注意网络测查在抑郁症患者诊疗中的应用

发布时间：2018-06-15 10:19

本文选题：注意网络测查 + 抑郁症　；参考：《浙江大学》2013年硕士论文

【摘要】：目的：本研究拟通过比较抑郁症个体和健康人群的注意网络测查(Attention Network Test, ANT)测查成绩,比较根据ANT成绩指导用药和经验用药治疗抑郁症的疗效,探究ANT在抑郁症诊疗中的作用。方法： 1.以健康人群ANT测查成绩建立正常样本数据,了解抑郁症组ANT成绩,事件相关电位(Event Related Potentials, ERPs)波形与正常对照有无差异。 2.以是否根据ANT成绩指导用药分为干预组和对照组,比较治疗后ANT测查成绩、临床心理评估等各项指标的组间差异。 3.结合事件相关电位定性比较治疗前后两组相应的头皮波幅分布图。结果： 1.根据健康人群ANT测查结果确定ANT测查行为学正常值的范围为警觉网络效率正常值范围：16.54-52.06；定向网络效率正常值范围：21.75-62.19；执行控制网络效率正常值范围：51.1-166.54。与正常样本数据比较,抑郁症组的警觉网络效率、定向网络效率和执行控制网络效率均显著异常。 2.抑郁症患者的执行控制网络ERPs波形与正常对照组相似,在前额叶区域(FPZ/F1/F2)在200-400ms存在P200-400,在枕叶区域(01/02)和顶叶区域(PZ)存在200-400ms的N200-400。抑郁症组在FPZ的P200-400波幅均显著小于正常对照组(P0.05)；抑郁症组在中央提示和双重提示条件下诱发的波形与正常对照组基本相似,正常对照组在T6电极较抑郁症组诱发出更负的N150-250(P0.05),在枕叶中央区域(OZ)较抑郁症组诱发出更正的P150-250(P0.05)；抑郁症组在空间提示条件下诱发的波形与正常对照组基本相似,正常对照组在OZ较抑郁症组诱发出更正的P150-250(P0.05)。 3.药物治疗后2、4、6、8周的简明精神病评定量表(Brief Psychiatric Rating Scale, BPRS),总分、蒙哥马利抑郁评定量(Montgomery-Asberg depression rating scale, MADRS),总分和临床疗效总评量表(Clinical Global Impression scale, CGI-GI),总分比较,除第2周BPRS总分、第6周、第8周的CGI-GI评分组间比较无显著性差异外,其他组间比较均存在显著性差异。 4.药物治疗后8周的ANT测查行为学结果显示干预组ANT测查的正确率、警觉网络效率和执行控制网络效率显著好于非干预组。两组间在正确的反应时间和定向网络效率上无显著性差异。 5.治疗后8周ANT测查ERPs头皮波幅分布图显示干预组执行控制网络成分300-400ms的前额叶区域激活明显大于非干预组；干预组中央提示和双重提示诱发的ERPs成分150-250ms的前额叶区域激活明显大于非干预组,左侧颞枕区激活明显大于非干预组；干预组空间提示诱发的ERPs成分150-250ms的头皮波幅分布图与非干预组基本相似。结论： 1.抑郁症患者存在注意网络功能的障碍。 2.采用注意网络测查成绩指导抑郁症药物治疗能提高疗效。 3.采用注意网络测查成绩指导抑郁症药物能提高抑郁症患者的注意网络功能。
[Abstract]:Objective: the purpose of this study was to compare the results of attention Network Test (ANT) test of depression individuals and healthy people, and to compare the efficacy of drug use and experiential medication in the treatment of depression according to ant scores. To explore the role of ant in the diagnosis and treatment of depression. Methods: 1. To establish the normal sample data from the ANT test results of healthy population, to understand the ANT scores, event related potentials (ERPs) waveforms of depression group and the normal control. 2. The patients were divided into intervention group and control group according to whether or not to guide drug use according to ANT scores. The differences of ANT test scores and clinical psychological evaluation were compared between groups. 3. The scalp amplitude distribution of the two groups before and after treatment was compared qualitatively with event-related potentials. Results: 1. According to the results of ant test in healthy population, the normal range of behavior of ant test is: normal value of alert network efficiency: 16.54-52.06; normal value of directed network efficiency: 21.75-62.19; normal value of executive control network efficiency: 51.1-166.54. Compared with normal sample data, the alertness network efficiency, directed network efficiency and executive control network efficiency of depression group were significantly abnormal. 2. The ERPs waveform of the executive control network in patients with depression was similar to that in the normal control group. There were P200-400 in 200-400ms, N200-400 in occipital area and N200-400 in parietal area. The amplitude of P200-400 in depression group was significantly lower than that in normal control group (P 0.05), and the waveform in depression group was similar to that in normal control group under central and double cues. In the normal control group, more negative N150-250 P0.05 was induced at the T6 electrode than in the depression group, and the corrected P150-250 P0.05 was induced in the central occipital area of the depression group, and the waveform in the depression group was similar to that in the normal control group under the spatial cues. In the normal control group, the corrected P150-250 P0.05A was induced in OZ group than that in the depression group. 3. Brief Psychiatric rating scale (BPRS), total score, Montgomery-Asberg depression rating scale, MADRSs, total score and clinical efficacy scale, CGI-GI, total score, except for the second week BPRS total score, the 6th week, the total score, the total score and the clinical global impact scale, CGI-GI, total score, Montgomery-Asberg depression rating scale, Madrid score, total score and clinical curative effect scale, CGI-GI, total score comparison, except for the 2nd week BPRS total score, the 6th week, There was no significant difference in CGI-GI score between the groups in the 8th week, but there was significant difference between the other groups. 4. After 8 weeks of drug therapy, the behavioral results of ant test showed that the correct rate of ANT test, alert network efficiency and executive control network efficiency in the intervention group were significantly better than those in the non-intervention group. There was no significant difference between the two groups in the correct reaction time and directional network efficiency. 5. 5. 8 weeks after treatment, the scalp amplitude distribution of ERPs by ANT showed that the activation of prefrontal area of 300-400ms in the intervention group was significantly higher than that in the non-intervention group. In the intervention group, the activation of the prefrontal area of 150-250ms was significantly greater than that of the non-intervention group, and the activation of the left temporooccipital area was significantly greater than that of the non-intervention group. The scalp amplitude distribution of 150-250ms induced by spatial cues in the intervention group was similar to that in the non-intervention group. Conclusion: 1. Depression patients have attention network dysfunction. 2. Using attention network test results to guide depression drug treatment can improve the efficacy. 3. Using attention network test to guide depression drugs can improve the attention network function of depression patients.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R749.4

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