CAJ | 학술논문

目的探讨急性重性创伤后应激障碍(post traumatic stress disorder,PTSD)患者的脑功能及执行记忆功能时的脑反应.方法采用功能磁共振成像技术,对经历矿难的10例急性重性PTSD患者(PTSD组)和7例非PTSD对照(非PTSD组)执行症状激发任务,并首次采用1项创伤有关的短期记忆提取任务进行记忆功能的测定.结果症状激发试验中,PTSD组负性图片相比中性图片,左侧后扣带回、双侧尾状核和右侧丘脑等脑区激活增强,右侧扣带回和双侧额中回激活下降;PTSD组相比非PTSD组,右侧前扣带回、左侧额下回、双侧额中回及双侧颞中回等脑区激活下降,左侧海马旁回激活增高.短期记忆提取任务中,PTSD组负性图片相比中性图片,右侧后扣带回和双侧海马存在明显激活;PTSD组相比非PTSD组,右侧额下回、右侧额中回、左侧枕中回等脑区激活下降.记忆提取任务相比症状激发任务,PTSD组右侧海马旁回激活下降.结论急性重性PTSD患者在急性期已存在部分脑区激活的下降以及记忆功能的减退.
목적 탐토급성중성창상후응격장애(post traumatic stress disorder,PTSD)환자적뇌공능급집행기억공능시적뇌반응.방법 채용공능자공진성상기술,대경력광난적10례급성중성PTSD환자(PTSD조)화7례비PTSD대조(비PTSD조)집행증상격발임무,병수차채용1항창상유관적단기기억제취임무진행기억공능적측정.결과 증상격발시험중,PTSD조부성도편상비중성도편,좌측후구대회、쌍측미상핵화우측구뇌등뇌구격활증강,우측구대회화쌍측액중회격활하강;PTSD조상비비PTSD조,우측전구대회、좌측액하회、쌍측액중회급쌍측섭중회등뇌구격활하강,좌측해마방회격활증고.단기기억제취임무중,PTSD조부성도편상비중성도편,우측후구대회화쌍측해마존재명현격활;PTSD조상비비PTSD조,우측액하회、우측액중회、좌측침중회등뇌구격활하강.기억제취임무상비증상격발임무,PTSD조우측해마방회격활하강.결론 급성중성PTSD환자재급성기이존재부분뇌구격활적하강이급기억공능적감퇴.
Objective To characterize the brain functions of patients with acute severe PTSD and study the brain responses when implementing memory function. Methods Individuals with acute severe PTSD ( n = 10 ) resulting from a mining accident and 7 men exposed to the mining accident without PTSD underwent functional magnetic resonance imaging (fMRI) while performing the symptom provocation paradigm. Memory function was analyzed through a trauma-related short-term memory recall paradigm firstly. Results During symptom provocation paradigm, PTSD subjects ( negative pictures vs. neutral pictures ) showed enhanced responses in left posterior cingulated gyrus, bilateral caudate and right thalamus,and diminished responses in right cingulated gyrus and bilateral middle frontal gyrus. PTSD subjects showed diminished responses in right anterior cingulated gyrus, left inferior frontal gyrus, bilateral middle frontal gyrus and bilateral middle temporal gyrus and enhanced left parahippocampal gyrus response compared with controls. During the short-term memory recall paradigm, PTSD group ( negative pictures vs. neutral pictures ) showed enhanced responses in right posterior cingulated gyrus and bilateral hippocampus; PTSD subjects showed diminished responses in right inferior frontal gyrus, right middle frontal and left middle occipital gyrus etc in comparison with controls. PTSD group exhibited diminished right parahippocampal gyrus response during the memory recall task as compared to the symptom provocation task. Conclusion The decrease of activations in some brain zones and memory function have developed in acute severe PTSD.