前额皮质区与正负性情绪词执行加工的功能磁共振研究
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摘要
目的：探讨汉语双字情绪词的识别加工过程中大脑相关区域的激活特征,并且通过正常组和反社会人格障碍组的对比来探讨大脑情绪处理区域的作用差异,及反社会人格障碍患者灰质白质体积改变特征。
方法：对正中负性双字汉语词语进行评定,最终三种词性各选20个作为刺激,它们在熟悉度,优势度,唤醒度及笔画上没有差异。选择符合DSM-Ⅳ诊断标准的反社会人格障碍者(antisocial personality disorder,APD)20人和正常志愿者17人参加实验。实验设计为组块设计,一共13个组块,任务及静息均为24秒,每个组块有8个刺激,每个刺激中,情绪词呈现1秒,等待反应2秒。使用德国Simens公司的Avanto1.5T磁共振成像系统和深圳美德公司的SAMRTEC视听觉刺激系统采集数据。扫描数据包括T1结构像、功能像和3D结构像。利用SPM8及DARTEL工具箱对扫描获得的功能图像和结构图像进行预处理,再对APD组和正常对照组的脑激活区域及全脑灰质白质体素进行统计分析。
结果：
1、功能像分析结果显示,正常组进行汉语正负性情绪词作业时激活的脑区有双侧额内侧回(BA8),右侧额下回(BA47),右前扣带回(BA32),左额上回(BA6)及右枕叶(BA18),以右侧额叶为主,而反社会人格障碍组左右额叶均有广泛的激活,包括双侧前额(BA8／9／45／46),顶叶(BA40)、枕叶(BA17／18／46)及小脑,且以左侧额叶为主。正常组减反社会人格障碍组,有差异的激活区以右侧前额区(BA6／8／9／32)为主。反社会人格障碍组减正常组,有差异的激活区有,右额内侧回,左右额中回,前扣带回,颞叶及小脑,主要以左侧前额区(BA10／46／9)为主。
2、脑灰质结构分析显示,与正常对照组比较,反社会人格障碍患者主要表现为左侧额叶(BA6／9／10／47／32)、右颞上回、双侧中央后回(BA6／4)、双侧顶下小叶(BA40)、右侧楔前叶(BA7)、双侧梭状回(BA38／20)、右海马旁回(BA36)及前部扣带回(BA32／9)灰质体积增加。与正常对照组比较,反社会人格障碍患者主要表现为双侧前部额区(BA10／47／9／8)、左枕下回(BA37)、右枕中回、左颞上回的体积减小。
白质结构分析显示,与正常对照组比较,反社会人格障碍患者主要表现为左侧额叶(BA6／9／10／32／8)、右岛叶(BA6／44)、中央前回(BA4／6),左右颞上回(BA38／22)、右中央后回(BA4／3)、右侧顶下小叶(BA40)、右侧楔前叶(BA7)、右枕中叶(BA18)、右海马旁回(BA27)及双侧扣带回(BA32／6)白质体积增加。与正常对照组比较,反社会人格障碍患者主要表现为左颞中叶(BA22)、右小脑的体积减小。
结论正负性汉语情绪词执行加工需要前额区及扣带回的参与,与正常人群比较,反社会人格障碍者前额区及扣带回功能存在障碍。正常人执行加工汉语正负性情绪词的言语信息时启动右额极一扣带回通路。反社会人格障碍组由于前扣带回BA32／8和背外侧前额区的结构和功能异常,正常通路发生严重障碍,无法通过此条途径处理汉语正负性情绪词信息,只能启动背外侧前额区—颞叶—边缘系统—小脑通路回路来代偿。
Objective This study is aimed to discuss the activation characteristic in the related brain section during the process identifying two character Chinese effective words.Meanwhile,the processing difference of brain emotion management section is compared by contrasting the normal and the antisocial personality disorder(APD) groups.The gray and white matter volume changes of the two groups are measured as well.
Methods The Chinese effective words are assessed and classify as positive, neutral and negative property sets and twenty words of each set are selected as stimulations, whose familiarity, preponderance, arousal and stroke are of no difference.Twenty APD sufferers tally with the DSM-Ⅳstandard and seventeen healthy volunteers are chosen for the experiment as well.The experimentation is block designed, with thirteen blocks in all,formed by tasks and rests.Each task consists of 8 stimulations, with 1 second appearance of the word and 2 seconds delay for responding The data of the experiment are collected with Avanto 1.5 magnetic resonance imaging (MRI,manufactured by Simens,Germany) and video & audio presentation system (manufactured by Meide, Shenzhen).The two of which start simultaneously. Each data set includes T1 weighted structure images, functional images and 3D structure images.The images are pretreated with SPM8 and DARTEL tool boxes.Then the activated sections and the whole brain gray and white matter volume of the APD sufferers and the contrast group are compared.
