抑郁症患者不确定奖赏抉择加工神经激活特征研究

发布时间：2018-05-15 21:31

本文选题：抑郁症 + 抉择　；参考：《青岛大学》2013年硕士论文

【摘要】：目的应用功能磁共振成像技术与认知神经科学的方法研究抑郁症患者不确定奖赏抉择加工过程神经激活特征。方法 13例单相抑郁症患者与15例正常健康者进行三种不同程度(确定、风险、含糊)奖赏抉择实验,通过SA-9800脑功能视听觉刺激系统与GE Signa HDx3. OT超导型核磁共振扫描仪程序对接,采用平面回波成像(EPI)序列对受试者进行大脑同步扫描。采用SPM8及REST软件进行预处理、个体分析、组分析、组间分析获得相关激活脑区和激活强度值。比较抑郁症患者与正常健康者不确定奖赏抉择加工神经激活特征,尤其是抑郁症患者神经激活的特点。结果 (一)正常健康者不确定奖赏抉择加工神经激活特点：正常健康者确定奖赏抉择时眶额叶被激活,平均激活强度2.4328±0.1949；风险奖赏抉择时前额叶、中央前回、枕叶联合视皮层、顶下小叶、小脑后叶、颞中回、颞下回、边缘叶及中脑被激活,平均激活强度2.4228±1.3762；含糊奖赏抉择时前额叶、颞极区及颞下回、枕叶视皮层、小脑后叶被激活,平均激活强度2.4056±0.4222。风险奖赏抉择与确定奖赏抉择比较,腹外侧前额叶、前额叶额极、眶额叶、中央前回、颞下回及梭状回、缘上回、顶下小叶、小脑后叶显著被激活(P＜0.05)；含糊奖赏抉择与确定奖赏抉择比较,前额叶额极显著被激活(P＜0.05)；与风险奖赏抉择比较,背外侧前额叶、小脑后叶显著被激活(P＜0.05)。 (二)抑郁症患者不确定奖赏抉择加工神经激活特点：抑郁症患者确定奖赏抉择时枕叶联合视皮层被激活,平均激活强度2.3132±0.4287；风险奖赏抉择前额叶额极、小脑后叶、边缘叶、颞上回、颞极区、枕叶视皮层被激活,平均激活强度1.6704±0.3632；含糊奖赏抉择前额叶额极、颞上回、边缘叶、枕叶视皮层、小脑后叶被激活,平均激活强度1.6965±0.2319；风险奖赏抉择与确定奖赏抉择比较,无激活增强的脑区,但背外侧前额叶,后扣带回,角回,颞中回、颞下回、小脑蚓部激活减低(P＜0.05)；含糊赏奖抉择与确定奖赏抉择比较,无激活增强和减低的脑区(P＞0.05)；含糊奖赏抉择与风险奖赏抉择比较,无激活增强和减低的脑区(P＞0.05)。 (三)抑郁症患者与正常健康者比较,不确定奖赏抉择加工时的神经激活特征：抑郁症组与正常组比较,确定奖赏抉择时,抑郁症组小脑后叶激活增强,但眶额叶、背外侧及腹外侧前额叶、颞中回、颞下回、颞极区、项下小叶激活减低(P＜0.05)；风险奖赏抉择时,抑郁症组无激活增强的脑区,但眶额叶、腹外侧及背外侧前额叶、颞中回、颞下回、顶下小叶激活减低(P＜0.05)；含糊奖赏抉择时,抑郁症组无激活增强的脑区,但眶额叶、腹外侧前额叶、前扣带回、颞中回、中脑、边缘叶、枕叶视皮层激活减低(P＜0.05)。结论 1、不确定奖赏程度不同,抑郁症患者参与加工的脑区存在差异,表现为随着抉择不确定性程度的增加,抑郁症患者激活脑区增多。 2、与正常者比较,抑郁症患者存在奖赏抉择加工异常。表现为奖赏预期效用加工时奖赏相关脑区激活减低,上述异常可能是抑郁症发病的神经病理基础之一。
[Abstract]:objective
Functional neuromagnetic resonance imaging (fMRI) and cognitive neuroscience were used to study the neural activation characteristics of patients with depression during the process of uncertain reward selection.
Method
13 patients with monophasic depression and 15 normal healthy persons were given three different degrees of reward choice experiment (determined, risk, ambiguous). Through the SA-9800 brain functional audio-visual stimulation system and the GE Signa HDx3. OT superconducting NMR scanner program, a plane echo imaging (EPI) sequence was used to synchronize the brain of the subjects. S PM8 and REST software were pretreated, individual analysis, group analysis, and inter group analysis were used to obtain the related activation brain regions and activation intensity values. The characteristics of neural activation in patients with depression and normal health were compared with those of normal healthy individuals, especially in patients with depression.
Result
(1) the normal healthy person is not sure the reward choice processing nerve activation characteristic: the normal healthy person determines the reward choice when the choice is activated, the average activation intensity is 2.4328 + 0.1949; the risk reward choice is the prefrontal lobe, the anterior central gyrus, the occipital lobe combined visual cortex, the lower lobule, the posterior lobe, the middle temporal gyrus, the inferior temporal gyrus, the marginal lobe and the mesencephalon. The average activation intensity was 2.4228 + 1.3762; the prefrontal lobe, the temporal and lower temporal gyrus, the occipital cortex, the posterior lobe of the cerebellum were activated, the average activation intensity was 2.4056 + 0.4222., the ventral prefrontal cortex, the frontal frontal lobe, the frontal lobe, the frontal lobe, the anterior central gyrus, the lower temporal gyrus, the fusiform gyrus, the top margin, the top. Lower lobule, posterior cerebellar lobe was activated significantly (P < 0.05); the prefrontal frontal frontal lobe was significantly activated (P < 0.05) compared with the choice of reward choice (P < 0.05); the dorsal frontal lobes and posterior cerebellar lobe were significantly activated (P < 0.05).
