發(fā)布時(shí)間：2019-02-17 09:59

【摘要】：目的： 相關(guān)研究證實(shí)抑郁癥患者前額葉皮層-邊緣系統(tǒng)存在結(jié)構(gòu)上和功能上的異常,Granger預(yù)測(cè)分析(GCA)方法能有效地應(yīng)用于靜息態(tài)功能磁共振(fMRI)效應(yīng)連接研究,我們運(yùn)用該技術(shù)來研究首發(fā)未服藥抑郁癥患者前額葉皮層-邊緣系統(tǒng)靜息態(tài)下效應(yīng)連接的改變,并探討異常效應(yīng)連接與患者疾病嚴(yán)重程度和認(rèn)知功能的關(guān)系。 方法： 23例符合重性抑郁發(fā)作(MDD)的患者(年齡31.1±1.5歲,全為右利手)參與本研究,對(duì)照組采用20例性別和年齡匹配的正常志愿者,分別使用漢密爾頓抑郁量表(HAMD)、Montgomery-Asberg抑郁量表(MADRS)和漢密爾頓焦慮量表(HAMA)進(jìn)行病情評(píng)定,然后用Stroop色詞測(cè)驗(yàn)(SCWT)和連線測(cè)驗(yàn)(TMT)進(jìn)行認(rèn)知功能測(cè)試。在完成神經(jīng)心理測(cè)驗(yàn)后進(jìn)行靜息態(tài)功能磁共振掃描,數(shù)據(jù)預(yù)處理后,使用REST-GCA軟件包,以MDD的Meta分析中前扣帶回(ACC)結(jié)果做為種子點(diǎn)坐標(biāo)進(jìn)行基于系數(shù)的GCA分析,雙樣本t檢驗(yàn)分析兩組之間的效應(yīng)連接的差異,最后提取MDD中有顯著統(tǒng)計(jì)學(xué)差異的異常效應(yīng)連接改變腦區(qū)的GCA值與臨床量表和認(rèn)知功能成績做相關(guān)分析。 結(jié)果： 兩組被試的認(rèn)知功能測(cè)驗(yàn)并沒有顯示出顯著的統(tǒng)計(jì)學(xué)差異,在靜息態(tài)fMRI分析結(jié)果中,相比正常對(duì)照,MDD患者的全腦到ACC的效應(yīng)連接增加的區(qū)域主要有右側(cè)島葉皮層(rAI)、右殼核,而效應(yīng)連接降低的腦區(qū)主要有雙側(cè)背外側(cè)額葉皮層,內(nèi)側(cè)前額葉皮層,左側(cè)眶額皮層(P0.05,Alphasim校正)。ACC到全腦的效應(yīng)連接沒有發(fā)現(xiàn)顯著的統(tǒng)計(jì)學(xué)差異。在后驗(yàn)性臨床認(rèn)知相關(guān)分析中,MDD患者左、右DLPFC到ACC效應(yīng)連接與TMT-A完成時(shí)間呈負(fù)相關(guān)(r=-0.59,P0.01；r=-0.77,P0.01),MPFC到ACC效應(yīng)連接的GCA值也與TMT-A完成時(shí)間呈負(fù)相關(guān)(r=-0.70,P0.01),右DLPFC的效應(yīng)連接也和TMT-B完成時(shí)間呈弱負(fù)相關(guān)(r=-0.42,P0.05)。 結(jié)論： 雙側(cè)背外側(cè)額葉皮層的效應(yīng)連接的改變驗(yàn)證了MDD存在自上而下認(rèn)知控制功能減低,揭示出MDD患者潛在的執(zhí)行功能和注意功能障礙。rAI到ACC效應(yīng)連接的異常提示靜息態(tài)下SN切換已出現(xiàn)問題,加上紋狀體到ACC效應(yīng)連接改變,更進(jìn)一步驗(yàn)證了邊緣系統(tǒng)-皮質(zhì)-紋狀體-蒼白球-丘腦神經(jīng)環(huán)路失調(diào),這些特異的異常連接進(jìn)一步補(bǔ)充了MDD患者PLN動(dòng)態(tài)的活動(dòng)過程,反映了其非任務(wù)狀態(tài)下神經(jīng)活動(dòng)基線的異常改變,這些發(fā)現(xiàn)能夠幫助我們區(qū)分和理解MDD的病理機(jī)制。
[Abstract]:Objective: to confirm the structural and functional abnormalities of the prefrontal cortex-marginal system in patients with depression. The Granger predictive analysis (GCA) method can be used effectively in the study of resting functional magnetic resonance (fMRI) effect junctions. We used this technique to study the changes of effect junctions in the prefrontal cortex-marginal system in patients with first-episode depression, and to explore the relationship between abnormal effect connections and the severity of disease and cognitive function in patients with first-episode depression. Methods: Twenty-three patients (31.1 鹵1.5 years old, all right-handedness) who were consistent with (MDD) were enrolled in this study. The control group consisted of 20 normal volunteers who matched their sex and age. Hamilton Depression scale (HAMD), Montgomery-Asberg), Depression scale (MADRS) and Hamilton anxiety scale (HAMA) were used to evaluate the patients' condition, and then the cognitive function was tested by Stroop color-word test (SCWT) and wired test (TMT). The rest functional magnetic resonance imaging (fMRI) was performed after the completion of the neuropsychological test. After data preprocessing, the coefficent GCA analysis was carried out using the (ACC) result of the anterior cingulate in the Meta analysis of MDD as the seed point coordinate. Two-sample t-test was used to analyze the difference of effect connection between the two groups. Finally, the significant difference of abnormal effect junction in MDD was extracted to analyze the GCA value of the brain region and the clinical scale and cognitive function scores. Results: there was no significant difference in cognitive function test between the two groups. In resting fMRI analysis, there was no significant difference between the two groups. In patients with MDD, the increase of effectual junctions from the whole brain to ACC was mainly in the right isobaric cortex (rAI), right putamen nucleus, while the decrease of the effect junction mainly included bilateral dorsolateral frontal cortex, medial prefrontal cortex, left orbital frontal cortex (P0.05), and the bilateral dorsolateral frontal cortex, medial prefrontal cortex, left orbital frontal cortex (P0.05). No significant statistical difference was found between Alphasim and the effect junctions of). ACC to the whole brain. In posterior clinical cognitive correlation analysis, there was a negative correlation between left and right DLPFC to ACC effect junctions and TMT-A completion time in MDD patients (r = 0.59, P 0.01). The GCA value of r-0.77), MPFC to ACC effect connection was also negatively correlated with the completion time of TMT-A (r-0.70 P0.01), and the effect connection of right DLPFC was negatively correlated with the completion time of TMT-B (r-0.42). P0.05). Conclusion: the changes of the effect junctions in bilateral dorsolateral frontal cortex confirm that there is a decrease in top-down cognitive control function in MDD. The abnormal connection between rAI and ACC effect suggests that there is a problem with SN switching in resting state, coupled with changes in striatum to ACC effect junctions. It is further demonstrated that the marginal system-cortex-striatum, globus pallidus and colliculus neurologic disorders, these specific abnormal junctions further supplement the dynamic process of PLN activity in patients with MDD. These findings can help us to distinguish and understand the pathological mechanism of MDD.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R749.4;R445.2