Results(1)The primary analysis of the functional images reveals that the activated brain sections of the contrast group during the tasks are double medial frontal gyrus, right inferior frontal gyrus, left superor frontal gyrus, right anterior cingulate gyrus and right occipital lobe, dominated by right prefrontal lobe, while APD group have broad activation in both prefrontal lobes, mainly found in the left one.When the healthy group data subtract the APD group data, the discrepant activated section is mainly right prefrontal cortex(BA6/8/9/32) And when the APD group data subtract the healthy group data, quite some discrepant activated sections are found in both bilateral brain areas,mostly in left prefrontal cortex(BA10/46/9)
(2) The gray matter VBM analysis shows that, compared to normal people, APD sufferers have a volume density increase mainly in left frontal lobe (BA6/9/10/47/32)、right superior temporal gyrus、bilateral postcentral gyrus (BA6/4)、right inferior parietal lobule(BA40)、right cuneus(BA7)、bilateral fusiform gyrus(BA38/20)、right parahippocampal gyrus(BA36),and anterior cingulate gyrus(BA32/9)and an decrease mainly in bilateral prefrontal cortex (BA10/47/9/8)、left lingual gyrus(BA37)、right middle occipital gyrus、left superior temporal gyrus.As to the white matter, APD sufferers undergo a volume density increase in left frontal lobe(BA6/8/9/10/32)、right insular cortex(BA6/44)、left precentral gyrus(BA4/3),bilateral superior temporal gyrus(BA38/22)、right postcentral gyrus(BA4/3)、right inferior parietal lobule (BA40)、right anterior cingulate gyrus(BA7)、right middle occipital gyrus (BA18)、right parahippocampal gyrus(BA27)、bilateral cingulate gyrus (BA32/6)and an decrease in right middle temporal gyrus(BA22)、right cerebellum.
Conclusion The process of Chinese effective words needs the participation of prefrontal cortex and cingulate gyrus,the function of which suffers disorder for the APD sufferers.Healthy people startup the right DLPFC-ACC thoroughfare,when processing the word diction information, while the APD sufferers'pathway is badly handicapped due to the structural and functional abnormity of their ACC and APFC.They have to startup the right DLPFC-temporal lobe-limbic system-cerebellum thoroughfare and bilateral VLPFC-ACC thoroughfare as compensation.
方法：对正中负性双字汉语词语进行评定,最终三种词性各选20个作为刺激,它们在熟悉度,优势度,唤醒度及笔画上没有差异。选择符合DSM-Ⅳ诊断标准的反社会人格障碍者(antisocial personality disorder,APD)20人和正常志愿者17人参加实验。实验设计为组块设计,一共13个组块,任务及静息均为24秒,每个组块有8个刺激,每个刺激中,情绪词呈现1秒,等待反应2秒。使用德国Simens公司的Avanto1.5T磁共振成像系统和深圳美德公司的SAMRTEC视听觉刺激系统采集数据。扫描数据包括T1结构像、功能像和3D结构像。利用SPM8及DARTEL工具箱对扫描获得的功能图像和结构图像进行预处理,再对APD组和正常对照组的脑激活区域及全脑灰质白质体素进行统计分析。
结果：
1、功能像分析结果显示,正常组进行汉语正负性情绪词作业时激活的脑区有双侧额内侧回(BA8),右侧额下回(BA47),右前扣带回(BA32),左额上回(BA6)及右枕叶(BA18),以右侧额叶为主,而反社会人格障碍组左右额叶均有广泛的激活,包括双侧前额(BA8／9／45／46),顶叶(BA40)、枕叶(BA17／18／46)及小脑,且以左侧额叶为主。正常组减反社会人格障碍组,有差异的激活区以右侧前额区(BA6／8／9／32)为主。反社会人格障碍组减正常组,有差异的激活区有,右额内侧回,左右额中回,前扣带回,颞叶及小脑,主要以左侧前额区(BA10／46／9)为主。
2、脑灰质结构分析显示,与正常对照组比较,反社会人格障碍患者主要表现为左侧额叶(BA6／9／10／47／32)、右颞上回、双侧中央后回(BA6／4)、双侧顶下小叶(BA40)、右侧楔前叶(BA7)、双侧梭状回(BA38／20)、右海马旁回(BA36)及前部扣带回(BA32／9)灰质体积增加。与正常对照组比较,反社会人格障碍患者主要表现为双侧前部额区(BA10／47／9／8)、左枕下回(BA37)、右枕中回、左颞上回的体积减小。
白质结构分析显示,与正常对照组比较,反社会人格障碍患者主要表现为左侧额叶(BA6／9／10／32／8)、右岛叶(BA6／44)、中央前回(BA4／6),左右颞上回(BA38／22)、右中央后回(BA4／3)、右侧顶下小叶(BA40)、右侧楔前叶(BA7)、右枕中叶(BA18)、右海马旁回(BA27)及双侧扣带回(BA32／6)白质体积增加。与正常对照组比较,反社会人格障碍患者主要表现为左颞中叶(BA22)、右小脑的体积减小。
结论正负性汉语情绪词执行加工需要前额区及扣带回的参与,与正常人群比较,反社会人格障碍者前额区及扣带回功能存在障碍。正常人执行加工汉语正负性情绪词的言语信息时启动右额极一扣带回通路。反社会人格障碍组由于前扣带回BA32／8和背外侧前额区的结构和功能异常,正常通路发生严重障碍,无法通过此条途径处理汉语正负性情绪词信息,只能启动背外侧前额区—颞叶—边缘系统—小脑通路回路来代偿。