(two) the characteristics of neural activation of the choice of reward choice processing in the patients with depression: the occipital lobe combined visual cortex was activated when the patients were determined to decide the reward. The average activation intensity was 2.3132 + 0.4287. The risk reward choice was the frontal frontal lobe, the posterior lobe of the cerebellum, the marginal lobe, the upper temporal, the temporal region, the occipital visual cortex were activated and the average activation intensity was 1.6704 + 0. .3632; vaguely rewarded with frontal frontal frontal lobe, upper temporal gyrus, marginal lobe, occipital lobe, posterior lobes of the occipital lobe, and posterior lobe of the cerebellum were activated with an average activation intensity of 1.6965 + 0.2319; the risk reward choice was compared with the decision to determine the reward choice, but the lateral prefrontal lobe, the posterior cingulate gyrus, the angular gyrus, the middle temporal gyrus, the inferior temporal gyrus, and the cerebellar vermis activation decreased (P < 0.). 05); there was no activation and reduction of brain area (P > 0.05) in the choice of vagueness reward choice and determination of choice of reward (P > 0.05).
(three) the depressive patients were compared with the normal healthy people, and the nerve activation characteristics of the reward choice processing were not determined. The depression group was compared with the normal group. When the reward choice was determined, the posterior cerebellar lobe activation was enhanced in the depression group, but the orbital frontal lobe, the dorsolateral and ventral prefrontal lobes, the middle temporal gyrus, the inferior temporal gyrus, the temporal region, and the lower lobule activation decreased (P < 0.05). When the risk reward choice was chosen, the depression group did not activate the enhanced brain area, but the orbital frontal lobe, the ventral lateral and the dorsolateral prefrontal lobes, the middle temporal gyrus, the inferior temporal gyrus, and the lower lobule activation decreased (P < 0.05); the depressive group was not activated by the vagus reward choice, but the orbital frontal lobe, the ventral lateral prefrontal lobe, the anterior cingulate gyrus, the middle temporal gyrus, the mesencephalon, the marginal leaf, and the occipital. The activation of visual cortex was decreased (P < 0.05).
conclusion
1, there is a difference in the degree of uncertainty in the degree of reward, and the difference in the brain area of the patients with depression is found, which shows that with the increase of the degree of uncertainty, the brain area of the depressive patients is increased.
2, compared with the normal person, the patients with depression had a reward choice processing anomaly. The reward related brain area activation decreased during the reward expected utility processing. The above abnormality may be one of the neuropathological bases of depression.

【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R749.4

【参考文献】