but no significant decreased activation area was found. There is a negative cognitive model. 2. In the negative emotional picture stimulation, the activation of multiple brain regions in the stress group was higher than that in the non-stress group, including bilateral superior temporal gyrus, left middle temporal gyrus, left middle occipital gyrus, left medial frontal gyrus, right inferior frontal gyrus, bilateral precentral gyrus and bilateral posterior central gyrus. Bilateral middle frontal gyrus, right anterior cuneate lobe, left central lobe, bilateral thalamus, bilateral hippocampus, left cerebellum. And there is more obvious negative cognition.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R445.2;R749.4

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