晚发抑郁症患者情绪面孔持续注意偏向的瞳孔监测研究  

Sustained attentional bias to emotional faces in late-onset depression: a pupilometry study

作　　者：高存友 郭本玉[1] 孔素丽 高红艳[3] 班春霞[1] 李莉[1] 李质彬[3] GAO Cun-you;GUO Ben-yu;KONG Su-li;GAO Hong-yan;BAN Chun-xia;LI Li;LI Zhi-bin(Jiading District Mental Health Center,Shanghai,201803 China)

机构地区：[1]上海市嘉定区精神卫生中心精神科,201803 [2]上海市嘉定区精神卫生中心康复科,201803 [3]上海市嘉定区精神卫生中心老年科,201803

出　　处：《临床精神医学杂志》2018年第5期293-296,共4页Journal of Clinical Psychiatry

基　　金：上海市嘉定区精神卫生重点专科建设项目(JDYXZDZK-3)

摘　　要：目的:研究晚发抑郁症(late-onset depression,LOD)患者早期、中期和持续注意偏向特点,探索抑郁症早期干预的潜在认知靶点。方法:以符合《国际疾病分类》第10版抑郁发作诊断标准的36例LOD患者为患者组,匹配27名正常志愿者为对照组。采用真人情绪面孔图片作为刺激材料,应用点探测任务范式进行实验,任务过程中测试瞳孔直径、注视方向和反应时间;情绪面孔呈现时间为200 ms与2 000 ms,瞳孔直径监测时间为11. 5 s。结果:患者组点探测任务中平均反应时长于对照组[(459. 6±104. 8) ms vs.(441. 3±112. 1) ms,F=4. 23,P <0. 05];延长刺激呈现时间被试整体反应时间缩短[(438. 5±93. 6) ms vs.(460. 2±123. 3) ms,F=22. 34,P <0. 01]。患者组对恐惧面孔首凝视点定向偏向分数显著小于对照组(F=8. 64,P <0. 01)。长呈现时间、一致试验后部分患者组比对照组瞳孔扩张更明显(F=5. 1,P <0. 05);短呈现时间、不一致试验后部分对照组比患者组的瞳孔扩张更明显(F=7. 63,P <0. 01)。结论:LOD患者存在持续的认知-感情负荷改变,导致较为固定的负性注意偏向。早期干预这些改变的靶点可能对避免或延缓抑郁症的发作与复发有重要的临床价值。Objective:To explore early,intermediate and sustained forms of attentional bias in late-onset depression(LOD),to gain insight into potential cognitive targets for early intervention. Method:The diagnoses were made according to international statistical classification of diseases and related health problem,tenth revision(ICD-10)criteria.Totally 36 patients with LOD(MD)were enrolled in the study.And 27 non-depression control participants(NC)matched with MD group.All participants completed a dot-probe task to assess attentional preference for facial stimuli with varying valence.Emotional faces were presented for 200ms/2000ms intervals and followed by a sustained post-stimulus interval.Pupil dilation,gaze direction,and reaction times were measured during task completion for 11.5 s.Results:The mean reaction times(RTs)of MD group was longer than that of NC group in the dot-probe task[(459.6±104.8)ms vs.(441.3±112.1)ms,F=4.23,P<0.05].The overall reaction time to longer duration presentator of fearful faces.[(438.5±93.6)ms vs.(460.2±123.3)ms,F=22.34,P<0.01].MD group demonstrated less attentioned bias score for fearful faces than control group.(F=8.64,P<0.01).The pupil dilation was greater in MD group for congruent trials during the latter portions of long trials(F=5.1,P<0.05),but NC group show greater pupil dilation during the latter portions of short in congruent trials(F=7.63,P<0.01).Conclusion:LOD patients have sustained cognitive-affective load alterations,consequently lead to inflexible attentional bias.Early intervention in these changes may have important clinical value in avoiding or delaying the onset and recurrence of depression.

关 键 词：抑郁症 情绪面孔 注意偏向 瞳孔监测 

分 类 号：R749.4[医药卫生—神经病学与精神病学]