本文選題：功能磁共振　切入點(diǎn)：局部一致性　出處：《南京醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的 檢測(cè)抑郁癥(major depressive disorder)患者在認(rèn)知行為治療(cognitive-behavior therapy, CBT)前后的大腦功能活動(dòng)變化的情況,以初步探索CBT對(duì)抑郁癥的神經(jīng)生物學(xué)機(jī)制。 方法 11名首次發(fā)病且未經(jīng)任何系統(tǒng)治療的抑郁癥患者及12名在性別、年齡、教育年限上相匹配的健康對(duì)照者,進(jìn)行靜息態(tài)與任務(wù)態(tài)的功能磁共振(function magnetic resonance imaging)掃描。任務(wù)態(tài)掃描中被試需執(zhí)行一個(gè)對(duì)面部表情圖片進(jìn)行性別判斷的任務(wù),圖片包括中性、負(fù)性及正性三種情緒類型�；颊咴�6周的CBT后再次接受相同的功能磁共振掃描。采用Rest和SPM8軟件處理影像數(shù)據(jù),包括靜息態(tài)下的局部一致性(Regional homogeneity, ReHo)和任務(wù)態(tài)下的腦激活強(qiáng)度分析。 結(jié)果 相對(duì)于正常對(duì)照組,靜息態(tài)下,治療前抑郁癥患者右緣上回(t=-3.18,P0.05)和右額下回島蓋部(t=-2.99,P0.05)的ReHo值降低。治療后患者左額中回(t=3.24,P0.05)和右額中回(t=3.06,P0.05)的ReHo值增高；負(fù)性刺激下,治療前患者右小腦(t=-3.53,P0.05)和左中央后回(t=-4.31,P0.05)激活降低,治療后小腦蚓部激活降低(t=-4.07,P0.05)。相對(duì)于治療前,靜息態(tài)下,治療后患者左海馬(t=-3.92,P0.05)的ReHo值增高；負(fù)性刺激下,患者左梭狀回(t=-5.05,P0.05)、右島葉(t=-4.71,P0.05)、左尾狀核(t=-4.13,P0.05)、右額中回(t=-5.96,P0.05)、左頂下小葉(t=-5.08,P0.05)激活較前增高；正性表情刺激下,患者左中央前回(t=4.67,P0.05)、右額下回島蓋部(t=5.10,P0.05)、兩側(cè)緣上回(右：t=5.19；左：t=4.81,P0.05)激活降低。 結(jié)論 本研究結(jié)果提示短程的CBT治療以后,一方面,上調(diào)情緒加工及認(rèn)知監(jiān)控系統(tǒng),促使患者更好地識(shí)別與處理負(fù)性情緒；另一方面,下調(diào)異常的反應(yīng)抑制系統(tǒng),與自身癥狀無關(guān)的外界信息的抑制減少,加工資源得以重新配置,促使患者不再聚焦于癥狀本身。這兩方面相互作用,促進(jìn)內(nèi)在情緒與外界環(huán)境信息的平衡與穩(wěn)定,以達(dá)到抗抑郁的治療效果。
[Abstract]:Purpose. The changes of brain function in patients with major depressive before and after cognitive-behavior therapy were detected to explore the neurobiological mechanism of CBT in depression. Method. Eleven first-time depressive patients without any systematic treatment and 12 healthy controls matched in sex, age, and years of education. The rest and task states were scanned by functional magnetic resonance imaging.The subjects were asked to perform a gender judgment task on the facial expression images, which included neutral, neutral, and neutral images. The patients received the same fMRI scan again after 6 weeks of CBT. Rest and SPM8 software were used to process the image data. The regional homogeneity (ReHox) in resting state and the brain activation intensity in task state are analyzed. Results. Compared with the normal control group, the ReHo values of the patients with depression before treatment were significantly lower than those of the normal control group. The ReHo values of the patients with depression before treatment were lower than those of the patients with depression before treatment. The ReHo values of the right inferior frontal gyrus and the right inferior frontal gyrus were significantly lower than those of the patients with depression before treatment. After treatment, the ReHo values of the left middle frontal gyrus and the right middle frontal gyrus were higher than those of the right middle frontal gyrus and the right middle frontal gyrus. Before treatment, the activation of the right cerebellum was decreased, and the activation of the left posterior gyrus was decreased, and the activation of the cerebellar vermis was decreased after treatment. Compared with the patients before and after treatment, the ReHo values of the left hippocampus increased after treatment. In the left fusiform gyrus, the activation was higher in the left fusiform gyrus than in the left fusiform gyrus, and the activation was higher in the right fusiform gyrus, the right precentral gyrus, the right inferior frontal gyrus, the right middle frontal gyrus and the left inferior parietal lobule, and the activation of the left central gyrus t4.67 and the right inferior frontal gyrus was decreased, and the activation of the superior marginal gyrus was 5.19; the left subparietal lobe was 4.81P0.05; and the activation of the right inferior frontal gyrus was decreased in the right inferior frontal gyrus (T5.10P0.05). Conclusion. The results of this study suggest that after short-term CBT therapy, on the one hand, the emotional processing and cognitive monitoring system can be upregulated to promote the patients to better identify and deal with negative emotions; on the other hand, the abnormal response inhibition system can be down-regulated. The inhibition of external information, which is independent of symptoms, is reduced, and processing resources are reconfigured so that patients are no longer focused on the symptoms themselves. These two aspects interact to promote the balance and stability of internal emotions and external environmental information. In order to achieve antidepressant effect.
【學(xué)位授予單位】：南京醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：B842

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本文編號(hào)：1603241