伴自杀意念抑郁症静息态比率低频振幅和事件相关电位P3研究

发布时间：2018-05-02 08:17

本文选题：抑郁症 + 自杀意念　；参考：《重庆医科大学》2017年硕士论文

【摘要】：目的抑郁症是一类具有严重危害性的精神障碍,10%-15%的患者可有自杀行为。自杀意念是自杀死亡的重要危险因素,有效预测自杀意念并及时进行干预可减少抑郁症的自杀风险。目前国内外主要是从社会心理学角度对抑郁症的自杀意念进行研究,但其相应生物学指标尚不明确。故本研究将运用静息态功能磁共振比率低频振幅和事件相关电位P3来研究伴自杀意念抑郁症的脑影像学和脑电生物学特征。方法按照性别、年龄、受教育程度相匹配的原则在重庆医科大学附属第一医院心理卫生中心收集未治疗伴自杀意念抑郁症患者30例、不伴自杀意念抑郁症患者30例和正常对照组30名,完成一般资料收集及临床心理量表的评定。采集三组被试的静息态脑功能磁共振成像(resting-state functional magnetic resonance imaging,rs-fMRI)数据,用比率低频振幅方法对伴与不伴自杀意念抑郁症组、对照组的静息态脑功能磁共振图像进行比较,得到差异脑区,将伴自杀意念抑郁症组差异脑区的比率低频振幅值与汉密尔顿抑郁量表17项总分、Beck自杀意念量表的总分、自杀意念和自杀危险因子分分别做相关分析;伴自杀意念抑郁症组完成词-面孔干扰的情绪stroop试验,并记录其脑电和行为学数据,比较该组患者在不同类型词-面孔情绪stroop试验的反应时及p3波形的潜伏期和波幅。并将事件相关电位p3的潜伏期和波幅与汉密尔顿抑郁量表17项、beck自杀意念量表的总分、自杀意念和自杀危险因子分分别做相关分析。结果1、与正常对照组相比,伴自杀意念抑郁症组左侧枕上回/枕中回、右侧枕中回/枕下回falff值升高,而右侧颞下回、左侧颞下回及左侧额中回/额上回falff值降低;与正常对照组相比,不伴自杀意念抑郁症组左侧枕上回/枕中回falff值升高,而右侧颞下回、左侧颞下回及左侧额中回/额上回falff值降低;与不伴自杀意念抑郁症组相比,伴自杀意念抑郁症组左侧枕上回/枕中回、右侧枕中回/枕下回falff值升高。伴自杀意念抑郁症组双枕中回的falff值分别与hamd-17项总分正相关,而与beck自杀意念量表相关无统计学意义。2、在不同类型词-面孔情绪stroop条件的下,伴自杀意念抑郁症组平均反应时、erps相关成分p3的波幅差异有统计学意义。p3的波幅与hamd-17项总分、beck自杀意念量表总分、自杀意念因子分和自杀危险因子分负相关。结论伴自杀意念抑郁症组的双侧枕中回的脑功能活动存在异常,抑郁严重程度可能影响其局部异常脑功能活动。伴自杀意念抑郁症在不同情绪面孔刺激下可出现不同程度的注意偏向和认知损害。
[Abstract]:Objective Depression is a serious mental disorder with 10-15% of patients with suicidal behavior. Suicide ideation is an important risk factor for suicide death. Effective prediction of suicide ideation and timely intervention can reduce the suicide risk of depression. At present, the suicide ideation of depression is mainly studied from the angle of social psychology at home and abroad, but its corresponding biological index is not clear. In this study, the resting functional magnetic resonance ratio, low-frequency amplitude and event-related potential P3 were used to study the brain imaging and electrobiological characteristics of depression with suicidal ideation. Methods 30 patients with suicidal ideation depression were collected from the Mental Health Center of the first affiliated Hospital of Chongqing Medical University according to the principle of matching sex, age and education. 30 patients with depression without suicidal ideation and 30 normal controls completed general data collection and evaluation of clinical psychological scale. Resting-state functional magnetic resonance imagingrs-fMRI data were collected from three groups of subjects. The resting brain functional magnetic resonance images of depression group with and without suicidal ideation and control group were compared with low-frequency amplitude ratio method, and the difference brain regions were obtained. The low frequency amplitudes of different brain regions in patients with depression with suicidal ideation were correlated with the total scores of 17 items of Hamilton Depression scale and Beck suicide ideation scale, suicide ideation and suicide risk factors. The mood stroop test of word face interference was completed in the depression group with suicide ideation, and the EEG and behavioral data were recorded. The latency and amplitude of p3 wave were compared in the response time and p3 wave of different types of word face emotion stroop test. The latency and amplitude of event-related potential p3 were correlated with the total scores of 17 items of Hamilton Depression scale, suicidal ideation scale, suicidal ideation score and suicide risk factor score. Results 1. Compared with the control group, the falff values of left superior occipital gyrus / middle occipital gyrus, right middle occipital gyrus / inferior occipital gyrus increased, while falff values of right infratemporal gyrus, left infratemporal gyrus and left middle frontal / suprafrontal gyrus decreased in patients with suicide ideation depression. Compared with the control group, the falff value of left superior occipital gyrus / middle occipital gyrus in depression group without suicidal ideation was increased, while the falff value in right inferior temporal gyrus, left inferior temporal gyrus and left middle frontal / superior frontal gyrus was lower than that in depression group without suicidal ideation. The falff values of left superior / middle occipital gyrus and right middle occipital / suboccipital gyrus were increased in patients with suicide ideation depression. The falff value of the middle occipital gyrus in the depression group with suicidal ideation was positively correlated with the total score of hamd-17, but had no significant correlation with the beck suicide ideation scale. Under the stroop condition of different types of word-face emotion, there was no significant difference between them. There was a significant difference in the amplitude of p3 in patients with suicidal ideation depression. The amplitude of p3 was negatively correlated with the total score of hamd-17, the factor score of suicidal ideation and the score of suicide risk factor. Conclusion the brain function of bilateral middle occipital gyrus is abnormal in patients with suicidal ideation depression, and the severity of depression may affect the local abnormal brain function. Depression with suicidal ideation may lead to different degrees of attention bias and cognitive impairment under the stimulation of different emotional faces.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.4

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