【摘要】：目的通過對(duì)抑郁癥患者及正常人的工作記憶容量進(jìn)行對(duì)比分析,探討抑郁癥患者的工作記憶功能障礙特點(diǎn)及相應(yīng)的腦電生理特征變化規(guī)律。 方法以27例符合CCMD-3首次抑郁發(fā)作診斷標(biāo)準(zhǔn)且測評(píng)前2月內(nèi)未服用精神科藥物和30例年齡、性別、文化程度相似的正常對(duì)照為研究對(duì)象。采用漢密爾頓抑郁量表17項(xiàng)版本評(píng)定抑郁癥狀的嚴(yán)重程度。通過工作記憶廣度測驗(yàn)、記憶加工水平測驗(yàn)、視聽整合連續(xù)測試、STOORP效應(yīng)測驗(yàn)和面部表情辨認(rèn)測驗(yàn)等方法評(píng)估抑郁癥患者的工作記憶容量及注意、情緒對(duì)工作記憶容量的影響。并對(duì)其中14例患者和14例健康對(duì)照者做了定量腦電分析。 結(jié)果(1)抑郁癥患者工作記憶廣度明顯低于對(duì)照組,差異有顯著性(P0.05),其差異在水平2、水平3最明顯；記憶加工水平測驗(yàn)辨認(rèn)舊詞、辨認(rèn)新詞個(gè)數(shù)明顯低于對(duì)照組,差異有顯著性(P0.01)；視聽整合連續(xù)測試、STOORP效應(yīng)測驗(yàn)結(jié)果低于對(duì)照組,差異有顯著性(P0.05或P0.01)；面部表情辨認(rèn)測驗(yàn)時(shí)患者面部表情總正確率明顯低于對(duì)照組,差異有顯著性(P0.01),其對(duì)恐懼、悲傷表情的辨認(rèn)正確率差異最顯著。(2)在安靜狀態(tài)下與心理負(fù)荷狀態(tài)下對(duì)患者組與對(duì)照組進(jìn)行信息傳輸與響應(yīng)時(shí)間變化的比較,結(jié)果顯示在安靜狀態(tài)下F3(左額)、F4(右額)、C4(中央)區(qū)域患者組比對(duì)照組信息保持強(qiáng)度衰減明顯,傳輸響應(yīng)周期延長,心理負(fù)荷狀態(tài)下患者組在右側(cè)顳區(qū)、前額、右頂部與對(duì)照組差異較大(P0.05)。 結(jié)論(1)抑郁癥患者存在工作記憶容量的損害。(2)抑郁癥患者的注意、情緒狀態(tài)影響工作記憶的容量。(3)抑郁癥患者的腦電特征參數(shù)分析結(jié)果顯示,在心理負(fù)荷狀態(tài)下腦電信息傳輸與響應(yīng)時(shí)間變化在右側(cè)顳區(qū)、前額、右頂部差異較大,提示左額葉外側(cè)皮層可能存在功能減退或失調(diào)。
[Abstract]:Aim to compare and analyze the working memory capacity of depression patients and normal people, and to explore the characteristics of working memory dysfunction and the corresponding changes of brain electrophysiological characteristics in patients with depression. Methods 27 patients who met the diagnostic criteria of the first depressive episode of CCMD-3 and 30 normal controls with similar age, sex and education within 2 months before the evaluation were selected as the subjects. The severity of depressive symptoms was assessed by the Hamilton Depression scale (Hamd) in 17 versions. The working memory capacity, attention and emotion of depression patients were evaluated by working memory span test, memory processing level test, audiovisual integration continuous test, STOORP effect test and facial expression recognition test. Quantitative EEG analysis was performed in 14 patients and 14 healthy controls. Results (1) the working memory span of depression patients was significantly lower than that of control group (P0.05), the most significant difference was at level 2 and level 3; Memory processing level test to identify old words, identify the number of new words was significantly lower than the control group (P0.01), audio-visual integration continuous test, STOORP effect test results were lower than the control group, the difference was significant (P0.05 or P0.01). The total correct rate of facial expression in patients with facial expression recognition test was significantly lower than that in the control group (P0.01). (2) comparing the changes of information transmission and response time between the patient group and the control group under the quiet state and the psychological load state, the results showed that the F3 (left forehead) was in the quiet state, and the difference of the response time between the patient group and the control group was better than that of the control group. In F4 (right frontal), C4 (central) area group, the attenuation of information intensity was more obvious than that of the control group, and the transmission response cycle was prolonged. Under psychological load, the patients in the right temporal region, forehead, right parietal region were significantly different from those in the control group (P0.05). Conclusion (1) there are impairment of working memory capacity in patients with depression. (2) the attention and emotional state of depression patients affect the capacity of working memory. (3) the results of EEG characteristic parameter analysis of depression patients show that their attention and emotional state affect the capacity of working memory. The changes of transmission and response time of EEG in the right temporal area, prefrontal area and right parietal region were significantly different under psychological stress, suggesting that there might be dysfunction or imbalance in the lateral cortex of the left frontal lobe.
【學(xué)位授予單位】：浙江中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R749.4

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