本文選題：抑郁癥 + 兒童期創(chuàng)傷��； 參考：《中南大學(xué)》2013年博士論文

【摘要】：背景：抑郁癥是一類最常見的精神障礙,抑郁癥的高患病率、高致殘率、高致死率給患者及家人、社會(huì)帶來嚴(yán)重的危害和極大的負(fù)擔(dān),在疾病負(fù)擔(dān)研究中,抑郁癥在全世界致殘疾病中排名第一,在總疾病負(fù)擔(dān)中排名第四,并預(yù)計(jì)到2020年會(huì)躍居至疾病總負(fù)擔(dān)排名的第二。抑郁癥的相關(guān)機(jī)制研究是現(xiàn)在精神疾病研究中的熱點(diǎn)與前沿問題。目前認(rèn)為抑郁癥的發(fā)生是遺傳因素和環(huán)境因素相互作用的結(jié)果,雙生子和家系研究顯示遺傳因素在抑郁癥發(fā)生中的作用約為三分之一,而環(huán)境因素的作用則約為三分之二。兒童創(chuàng)傷是環(huán)境因素影響抑郁癥發(fā)生的主要方式之一,臨床樣本研究、社區(qū)人群研究以及流行病學(xué)研究一致顯示兒童期創(chuàng)傷和抑郁癥顯著相關(guān)。兒童期創(chuàng)傷不僅影響抑郁癥的發(fā)生,而且是影響抑郁癥的病程和預(yù)后的重要因素。然而,有兒童期創(chuàng)傷經(jīng)歷的抑郁癥患者的生物學(xué)特征尚不清楚。 目的：本研究的研究目的是采用靜息態(tài)功能磁共振技術(shù),使用基于圖論的腦功能網(wǎng)絡(luò)的數(shù)據(jù)分析方法,研究有兒童期創(chuàng)傷的抑郁癥患者的腦功能網(wǎng)絡(luò)特征。 方法：共有18例有兒童期創(chuàng)傷經(jīng)歷的抑郁癥患者、20例沒有兒童期創(chuàng)傷經(jīng)歷的抑郁癥患者和20例正常對(duì)照進(jìn)行靜息態(tài)腦功能磁共振掃描。采用基于體素的全腦功能連接網(wǎng)絡(luò)分析方法,研究有兒童期創(chuàng)傷經(jīng)歷的抑郁癥患者的腦功能網(wǎng)絡(luò)連接的特性,并使用多元回歸分析方法探討腦功能連接網(wǎng)絡(luò)改變與兒童期創(chuàng)傷的關(guān)系。 結(jié)果：以年齡、性別、受教育程度為協(xié)變量,對(duì)三組的腦功能連接網(wǎng)絡(luò)圖進(jìn)行方差分析發(fā)現(xiàn)三個(gè)組在雙內(nèi)側(cè)前額皮質(zhì)、雙外側(cè)前額葉皮質(zhì)、內(nèi)側(cè)顳葉、島葉、丘腦等多個(gè)腦區(qū)存在顯著差異。Post hoc組間兩兩比較發(fā)現(xiàn),與正常對(duì)照相比,沒有兒童期創(chuàng)傷經(jīng)歷的抑郁癥患者組雙側(cè)腹內(nèi)側(cè)前額葉/腹側(cè)前扣帶的功能連接強(qiáng)度減低,而有兒童期創(chuàng)傷經(jīng)歷的抑郁癥患者雙側(cè)腹內(nèi)側(cè)前額葉/腹側(cè)前扣帶、雙側(cè)外側(cè)前額葉、背內(nèi)側(cè)前額葉、島葉、尾狀核、丘腦、海馬旁回、海馬、杏仁核、小腦等廣泛腦區(qū)功能連接強(qiáng)度減低。值得注意的是,兩組抑郁癥患者都顯示出雙側(cè)腹內(nèi)側(cè)前額葉/腹側(cè)前扣帶功能連接強(qiáng)度的減低,而兩抑郁癥組的直接比較發(fā)現(xiàn)有兒童期創(chuàng)傷經(jīng)歷的抑郁癥患者許多腦區(qū)的功能連接強(qiáng)度較沒有兒童期創(chuàng)傷經(jīng)歷的抑郁癥患者減低,這些腦區(qū)中大部分(雙側(cè)腹內(nèi)側(cè)前額葉/腹側(cè)前扣帶除外)在有兒童期創(chuàng)傷經(jīng)歷的抑郁癥患者與正常對(duì)照比較時(shí)也得到發(fā)現(xiàn)�；隗w素的多元回歸分析顯示有兒童期創(chuàng)傷經(jīng)歷的抑郁癥患者雙側(cè)內(nèi)側(cè)前額葉、雙側(cè)背外側(cè)前額葉、雙側(cè)丘腦、前扣帶以及左側(cè)島葉與兒童期創(chuàng)傷呈顯著負(fù)相關(guān)。 結(jié)論：有兒童期創(chuàng)傷經(jīng)歷的抑郁癥患者和沒有兒童期創(chuàng)傷經(jīng)歷的抑郁癥患者存在共同的腦功能連接強(qiáng)度的減低：兩組抑郁癥患者均顯示出雙側(cè)腹內(nèi)側(cè)前額葉/腹側(cè)前扣帶功能連接強(qiáng)度的減低。廣泛的前額葉-邊緣系-丘腦-小腦環(huán)路腦區(qū)的功能連接強(qiáng)度減低是有兒童期創(chuàng)傷經(jīng)歷的抑郁癥患者的特征性改變,且功能連接強(qiáng)度的減低與兒童期創(chuàng)傷顯著相關(guān)。
[Abstract]:Background: depression is the most common mental disorder, the high incidence of depression, high disability rate, high mortality rate to the patients and family, and the great burden of society. In the study of the burden of disease, depression is ranked first in the worldwide disabling disease, and is ranked fourth in the total disease burden, and is expected to be in 2020. The study on the related mechanism of depression is second. The research on the mechanism of depression is a hot and front issue in the study of mental illness. The occurrence of depression is considered as a result of the interaction of genetic and environmental factors. The study of double birth and family studies shows that the role of genetic factors in the occurrence of depression is about 1/3. The effect of environmental factors is about 2/3. Children's trauma is one of the main ways of environmental factors affecting depression. Clinical sample studies, community population studies and epidemiological studies show a significant correlation between childhood trauma and depression. Childhood trauma not only affects the occurrence of depression, but also affects depression. However, the biological characteristics of depressive patients with childhood trauma are unclear.
