惊恐障碍患者负性情绪加工异常的任务态功能磁共振研究  

Task-state functional magnetic resonance imaging study of negative emotional processing in panic disorder

作　　者：庞曼珑 钟元[1] 滕昌军 肖朝勇[1] 刘崇瑞 李鸿磊 吴云 马紫娟 卢馨 李金阳 张宁[1] 王纯[1] PANG Man-long;ZHONG Yuan;TENG Chang-jun;XIAO Chao-yong;LIU Chong-rui;LI Hong-lei;WU Yun;MA Zi-juan;LU Xin;LI Jin-yang;ZHANG Ning;PANG Chun(Affiliated Nanjing Brain Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属脑科医院,210029

出　　处：《临床精神医学杂志》2018年第3期154-158,共5页Journal of Clinical Psychiatry

基　　金：国家自然科学基金(81571344;81201064;91232304);江苏省自然科学基金(BK20161109);南京市医学科技发展杰出青年基金项目(JQX14008);南京市科技计划项目(201405008)

摘　　要：目的:通过功能磁共振(f MRI)扫描,探讨惊恐障碍(PD)患者认知监控网络(cognitive control network,CCN)及情绪调节网络(mood regulating circuit,MRC)的功能异常。方法:对19例PD患者(PD组)和18名健康志愿者(健康对照组)在负性情绪图片刺激下进行f MRI扫描,并收集其基本资料,使用两样本t检验比较两组被试CCN及MRC脑区的差异,采用独立样本t检验对其一般资料和临床量表进行分析。结果:与健康对照组相比,以中性情绪图片为基线,PD患者在观察负性情绪图片时,左侧背外侧前额叶(MNI:-21,3,60;t=-3.15;P<0.05)、右侧背外侧前额叶(MNI:21,0,66;t=-2.70;P<0.05)、左侧背外侧前扣带回(MNI:-6,15,24;t=-1.82;P<0.05)、右侧背外侧前扣带回(MNI:6,-12,30;t=-3.04;P<0.05)、右侧丘脑(MNI:18,-9,0;t=-2.56;P<0.05)、左侧楔前叶(MNI:-12,-66,51;t=-2.86;P<0.05)、左侧背外侧海马(MNI:-18,-36,6;t=-1.80;P<0.05)脑区激活减弱;左侧腹内侧海马(MNI:-18,-15,-18;t=2.06;P<0.05)、左侧腹内侧前额叶(MNI:-6,45,-9;t=2.48;P<0.05)脑区激活增强。结论:PD的发病机制可能与患者CCN认知监控能力减弱和MRC负性情绪反应增强有关。Objective： To investigate the functional abnormalities of cognitive control network（ CCN）and mood regulating circuit（ MRC） in panic disorder（ PD） by functional magnetic resonance imaging（ f MRI）. Method： We recruited 19 PD patients and 18 healthy controls to task-state f MRI scans and collected their demographics and clinical characteristics. Then we used two sample t-test to analyze the difference between the two groups. Results： In task-related condition,while the neutral mood pictures were used as a baseline contrast,the negative pictures decreased the activation of left dorsolateral prefrontal cortex（ MNI：-21,3,60;t =-3. 15; P〈0. 05）,right dorsolateral prefrontal cortex（ MNI： 21,0,66; t =-2. 70; P〈0. 05）,left dorsal anterior cingulate cortex（ MNI：-6,15,24; t =-1. 82; P〈0. 05）,right dorsal anterior cingulate cortex（ MNI：6,-12,30; t =-3. 04; P〈0. 05）,right thalamus（ MNI： 18,-9,0; t =-2. 56; P〈0. 05）,left precuneus（ MNI：-12,-66,51; t =-2. 86; P〈0. 05）,left dorsal hippocampus（ MNI：-18,-36,6; t =-1. 80; P〈0. 05） and activated left ventral hippocampus（ MNI：-18,-15,-18; t = 2. 06; P〈0. 05）,left ventromedial prefrontal cortex（ MNI：-6,45,-9; t = 2. 48; P〈0. 05） in PD patients. Conclusion： Our results suggest that PD patients may have weakened cognitive regulation of the CCN and enhanced negative emotion reaction of the MRC,which may be associated with the disease mechanism of PD.

关 键 词：惊恐障碍 情绪加工 任务态 认知监控网络 情绪调节网络 

分 类 号：R749.7[医药卫生—神经病学与精神病学]