本文選題：重度抑郁癥　切入點：功能性磁共振　出處：《天津醫(yī)科大學》2013年碩士論文　論文類型：學位論文

【摘要】：目的通過國際情緒圖片視覺刺激模式誘發(fā)情緒,分別比較正常對照與首發(fā)重度女性抑郁癥患者,應激組與非應激組在負性情緒圖片刺激下腦激活區(qū)的異同,探討抑郁癥患者負性認知模式的神經(jīng)病理機制及應激因素對抑郁癥的影響。 方法對20名女性正常志愿者和33名首發(fā)重度女性抑郁癥患者進行中性和負性情緒圖片的交叉視覺刺激,刺激過程中進行功能磁共振成像。采用基于MATLAB平臺的SPM8軟件包進行功能數(shù)據(jù)預處理、統(tǒng)計分析和結(jié)果顯示。統(tǒng)計分析中,采用SPM8基本模式中的單樣本t-檢驗進行組分析,獨立雙樣本t-檢驗進行組間分析。 結(jié)果 1、正常對照組面對負性情緒圖片刺激時平均激活的腦區(qū)為：兩側(cè)顳中回、右顳下回、右枕中回、右角回、左島葉及雙側(cè)小腦。 2、抑郁癥患者面對負性情緒圖片刺激時平均激活的腦區(qū)為：雙側(cè)顳中回、左顳下回、左枕下回、左枕上回、雙側(cè)舌回、雙側(cè)梭狀回、左額上回、右楔前葉、雙側(cè)角回、左小腦、腦干。 3、與正常對照組相比,面對負性情緒圖片刺激時,抑郁癥患者的雙側(cè)海馬、雙側(cè)楔前葉、雙側(cè)后扣帶回、右角回、右枕中回、右顳上回、右島葉及右側(cè)小腦激活程度顯著增加；未見明顯激活減低區(qū)。 4、與非應激組相比,在負性情緒圖片刺激下,應激組激活顯著增加的腦區(qū)有：雙側(cè)顳上回、左顳中回、左枕中回、左額內(nèi)側(cè)回、右額下回、雙側(cè)中央前回、雙側(cè)中央后回、雙側(cè)額中回、右楔前葉、左中央旁小葉、雙側(cè)丘腦、雙側(cè)海馬、左小腦；未見明顯激活減低區(qū)。 結(jié)論 1.抑郁癥患者在負性情緒圖片刺激下存在著與情緒處理相關(guān)腦區(qū)的激活異常。結(jié)果顯示,抑郁癥患者和正常對照相比較,在負性情緒圖片刺激時表現(xiàn)為雙側(cè)海馬、雙側(cè)楔前葉、雙側(cè)后扣帶回、右角回、右枕中回、右顳上回、右島葉及右側(cè)小腦激活程度顯著增加；而未見激活顯著減低區(qū)。提示抑郁癥患者對負性情緒刺激的神經(jīng)反應增強,存在負性認知模式。 2.應激組在負性情緒圖片刺激時,多個腦區(qū)的激活較非應激組增強,包括雙側(cè)顳上回、左顳中回、左枕中回、左額內(nèi)回、右額下回、雙側(cè)中央前回、雙側(cè)中央后回、雙側(cè)額中回、右楔前葉、左中央旁小葉、雙側(cè)丘腦、雙側(cè)海馬、左小腦。提示發(fā)病前存在應激性生活事件的患者對負性情緒刺激的感知判斷可能存在更大的偏倚,及存在更為明顯的負性認知。
[Abstract]:Objective to compare the differences and similarities between the normal control group and the first-episode severe female depression patients, the stress group and the non-stress group under the negative emotional picture stimulation in the brain activation region by the visual stimulation mode of the international emotional picture, and to compare the difference between the normal control group and the first-episode severe female depression group. To explore the neuropathological mechanism of negative cognitive model and the effect of stress factors on depression. Methods Twenty normal female volunteers and 33 first-episode patients with severe female depression were subjected to cross-visual stimulation of neutral and negative emotional images. Functional magnetic resonance imaging (fMRI) was performed during stimulation. SPM8 software package based on MATLAB platform was used for functional data preprocessing, statistical analysis and results showed. In the statistical analysis, a single sample t-test in the basic SPM8 model was used for group analysis. Independent double-sample t-test was used for inter-group analysis. Results. 1. In the normal control group, the average activation areas of the brain were: bilateral middle temporal gyrus, right inferior temporal gyrus, right middle occipital gyrus, right angle gyrus, left island lobe and bilateral cerebellum. 2. The average activation areas of depression patients in the face of negative emotional picture stimulation were: bilateral middle temporal gyrus, left inferior temporal gyrus, left inferior occipital gyrus, left superior occipital gyrus, bilateral lingual gyrus, bilateral fusiform gyrus, left superior frontal gyrus, right anterior wedge lobe, bilateral angular gyrus, left cerebellum, left cerebellum, left superior occipital gyrus, bilateral fusiform gyrus, left superior frontal gyrus. Brain stem. 3Compared with the normal control group, the activation degree of bilateral hippocampus, bilateral anterior cuneate lobe, bilateral posterior cingulate gyrus, right angle gyrus, right middle occipital gyrus, right superior temporal gyrus, right insular lobe and right cerebellum were significantly increased in patients with depression. No significant activation decreased area was found. 4Compared with the non-stress group, under the stimulation of negative emotional picture, the activation of bilateral superior temporal gyrus, left middle temporal gyrus, left middle occipital gyrus, left medial frontal gyrus, right inferior frontal gyrus, bilateral precentral gyrus and bilateral posterior central gyrus were significantly increased in the stress group. Bilateral middle frontal gyrus, right anterior cuneate lobe, left paracentral lobule, bilateral thalamus, bilateral hippocampus, left cerebellum; Conclusion. 1. There were abnormal activation in the brain regions associated with emotion processing in patients with depression under negative emotional picture stimulation. The results showed that the depression patients showed bilateral hippocampal activity and bilateral anterior wedge lobe during negative emotional picture stimulation compared with normal controls. The activation degree of bilateral cingulate gyrus, right angle gyrus, right middle occipital gyrus, right superior temporal gyrus, right insular lobe and right cerebellum increased significantly, but no significant decreased activation area was found. There is a negative cognitive model. 2. In the negative emotional picture stimulation, the activation of multiple brain regions in the stress group was higher than that in the non-stress group, including bilateral superior temporal gyrus, left middle temporal gyrus, left middle occipital gyrus, left medial frontal gyrus, right inferior frontal gyrus, bilateral precentral gyrus and bilateral posterior central gyrus. Bilateral middle frontal gyrus, right anterior cuneate lobe, left central lobe, bilateral thalamus, bilateral hippocampus, left cerebellum. And there is more obvious negative cognition.
【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R445.2;R749.4

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