述情障碍者执行功能损伤及情绪对其执行功能的影响和神经机制

发布时间：2018-03-29 05:31

本文选题：述情障碍　切入点：Stroop　出处：《安徽医科大学》2012年博士论文

【摘要】：目的：述情障碍(alexithymia)是以情绪鉴别和情绪体验困难以及难以区分情感和身体的感觉为主要特征的情绪障碍。近来一些研究提出述情障碍者存在执行功能异常,但很少有研究深入关注述情障碍者的执行功能哪些方面出现损害以及情绪对其执行功能的调节影响作用。本研究是基于神经心理学和电生理的研究方法,探讨述情障碍者的执行功能损害情况,尤其关注冲突加工和反应抑制过程,并且通过事件相关电位(event-related potentials ERP)和源定位分析探讨情绪对述情障碍者反应抑制过程的调节作用及神经机制。方法：在安徽医科大学大三临床专业的400名学生中,选出多伦多述情障碍量表(TAS-20)得分在60分以上的33人为述情障碍组,得分在40分以下的30人为对照组。排除精神疾病,脑损伤,抑郁症,焦虑症等,并在年龄、教育、性别、利手方面均匹配。两组分别进行执行功能相关的神经心理学实验(Stroop色词实验,数字广度与数字符号实验(Digital Span and Digital Sign),注意网络实验(attention network test ANT)以及基于正、中、负三种不同情绪背景的Go/Nogo范式的事件相关电位研究。结果：1、神经心理学实验结果：与对照组比较,述情障碍组在Stroop实验中A、B卡片实验的反应时与错误率的差异无统计学意义(t=-0.87, P0.05,t=.34,P0.05),但C卡片的反应时显著延迟(t=2.83,P=0.006)。并且,述情障碍组的干扰效应(Stroop interference effects, SIE)显著长于对照组(t=3.75,P0.001)。述情障碍组在数字广度实验的顺向测试(t=-2.81,P=0.008)和反向测试的记忆数均低于对照组(t=-4.71,P0.001),数字符号得分也远低于对照组(t=-2.26,P0.05)。在ANT实验中,两组在注意网络测试的总反应时和正确率上无明显差别(r(63)=0.532, P=0.601,t(63)=0.345, P=0.738)。在执行冲突网络中,述情障碍组的反应时明显延长于对照组(t(63)=2.568,P=0.01)。在警觉和定向网络中,两组在反应时和所占总时间的比率均无统计学差异(t(63)=-0.42, P0.05,t(63)=1.448, P0.05)。 2、神经电生理实验结果：在负性情绪背景下,述情障碍组的Nogo-Go P3波幅远远高于对照组[F(1,29)=4.47,P0.05]。源定位分析提示,扣带前回(anterior cingulate cortex ACC)在述情障碍者情绪调节反应抑制的过程中显著激活。结论：述情障碍者存在执行功能受损,尤其在反应抑制方面。同时发现,对负性情绪体验困难是述情障碍者显著特征之一,并且研究提示ACC是述情障碍者情绪调节反应抑制的重要中枢。
[Abstract]:Objective: alexithymia (alexithymia) is an emotional disorder characterized by emotional discrimination and emotional experience difficulties and difficulty in distinguishing emotional and physical sensations. Some recent studies have suggested that alexithymia has abnormal executive function in patients with alexithymia. However, few studies have focused on which aspects of the executive function of alexithymia are impaired and the regulatory effects of emotion on their executive function. This study is based on neuropsychological and electrophysiological research methods. To explore the impairment of executive function in persons with alexithymia, paying particular attention to the process of conflict processing and response suppression, The effects of emotion on the inhibitory process of alexithymia were investigated by event-related potentials ERP and source location analysis. Methods: among the 400 students majoring in the third year clinical major of Anhui Medical University, 33 patients with alexithymia scored above 60 points were selected as the Toronto alexithymia scale, and 30 patients with the score below 40 were selected as the control group. Brain injury, depression, anxiety disorder, and age, education, sex, hand, etc. The two groups were tested with Stroop coloring words related to executive function. Digital Span and Digital sign, attention network test ANTand the event-related potentials of Go/Nogo paradigm based on positive, middle and negative emotional backgrounds. Results: compared with the control group, there was no significant difference in the response time and error rate between the alexithymia group and the Stroop test. There was no significant difference in the response time and error rate between the two groups, P 0.05, P 0.05, P 0.05, but the response time of the C card was significantly delayed by 2.83P0.006. and, in comparison with the control group, there was no significant difference in the response time and error rate between the alexithymia group and the control group. The interference effect of alexithymia group (sie) was significantly longer than that of control group (3.75g / P 0.001g). The memory of the alexithymia group was significantly lower than that of the control group in the anterograde test (-2.81g) and reverse test (P 0.008). The scores of digital symbols were also significantly lower than those in the control group (P 0.05). In the ANT experiment, the scores of digital symbols were also significantly lower than those in the control group (P < 0.05), which were also significantly lower than those in the control group (P < 0.05). In the ANT experiment, the memory of the patients with alexithymia was significantly lower than that of the control group. There was no significant difference between the two groups in the total response time and correct rate of attention network test. There was no significant difference between the two groups in the total reaction time and accuracy rate of the two groups. The response time of the alexithymia group was significantly longer than that of the control group in the conflict network. In the alertness and orientation network, the response time of the alexithymia group was significantly longer than that of the control group. In the alert and orientation network, the response time of the alexithymia group was significantly longer than that of the control group. There was no statistical difference in the ratio of reaction time and total time between the two groups. 2. Results of neuroelectrophysiological experiment: in negative emotional background, the amplitude of Nogo-Go P3 in alexithymia group was much higher than that in the control group [FF1O29] 4.47 (P0.05). Source localization analysis suggested that anterior cingulate cortex acc was significantly activated in the process of inhibition of emotional regulatory response in alexithymic patients with alexithymia. Conclusion: the executive function of alexithymia is impaired, especially in the aspect of response inhibition. At the same time, it is found that the difficulty in experiencing negative emotion is one of the significant characteristics of alexithymia. It is suggested that ACC is an important center for inhibition of mood regulation in alexithymia.
【学位授予单位】：安徽医科大学
【学位级别】：博士
【学位授予年份】：2012
【分类号】：R749

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