广泛性焦虑患者视觉任务的功能磁共振成像研究  

The dysfunction of right prefrontal,hippocampus and cerebehum in generalized anxiety disorder:a visual task functional magnetic resonance imaging study

作　　者：李清伟[1] 吴文源[1] 李春波[1] 戴工华[2] 申远[1] 王培军[2] 翁旭初[3] 

机构地区：[1]同济大学附属同济医院精神医学科,上海200065 [2]同济大学附属同济医院医学影像科,上海200065 [3]中国科学院心理研究所脑高级功能研究室

出　　处：《中华精神科杂志》2007年第3期152-156,共5页Chinese Journal of Psychiatry

基　　金：国家自然科学基金(30200081);中国博士后科学基金二等资助金(2005037118);上海高校优秀青年教师后备人选科研项目(03YQHB048)

摘　　要：目的观察广泛性焦虑患者处理情绪图片的脑功能定位,探讨其可能的精神病理机制。方法对9名广泛性焦虑患者(研究组)和9名健康对照者(对照组)评定汉密尔顿焦虑量表(HAMA)和焦虑状态特质问卷(STAI),并在完成国际情绪图片系统中的正性、中性、负性三种图片主动注视任务中,按照区块设计,应用 Marconi 1.5 T 磁共振仪横断位扫描脑功能磁共振成像(fMRI)。结果 (1)研究组 HAMA[(27.7±5.8)分]、STAI 特质评分[(43.0±14.4)分]和状态评分[(40.6±5.8)分]均高于对照组[分别为(1.8±1.3)分、(30.0±8.3)分和(32.4±5.2)分;P<0.05～0.01];两组对三组图片的愉悦度评价差异均无统计学意义(P>0.05)。(2)fMRI:两组比较,研究组右中央前回(t=5.009)、右海马(t=5.345)、右舌回(f=4.584)激活增强,右额中回(t=-5.095)、左旁中央小叶(t=-5.358)、右颞中回(t=-5.074)、右梭状回(t=-8.833)、左枕中回(t=-8.100)、右枕中回(t=-5.570)、右小脑扁桃体(t=-4.654)激活减弱,差异有统计学意义(P<0.001)。结论广泛性焦虑患者脑功能异常表现以右侧为主,主要是右侧额中回、右侧海马、右侧小脑和枕叶等区域异常。Objective To explore the possible psychopathological mechanisms in generalized anxiety disorder （GAD） by observing the related cerebral functioning during processing affective pictures in patients. Methods Nine patients with GAD （ GAD group） and nine healthy controls （ control group） were scanned with functional MRI at 1.5 T. The functional signals were collected during paying attention to pictures of the international affective pictures system （IAPS）. All BOLD-EPI data were analyzed by analysis of functional neuroImages software package. The subjects were measured with the Hamilton anxiety scale （HAMA）, state-trait anxiety inventory （STAI） and valence assessment of IAPS pictures. Results There was no statistical difference on the scores of valence of the three kinds of IAPS pictures between both groups （P 〉 0.05）. The stronger activations in the right precentral gyms, right hippocampus, right lingual gyms, while weaker activations in the right frontal gyrus, left paracentral gyms, right middle temporal gyrus, right fusiform gyrus, left middle occipital gyms, right tonsil of cerebellum were in GAD group than in control group （ P 〈 0. 001 ） . Conclusion The abnormal brain functioning may be mainly present in right hemisphere, especially right middle frontal gyms, right tonsil of cerebellum, right hippocampus and occipital lobe in patients with GAD.

关 键 词：焦虑 磁共振成像 脑 额叶 小脑 海马 国际情绪图片系统 

分 类 号：R749.7[医药卫生—神经病学与精神病学]