本文選題：抑郁癥 + 抉擇�。� 參考：《青島大學(xué)》2013年碩士論文

【摘要】：目的 應(yīng)用功能磁共振成像技術(shù)與認知神經(jīng)科學(xué)的方法研究抑郁癥患者不確定獎賞抉擇加工過程神經(jīng)激活特征。 方法 13例單相抑郁癥患者與15例正常健康者進行三種不同程度(確定、風(fēng)險、含糊)獎賞抉擇實驗,通過SA-9800腦功能視聽覺刺激系統(tǒng)與GE Signa HDx3. OT超導(dǎo)型核磁共振掃描儀程序?qū)?采用平面回波成像(EPI)序列對受試者進行大腦同步掃描。采用SPM8及REST軟件進行預(yù)處理、個體分析、組分析、組間分析獲得相關(guān)激活腦區(qū)和激活強度值。比較抑郁癥患者與正常健康者不確定獎賞抉擇加工神經(jīng)激活特征,尤其是抑郁癥患者神經(jīng)激活的特點。 結(jié)果 (一)正常健康者不確定獎賞抉擇加工神經(jīng)激活特點：正常健康者確定獎賞抉擇時眶額葉被激活,平均激活強度2.4328±0.1949；風(fēng)險獎賞抉擇時前額葉、中央前回、枕葉聯(lián)合視皮層、頂下小葉、小腦后葉、顳中回、顳下回、邊緣葉及中腦被激活,平均激活強度2.4228±1.3762；含糊獎賞抉擇時前額葉、顳極區(qū)及顳下回、枕葉視皮層、小腦后葉被激活,平均激活強度2.4056±0.4222。風(fēng)險獎賞抉擇與確定獎賞抉擇比較,腹外側(cè)前額葉、前額葉額極、眶額葉、中央前回、顳下回及梭狀回、緣上回、頂下小葉、小腦后葉顯著被激活(P＜0.05)；含糊獎賞抉擇與確定獎賞抉擇比較,前額葉額極顯著被激活(P＜0.05)；與風(fēng)險獎賞抉擇比較,背外側(cè)前額葉、小腦后葉顯著被激活(P＜0.05)。 (二)抑郁癥患者不確定獎賞抉擇加工神經(jīng)激活特點：抑郁癥患者確定獎賞抉擇時枕葉聯(lián)合視皮層被激活,平均激活強度2.3132±0.4287；風(fēng)險獎賞抉擇前額葉額極、小腦后葉、邊緣葉、顳上回、顳極區(qū)、枕葉視皮層被激活,平均激活強度1.6704±0.3632；含糊獎賞抉擇前額葉額極、顳上回、邊緣葉、枕葉視皮層、小腦后葉被激活,平均激活強度1.6965±0.2319；風(fēng)險獎賞抉擇與確定獎賞抉擇比較,無激活增強的腦區(qū),但背外側(cè)前額葉,后扣帶回,角回,顳中回、顳下回、小腦蚓部激活減低(P＜0.05)；含糊賞獎抉擇與確定獎賞抉擇比較,無激活增強和減低的腦區(qū)(P＞0.05)；含糊獎賞抉擇與風(fēng)險獎賞抉擇比較,無激活增強和減低的腦區(qū)(P＞0.05)。 (三)抑郁癥患者與正常健康者比較,不確定獎賞抉擇加工時的神經(jīng)激活特征：抑郁癥組與正常組比較,確定獎賞抉擇時,抑郁癥組小腦后葉激活增強,但眶額葉、背外側(cè)及腹外側(cè)前額葉、顳中回、顳下回、顳極區(qū)、項下小葉激活減低(P＜0.05)；風(fēng)險獎賞抉擇時,抑郁癥組無激活增強的腦區(qū),但眶額葉、腹外側(cè)及背外側(cè)前額葉、顳中回、顳下回、頂下小葉激活減低(P＜0.05)；含糊獎賞抉擇時,抑郁癥組無激活增強的腦區(qū),但眶額葉、腹外側(cè)前額葉、前扣帶回、顳中回、中腦、邊緣葉、枕葉視皮層激活減低(P＜0.05)。 結(jié)論 1、不確定獎賞程度不同,抑郁癥患者參與加工的腦區(qū)存在差異,表現(xiàn)為隨著抉擇不確定性程度的增加,抑郁癥患者激活腦區(qū)增多。 2、與正常者比較,抑郁癥患者存在獎賞抉擇加工異常。表現(xiàn)為獎賞預(yù)期效用加工時獎賞相關(guān)腦區(qū)激活減低,上述異常可能是抑郁癥發(fā)病的神經(jīng)病理基礎(chǔ)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.

【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R749.4

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