Objective: the purpose of this study was to use the resting state functional magnetic resonance (fMRI) technique and the data analysis method based on the graph based brain functional network to study the brain function network characteristics of the patients with childhood traumatic depression.
Methods: a total of 18 depressive patients with childhood traumatic experience, 20 depressive patients without childhood trauma and 20 normal controls were performed resting brain functional magnetic resonance imaging (fMRI). The whole brain functional connection network analysis based on voxel was used to study the brain function network of the depressive patients with childhood traumatic experience. The relationship between brain functional connectivity network and childhood trauma was explored by multiple regression analysis.
Results: with age, sex and education as covariates, the analysis of variance analysis of the three groups of brain functional connection networks found that there were significant differences between the three groups in the double medial prefrontal cortex, the double lateral prefrontal cortex, the medial temporal lobe, the insula, and the thalamus, which were significantly different between the.Post hoc groups. Compared with the normal control, no children were found. The functional connection intensity of bilateral ventral medial prefrontal lobes / ventral anterior cingulate bands, bilateral ventral medial prefrontal lobes / ventral anterior cingulate bands, bilateral lateral prefrontal lobes, medial prefrontal lobes, insula, caudate nucleus, thalamus, parahippocampal gyrus, hippocampus, amygdala, cerebellum, and other depressive patients with childhood traumatic experience were reduced. It is worth noting that the two groups of depressive patients show a reduction in bilateral ventral prefrontal prefrontal / ventral anterior cingulate functional connection intensity, while the two depressive group directly compares the functional connection intensity of many brain areas with children with childhood traumatic experience. Most depression patients in these regions (except for bilateral ventral medial prefrontal lobes / ventral anterior cingulate bands) were also found in children with childhood traumatic experience. Multiple regression analysis of voxel based regression analysis showed bilateral medial prefrontal lobes and bilateral dorsal parts of patients with childhood traumatic experience. The lateral prefrontal cortex, bilateral thalamus, anterior cingulate and left insula are negatively correlated with childhood trauma.
Conclusion: depressive patients with childhood traumatic experience and depressive patients without childhood traumatic experience have a common reduction in the intensity of brain function connection: two groups of depressive patients show a reduction in bilateral ventral prefrontal / ventral anterior cingulate functional connection intensity. The decrease of functional connectivity in the area is a characteristic change in the patients with childhood traumatic experience, and the reduction of functional connection intensity is significantly associated with childhood trauma.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2013
【分類號(hào)】：R749.4

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相關(guān)期刊論文 前2條

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本文編號(hào)：1969827