Objective This study is aimed to discuss the activation characteristic in the related brain section during the process identifying two character Chinese effective words.Meanwhile,the processing difference of brain emotion management section is compared by contrasting the normal and the antisocial personality disorder(APD) groups.The gray and white matter volume changes of the two groups are measured as well.
Methods The Chinese effective words are assessed and classify as positive, neutral and negative property sets and twenty words of each set are selected as stimulations, whose familiarity, preponderance, arousal and stroke are of no difference.Twenty APD sufferers tally with the DSM-Ⅳstandard and seventeen healthy volunteers are chosen for the experiment as well.The experimentation is block designed, with thirteen blocks in all,formed by tasks and rests.Each task consists of 8 stimulations, with 1 second appearance of the word and 2 seconds delay for responding The data of the experiment are collected with Avanto 1.5 magnetic resonance imaging (MRI,manufactured by Simens,Germany) and video & audio presentation system (manufactured by Meide, Shenzhen).The two of which start simultaneously. Each data set includes T1 weighted structure images, functional images and 3D structure images.The images are pretreated with SPM8 and DARTEL tool boxes.Then the activated sections and the whole brain gray and white matter volume of the APD sufferers and the contrast group are compared.
Results(1)The primary analysis of the functional images reveals that the activated brain sections of the contrast group during the tasks are double medial frontal gyrus, right inferior frontal gyrus, left superor frontal gyrus, right anterior cingulate gyrus and right occipital lobe, dominated by right prefrontal lobe, while APD group have broad activation in both prefrontal lobes, mainly found in the left one.When the healthy group data subtract the APD group data, the discrepant activated section is mainly right prefrontal cortex(BA6/8/9/32) And when the APD group data subtract the healthy group data, quite some discrepant activated sections are found in both bilateral brain areas,mostly in left prefrontal cortex(BA10/46/9)
(2) The gray matter VBM analysis shows that, compared to normal people, APD sufferers have a volume density increase mainly in left frontal lobe (BA6/9/10/47/32)、right superior temporal gyrus、bilateral postcentral gyrus (BA6/4)、right inferior parietal lobule(BA40)、right cuneus(BA7)、bilateral fusiform gyrus(BA38/20)、right parahippocampal gyrus(BA36),and anterior cingulate gyrus(BA32/9)and an decrease mainly in bilateral prefrontal cortex (BA10/47/9/8)、left lingual gyrus(BA37)、right middle occipital gyrus、left superior temporal gyrus.As to the white matter, APD sufferers undergo a volume density increase in left frontal lobe(BA6/8/9/10/32)、right insular cortex(BA6/44)、left precentral gyrus(BA4/3),bilateral superior temporal gyrus(BA38/22)、right postcentral gyrus(BA4/3)、right inferior parietal lobule (BA40)、right anterior cingulate gyrus(BA7)、right middle occipital gyrus (BA18)、right parahippocampal gyrus(BA27)、bilateral cingulate gyrus (BA32/6)and an decrease in right middle temporal gyrus(BA22)、right cerebellum.
Conclusion The process of Chinese effective words needs the participation of prefrontal cortex and cingulate gyrus,the function of which suffers disorder for the APD sufferers.Healthy people startup the right DLPFC-ACC thoroughfare,when processing the word diction information, while the APD sufferers'pathway is badly handicapped due to the structural and functional abnormity of their ACC and APFC.They have to startup the right DLPFC-temporal lobe-limbic system-cerebellum thoroughfare and bilateral VLPFC-ACC thoroughfare as compensation.
引文
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