焦虑症患者精神病理机制的功能性磁共振成像初步研究  

A functional magnetic resonance imaging study on the psydiopathology of patients with anxiety disorder

作　　者：李春波[1] 陈涤宇[1] 吴文源[1] 赵小虎[2] 杨振燕[2] 

机构地区：[1]同济大学附属同济医院心身医学科,200065 [2]同济大学附属同济医院医学影像科,200065

出　　处：《上海精神医学》2003年第z1期10-13,5,共5页Shanghai Archives of Psychiatry

基　　金：国家自然科学基金(No:30200081)

摘　　要：目的 探索焦虑症患者精神病理的可能机制。方法 20名受试对象,焦虑症组与正常对照组各10名。使用情绪词听觉刺激模式进行功能性磁共振成像实验。所得数据使用国际通用的统计参数图软件进行分析。结果 (1)使用焦虑状态量表评定患者组与对照组对威胁性词语的反应,两组有显著差异;(2)中性情绪词与无词语状态交替实验显示,患者组不仅在相关听觉和语义处理脑区有活动,还扩展到前额叶皮层。威胁性词语与中性情绪词交替实验中,与健康人相比,患者组异常激活了颞叶,前额叶,特别是眶额皮层和扣带回。结论 焦虑症患者颞叶和前额叶等功能区可能存在异常通路。Objective: To explore the psychopathology of anxiety disorder through using functional magnetic resonance imaging(fMRI) technique. Methods: 10 patients met the CCMD-Ⅲcriteria of generalized anxiety disorder and/or panic disorder. 10 healthy volunteers were also included. All subjects were right-handed. Some psychological measures were administered to all subjects. The subjects underwent noninvasive functional magnetic resonance imaging while listening actively to (i): emotionally neutral words alternating with no words as the control condition, and (ii) : threat-related words alternating with emotionally neutral words as the experimental condition. fMRI data were analyzed by using statistical parametric mapping(SPM99) software. Results: In the first fMRI experiment, when subjects listened to neutral words compared to no words, prefrontal cortex were activated in addition to BA 22 and BA42 which were activated in normal control subjects. In the second experiment, when subjects listened to threat-related words compared to neutral words, patients show increased activity in temporal lobe, prefrontal cortex, especially orbital frontal cortex and cingulate. Conclusion: Dysfunction in temporal and prefrontal lobe, especially orbital frontal cortex and cingulate may constitute an important circuit in the psychopathology of anxiety disorder.

关 键 词：焦虑症 功能性磁共振成像 情绪词 精神病理 

分 类 号：R749.7[医药卫生—神经病学与精神病学]