激活右腹外侧前额叶提高抑郁症患者对社会疼痛的情绪调节能力：一项TMS研究

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莫李澄¹, 郭田友¹^,², 张岳瑶¹, 徐锋³, 张丹丹¹(

)

¹深圳大学心理学院, 深圳 518060
²华中科技大学协和深圳医院, 深圳 518052
³深圳英智科技有限公司, 深圳 518010

收稿日期:2020-08-02出版日期:2021-05-25发布日期:2021-03-29
通讯作者:张丹丹E-mail:zhangdd05@gmail.com

基金资助:*国家自然科学基金面上项目(31970980);国家自然科学基金面上项目(31871115);深圳市基础研究(自由探索)(JCYJ20180305124305294);深港脑科学创新研究院(2019SHIBS0003)

The role of ventrolateral prefrontal cortex on emotional regulation of social pain in depressed patients: A TMS study

MO Licheng¹, GUO Tianyou¹^,², ZHANG Yueyao¹, XU Feng³, ZHANG Dandan¹(

)

¹School of Psychology, Shenzhen University, Shenzhen 518060, China
²Union Shenzhen Hospital (Nanshan Hospital), Shenzhen 518052, China
³Shenzhen Yingchi Technology Co. Ltd., Shenzhen 518010, China

Received:2020-08-02Online:2021-05-25Published:2021-03-29
Contact:ZHANG Dandan E-mail:zhangdd05@gmail.com

摘要/Abstract

摘要： 负性人际交往经历和负性社会事件是抑郁症的重要诱导因素, 而社会功能受损是抑郁症患者的重要特征之一, 患者通常表现出对社会疼痛的情绪失调。为了提高抑郁症患者在负性社交情境中或面对负性社会事件时的情绪调节能力, 本研究采用经颅磁刺激技术(transcranial magnetic stimulation, TMS), 考察抑郁症患者在腹外侧前额叶(the ventrolateral prefrontal cortex, VLPFC)被激活后其情绪调节能力的改变。结果表明, 当右侧VLPFC被TMS激活且患者采用认知重评策略调节情绪时, 实验组患者(n = 64)比对照组患者(n = 63)在社会排斥情境下报告了更弱的负性情绪体验, 这说明激活右侧VLPFC可以有效提高患者对社会疼痛的外显性情绪调节能力。本研究是采用TMS提高抑郁症患者情绪调节能力的首次尝试, 实验发现不但支持了VLPFC与认知重评策略的因果关系, 还为临床改善抑郁症等社会功能障碍患者的情绪调节能力提供了明确的神经治疗靶点。后续研究还需探讨多疗程TMS刺激方案、改变社会疼痛的诱发方式、对比左右侧VLPFC的治疗效果、尝试使用其他的情绪调节策略, 进一步验证本研究的结论, 优化TMS治疗方案。

图/表 4

表1本研究两组患者的人口学特征(M ± SD)

变量	实验组 (n = 64)	对照组 (n = 63)	差异检验
年龄(岁)	29.0 ± 2.3	28.8 ± 2.7	t = 0.5, p= 0.593
性别(女/男)	34/30	33/30	χ² = 0.007, p= 0.933
抑郁 (BDI-II)	23.3 ± 6.5	22.3 ± 5.8	t = 0.9, p= 0.382
社交焦虑(LSAS)	39.4 ± 20.2	39.8 ± 20.3	t = -0.1, p= 0.911
拒绝敏感性(RSQ)	9.0 ± 3.4	8.8 ± 3.8	t = 0.3, p= 0.763
共情(IRI)	51.1 ± 9.7	49.4 ± 10.5	t = 1.0, p= 0.328

表1本研究两组患者的人口学特征(M ± SD)

变量	实验组 (n = 64)	对照组 (n = 63)	差异检验
年龄(岁)	29.0 ± 2.3	28.8 ± 2.7	t = 0.5, p= 0.593
性别(女/男)	34/30	33/30	χ² = 0.007, p= 0.933
抑郁 (BDI-II)	23.3 ± 6.5	22.3 ± 5.8	t = 0.9, p= 0.382
社交焦虑(LSAS)	39.4 ± 20.2	39.8 ± 20.3	t = -0.1, p= 0.911
拒绝敏感性(RSQ)	9.0 ± 3.4	8.8 ± 3.8	t = 0.3, p= 0.763
共情(IRI)	51.1 ± 9.7	49.4 ± 10.5	t = 1.0, p= 0.328

图1实验材料及实验流程。A, 实验材料示例。本实验部分图片选自互联网, 为了不侵犯他人版权和肖像权, 此处图片中的人物为课题组研究生。B, 单个试次的刺激呈现内容。C, 实验流程图。

图2TMS电流分布模拟图。图中的颜色代表了归一化的电流场强度, 蓝色表示0, 红色表示个体最大值。

图3实验结果。A, 被动观看和认知重评过程中的负性情绪强度评分(1~9点评分, 1分表示最低强度的负性情绪, 9分表示最高强度的负性情绪)。B, 情绪调节30 min后的图片效价评分(1~9点评分, 1分表示最负性, 9分表示最正性)。图中的误差条表示均值的标准误。*p < 0.05。

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