CAJ | 학술논문

目的观察神经性贪食(BN)患者加工食物图片时的脑功能特点,探讨BN的精神病理机制.方法 BN患者7例,均为女性,符合中国精神障碍分类和诊断标准第三版(CCMD-3)神经性贪食诊断标准;健康对照7例.2组性别、年龄匹配.所有受试者完成汉密尔顿焦虑量表(HAMA)、17项汉密尔顿抑郁量表(HAMD-17)、视觉模拟量表(VAS)评估和fMRI检查.功能成像为组块设计,包括食物图片序列和非食物图片序列,均来自国际情绪图片系统(1APS),计算机自动呈现.结果 BN患者食物图片VAS评分高于对照组(P<0.05);BN患者食物图片平均脑激活强度(7.86±0.78)、平均激活体积(557 voxels),主要激活双侧前额叶、右尾状核、左杏仁核和小脑;对照组食物图片平均脑激活强度(9.89±1.03),平均激活体积均(1340 voxels),主要激活双侧舌回、楔前叶、右梭状回.2组食物图片下激活差异有显著性(P<0.05),非食物图片下激活差异无显著性.结论前额叶-纹状体-杏仁核-中脑通路功能异常可能是BN的主要神经病理机制.
목적 관찰신경성탐식(BN)환자가공식물도편시적뇌공능특점,탐토BN적정신병리궤제.방법 BN환자7례,균위녀성,부합중국정신장애분류화진단표준제삼판(CCMD-3)신경성탐식진단표준;건강대조7례.2조성별、년령필배.소유수시자완성한밀이돈초필량표(HAMA)、17항한밀이돈억욱량표(HAMD-17)、시각모의량표(VAS)평고화fMRI검사.공능성상위조괴설계,포괄식물도편서렬화비식물도편서렬,균래자국제정서도편계통(1APS),계산궤자동정현.결과 BN환자식물도편VAS평분고우대조조(P<0.05);BN환자식물도편평균뇌격활강도(7.86±0.78)、평균격활체적(557 voxels),주요격활쌍측전액협、우미상핵、좌행인핵화소뇌;대조조식물도편평균뇌격활강도(9.89±1.03),평균격활체적균(1340 voxels),주요격활쌍측설회、설전협、우사상회.2조식물도편하격활차이유현저성(P<0.05),비식물도편하격활차이무현저성.결론 전액협-문상체-행인핵-중뇌통로공능이상가능시BN적주요신경병리궤제.
Objective To observe the brain activation performance of bulimia nervosa (BN) patients and to investigate the possible mental mechanisms of BN. Method Seven female BN cases which met criteria of the 3rd version Chinese Criteria of Mental Diseases (CCMD-3) and seven matched health girls were enrolled. All sub-jects were evaluated by Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD-17), and visual ana-logue scale (VAS). Then fulfill functional magnetic resonance imaging (fMRI) examination. It was block-design. Food or non-food pictures selected from International Affective Picture System (IAPS) independently composed the food and non-food task run of fMRI and were showed by computer automatically. Result VAS-food score was higher in BN group than in control (P<0.05). The average intensity activated of BN under food pictures was 7.86 ±0.78 ,average volume activated was 557 voxels; main activation showed in bilateral prefrontal cortex, right cau-date,left amygdala and left cerebellum. The average intensity activated of control group under food pictures was 9.89±1.03, average volume activated was 1340 voxels;main activation showed in bilateral lingual gyrus, precune-us and fight fusiform gyms. Activation under food pictures was significantly different between two groups (P<0.05). Activation under nonfcod pictures did not show difference between two groups. Conclusion Dysfunction of prefrontal-striatum-amygdala-midbrain path may play a critical role in the psycho mechanisms of BN.