重性抑郁障碍患者N-back范式前额叶皮层的功能性近红外光谱成像初步观察  

A preliminary observation of functional near-infrared spectroscopy imaging of prefrontal cortex in patients with major depressive disorder using the N-back paradigm

作　　者：杨道良[1,2] 陈玄玄 胡姗姗[3] 陈龙云[1] 韩阳 YANG Daoliang;CHEN Xuanxuan;HU Shanshan(Shanghai Changning Mental Health Center,Mental Health Center Afiliated to East China Normal University,Shanghai200335,China)

机构地区：[1]上海市长宁区精神卫生中心精神科,华东师范大学附属精神卫生中心,上海200335 [2]上海市周家桥街道社区卫生服务中心 [3]上海健康医学院 [4]华东师范大学心理与认知科学学院

出　　处：《国际精神病学杂志》2024年第3期758-762,782,共6页Journal Of International Psychiatry

基　　金：上海市卫健委项目(编号:201940491);上海市长宁区科学技术委员会课题(编号:CNKW2020Z05)。

摘　　要：目的探讨功能性近红外光谱成像(functional near-infrared spectroscopy,fNIRS)对重性抑郁障碍(Major Depressive Disorder,MDD)患者的N-back表现及相关脑区激活情况。方法去符合美国《精神障碍诊断与统计手册第5版》(diagnostic and statistical manual of mental disorders,5th Edition,DSM-5)诊断标准的抑郁障碍患者26例为研究对象,并选择22名正常成人作为对照。使用17项汉密尔顿抑郁量表(17-item Hamilton depression scale,HAMD-17)评定患者抑郁症状,数字N-back测试评估工作记忆,应用fNIRS测量执行N-back任务时额叶脑区的激活情况。结果①在正确率和反应时间上,负荷水平主效应显著(P<0.05),组别和负荷水平的交互作用显著(P<0.05)。进行简单效应分析发现,在0-back条件下,MDD患者的正确率和反应时间与健康成人不存在显著差异(P>0.05),在1-back和2-back条件下,MDD患者的正确率和反应时间存在显著性差异(P<0.05)。②与健康对照组相比,MDD患者在2-back任务中,背外侧前额叶皮层(通道3、4、5、6、8)和额极皮层(通道47)氧合血红蛋白(Oxyhemoglobin,Oxy-Hb)的激活明显减少(P<0.05)。结论MDD患者fNIRS实验测试所见证据是背外侧前额叶皮层和额极皮层激活减弱。这一初步结果有待于进一步证实。Objective To investigate the N-back performance and associated brain activation in patients with major depressive disorder(MDD)using functional near-infrared spectroscopy(fNIRS)imaging technology.Methods 26 patients with MDD who met diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders,5th Edition,were selected as the study group,and 22 healthy adults were chosen as healthy controls.Depressive symptoms in patients was assessed by the 17-item Hamilton Depression Scale(HAMD-17)and working memory was evaluated by the digit N-back test.fNIRS was employed to measure activation in the frontal brain regions during the execution of the N-back working memory task.Resulsts①In terms of accuracy and reaction time,a significant main effect of load level were observed(P<0.05).Furthermore,there was a significant interaction between group and load level(P<0.05).Simple effect analyses revealed that under the 0-back condition,there were no significant differences in accuracy and reaction time between MDD patients and healthy adults(P>0.05).Moreover,under the 1-back and 2-back conditions,MDD patients exhibited significant differences in accuracy and reaction time(P<0.05).②Com-pared to the healthy control group,activation of the dorsolateral prefrontal cortex(channels 3,4,5,6,8)and the frontopolar cortex(channel 47)Oxyhemoglobin(Oxy-Hb)during the 2-back task were greatly reduced in MDD group(P<0.05).Conclusion The results of the fNIRS experiment in MDD patients suggest a reduction in activation within the dorsolateral prefrontal cortex and frontopolar cortex.The preliminary findings require further confirmation.

关 键 词：重性抑郁障碍 N-BACK 额叶 功能性近红外光谱成像 

分 类 号：R749.99[医药卫生—神经病学与精神病学]