神经性贪食的功能磁共振成像特征  

Characteristics of functional magnetic resonance imaging in patients with bulimia nervosa

作　　者：李沚芊 陈珏[2] Li Zhiqian;Chen Jue(Mental Health Center Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200030,China;Department of Clinical Psychology,Mental Health Center Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200030,China)

机构地区：[1]上海交通大学医学院附属精神卫生中心,上海200030 [2]上海交通大学医学院附属精神卫生中心临床心理科,上海200030

出　　处：《中华行为医学与脑科学杂志》2023年第11期1045-1050,共6页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：国家自然科学基金(82071545);上海市自然科学基金(SHDC12019129,202140092,20Y11906500,19MC1911100)。

摘　　要：神经性贪食(bulimia nervosa,BN)是以反复发作不可控制的暴食,并伴随防止体重增加的补偿性行为及对自身体重和体形的过分关注为主要特征的一类精神障碍。认知控制、奖赏加工、情绪处理是三个相互关联的神经心理过程,认知控制调节奖赏加工过程的同时也受情绪作用的调节。本文就BN中认知控制、奖赏加工、情绪处理及干预这四个方面的fMRI研究进行综述,旨在总结实质性进展,为未来针对BN的干预措施提供启发。通过综述可知,BN患者的认知控制异常和额叶-纹状体环路的功能活性减弱有关;其前后扣带皮层、腹侧纹状体和岛叶等奖赏加工相关的脑区有异常激活现象;负性情绪下BN患者右侧杏仁核和左侧前扣带皮层、左侧岛叶的反应较健康人群减弱。经过药物治疗和心理治疗后前额叶和边缘系统的异常得到一定改善。Bulimia nervosa(BN)is a kind of mental disorder characterized by repeated episodes of uncontrollable overeating,accompanied by compensatory behavior to prevent weight gain and excessive attention to one's own weight and body shape.Cognitive control,reward processing,and emotional processing are three interrelated neuropsychological processes.Cognitive control regulates reward processing while also being regulated by emotional effects.This article reviews functional magnetic resonance imaging(fMRI)researches on cognitive control,reward processing,emotional processing and intervention in BN,aiming to summarize substantive progress and provide inspiration for future interventions targeting BN.It can be seen from the review that the abnormal cognitive control of BN patients is related to the decreased functional activity of the frontal lobe striatum circuit.Abnormal activation of brain regions related to reward processing such as anterior and posterior cingulate cortex,ventral striatum and insula.The reaction of the right amygdala,the left anterior cingulate cortex and the left insular lobe of BN patients under negative emotion was weaker than that of healthy people.After medication and psychotherapy,the abnormalities of the prefrontal lobe and limbic system were improved to some extent.

关 键 词：神经性贪食 功能磁共振成像 认知控制 奖赏加工 情绪处理 干预 

分 类 号：R749.6[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]