【共引文獻(xiàn)】

相關(guān)期刊論文 前10條

1 彭紅軍;李凌江;鄭薈蓉;;抑郁癥靜息狀態(tài)功能磁共振研究進(jìn)展[J];國際精神病學(xué)雜志;2013年04期

2 齊志剛;鄔霞;孫黎;陳楠;李坤成;;健康老年人的背側(cè)注意網(wǎng)絡(luò):聯(lián)合獨(dú)立成分分析與功能連接分析[J];放射學(xué)實(shí)踐;2013年12期

3 張勁松;王新;程文紅;劉漪;;焦慮障礙青少年的反應(yīng)抑制性的探討(英文)[J];教育生物學(xué)雜志;2013年02期

4 謝生輝;牛廣明;韓曉東;喬鵬飛;;抑郁癥磁共振腦功能應(yīng)用研究進(jìn)展[J];國際醫(yī)學(xué)放射學(xué)雜志;2013年06期

5 王玉嬌;張慶林;韋世源;曾建敏;;獎(jiǎng)賞決策中自控與沖動(dòng)的神經(jīng)機(jī)制[J];心理與行為研究;2013年06期

6 陳曉霞;唐久來;;注意缺陷多動(dòng)障礙兒童的認(rèn)知功能研究[J];中國兒童保健雜志;2014年03期

7 梁艷玲;薛崢;康慧聰;朱遂強(qiáng);;56例成年癲癇患者抑郁、焦慮的臨床評(píng)估及危險(xiǎn)因素分析[J];神經(jīng)損傷與功能重建;2014年01期

8 魏夢(mèng)然;劉斌;羅聰;;基于功能核磁成像的靜息態(tài)功能腦網(wǎng)絡(luò)研究綜述[J];電腦知識(shí)與技術(shù);2014年03期

9 余苒;甘麗英;李學(xué)成;馮正直;朱廣義;劉可愚;;中國軍人生活事件、社會(huì)支持與抑郁的關(guān)系及路徑模型構(gòu)建[J];重慶醫(yī)學(xué);2014年15期

10 張浩云;康春燕;郭桃梅;;Simon效應(yīng)的近紅外研究[J];北京師范大學(xué)學(xué)報(bào)(自然科學(xué)版);2014年02期

相關(guān)會(huì)議論文 前3條

1 張銀鳳;韓玉;王永志;杜儀;賀永;夏明睿;李麗;;靜息態(tài)下抑郁癥患者虛證與實(shí)證的腦功能連接的初步探討[A];第五屆中國睡眠醫(yī)學(xué)論壇論文匯編[C];2013年

2 張銀鳳;韓玉;王永志;杜儀;賀永;夏明睿;李麗;;靜息態(tài)下抑郁癥患者虛證與實(shí)證的腦功能連接的初步探討[A];第九次全國中西醫(yī)結(jié)合基礎(chǔ)理論研究學(xué)術(shù)研討會(huì)論文匯編[C];2013年

3 戚洪莉;許毅;黃滿麗;;經(jīng)顱磁刺激對(duì)抑郁癥療效的相關(guān)因素研究[A];2013浙江省醫(yī)學(xué)會(huì)精神病學(xué)分會(huì)學(xué)術(shù)年會(huì)暨浙江省醫(yī)師協(xié)會(huì)精神科醫(yī)師分會(huì)第六屆年會(huì)論文匯編[C];2013年

相關(guān)博士學(xué)位論文 前10條

1 王昱青;基于運(yùn)動(dòng)任務(wù)的腦功能動(dòng)態(tài)網(wǎng)絡(luò)的整合研究[D];電子科技大學(xué);2011年

2 廖偉;基于磁共振成像的腦連接方法學(xué)及應(yīng)用研究[D];電子科技大學(xué);2011年

3 丁菊容;基于磁共振成像的腦網(wǎng)絡(luò)技術(shù)及臨床應(yīng)用研究[D];電子科技大學(xué);2012年

4 謝梓菁;基于多元Granger因果分析的針刺治療中風(fēng)偏癱的機(jī)制研究[D];北京中醫(yī)藥大學(xué);2013年

5 王美豪;語言功能腦區(qū)與運(yùn)動(dòng)性失語靜息態(tài)功能連接的功能磁共振研究[D];鄭州大學(xué);2013年

6 涂q，

本文編號(hào)：2425047