创伤后应激障碍的认知异常及神经机制  

Cognitive abnormalities and neural mechanisms in post-traumatic stress disorder

作　　者：胡婷 刘伟志 

机构地区：[1]第二军医大学心理与精神卫生学系,上海200433

出　　处：《解放军医学杂志》2017年第9期826-832,共7页Medical Journal of Chinese People's Liberation Army

基　　金：国家科技部重大专项课题(2010ZXJ0900X-002);上海市浦江人才计划项目(13PJC003);上海市教委科研创新重点项目(14ZS084)~~

摘　　要：创伤后应激障碍(PTSD)是指个体遭遇异常威胁性或灾难性事件导致强烈情绪反应后引起的疾病。闯入、闪回、病理性重复体验、持续性警觉性增高和回避等症状严重损害了PTSD患者的认知功能。目前研究显示PTSD患者具有自传体记忆的检索困难和叙述性紊乱、对创伤性刺激的注意偏向以及智力减弱等行为学水平的认知异常。其可能的神经生理机制包括海马和杏仁核体积变小,内质网过度应激,内侧前额皮质激活程度低,杏仁核对与恐惧相关刺激的高度亢奋应答等。认知异常方面的深入研究为PTSD的预防以及治疗提供了方向,延长暴露并同时进行注意控制的认知治疗可能是有效的治疗手段。Post-traumatic stress disorder （PTSD） is an anxiety disorder that develops usually in response to an overwhelmingly terrifying or a life-threatening event. The symptoms including intrusion, flashback, re-experiencing, hyperarousal and avoidance can seriously impair the cognitive functions. At present, the researches have found PTSD patients had the difficulty in retrieving autobiographical memory and narrative disorder, attention bias toward traumatic stimulus and intellectual decline. Decrease in hippocampus and amygdala＇s volumes, excess endoplasmic reticulum stress, medial prefrontal cortex＇s low activation and highly excited response of the amygdala to the traumatic stimulus may be the neural mechanisms of cognitive abnormalities. In- depth research on cognitive abnormalities provides directions for PTSD prevention and treatment, and the cognitive treatment by prolonged exposure and attention control may be the effective method.

关 键 词：创伤后应激障碍 认知异常 神经机制 

分 类 号：R749.5[医药卫生—神经病学与精神病学]