社会心理应激任务下抑郁症患者有效连接特征  

Study on Effective Connectivity in Major Depressive Disorder Patients under Psychosocial Stress Task

作　　者：钟雪 姚树桥[2] 程长 熊戈[2] 董戴凤 孙小强[2] ZHONG Xue;YAO Shu-qiao;CHENG Chang;XIONG Ge;DONG Dai-feng;SUN Xiao-qiang(School of Educational Science,Cognition and Human Behavior Key Laboratory of Hunan Province,Hunan Normal University,Changsha 410082,China;Medical Psychological Center,the Second Xiangya Hospital,Central South University,Changsha 410011,China)

机构地区：[1]湖南师范大学教育科学学院,认知与人类行为湖南省重点实验室,长沙410082 [2]中南大学湘雅二医院医学心理中心,长沙410011

出　　处：《中国临床心理学杂志》2023年第1期16-21,共6页Chinese Journal of Clinical Psychology

基　　金：湖南省教育厅重点项目:“儿童期创伤经历后弹性神经机制”(21A0064);湖南师范大学博士科研启动项目(2021051311)。

摘　　要：目的:考察抑郁症患者社会心理应激任务下大脑有效连接特征,并进一步探究伴儿童期创伤经历抑郁症患者有效连接特异性模式。方法:对79名抑郁症患者和46名健康对照者进行临床量表评估和任务态功能磁共振扫描。其中,依据儿童期创伤问卷,病例组分为伴儿童期创伤经历组(n=47)和无儿童期创伤经历组(n=32)。采用基于参数经验贝叶斯框架的动态因果模型方法计算社会心理应激任务下大脑有效连接特征及组间差异。结果:所有被试社会心理应激任务下岛叶对背外侧前额叶、楔前叶和腹内侧前额叶皮质存在有效连接;两个抑郁症患者组楔前叶到背外侧前额叶皮质有效连接减弱;伴儿童期创伤经历抑郁症患者组岛叶到腹内侧前额叶皮质抑制作用减弱。结论:应激状态下岛叶在大脑认知资源转换中起着关键作用,岛叶到腹内侧前额叶皮质有效连接异常可能是儿童期创伤经历所致抑郁症应激敏感的潜在神经机制。Objective: To investigate effective connectivity under psychosocial stress, especially the abnormal effective connectivity of major depressive disorder(MDD) patients with childhood maltreatment experience. Methods: 47 MDD patients with childhood maltreatment experience(CM-MDD), 32 MDD patients without childhood maltreatment and 46healthy controls(HC) were recruited to complete the functional magnetic resonance imaging scanning(fMRI). A newly developed parametric empirical Bayes framework dynamic causal modeling was used to probe the effective connectivity within stress networks under Montreal imaging stress task. Results: All groups showed effective connectivity between insula and dorsolateral prefrontal cortex(dlPFC), ventromedial prefrontal cortex(vmPFC) and precuneus. Compared to HC, both patient groups exhibited decreased connectivity from precuneus to dlPFC. Notably, CM-MDD had significantly reduced strength of the effective connectivity from insula to vmPFC. Conclusion: The findings suggest that insula is likely play a major role in switching between distinct brain networks. Childhood maltreatment experience is related to abnormal effective connectivity under stress.

关 键 词：抑郁症 儿童期创伤 应激 动态因果模型 任务态功能磁共振 

分 类 号：R395.1[哲学宗教—心理学]