认知行为治疗调节轻中度抑郁症情绪加工神经环路的动态机制

项目名称： 认知行为治疗调节轻中度抑郁症情绪加工神经环路的动态机制

项目编号： No.81201064

项目类型： 青年科学基金项目

立项/批准年度： 2013

项目学科： 神经系统疾病、精神疾病

项目作者： 王纯

作者单位： 南京医科大学

项目金额： 23万元

中文摘要： 心理治疗的神经机制是医学研究的新领域，目前心理治疗对抑郁症情绪加工神经环路的调节机制不明确。本研究拟在前期的抑郁症影像学研究和认知行为治疗（CBT）心身作用研究的基础上，采用前瞻性随机对照研究设计，设立治疗前、治疗初期、治疗稳定后3个时间点，以正常被试为基线对照，CBT为心理干预方法，5-羟色胺回收抑制剂为干预对照，基于血氧水平依赖功能磁共振成像、三维结构磁共振成像、弥散张量成像等不同的影像学技术，在静息和任务状态下，通过单个感兴趣区内连接的分析、局部脑网络连接的分析、Granger因果检验等方法，探索CBT对首发轻中度抑郁症患者情绪加工认知监控系统和情绪反应系统神经环路作用的靶点、途径及机制，对其通过调节认知监控系统、带动整个情绪加工神经环路的改善的假设进行论证。本研究成果可为心理治疗的科学性提供生物学支持，有望在未来根据生物学机制制定治疗策略。

中文关键词： 认知行为治疗；抑郁症；磁共振；神经环路；情绪加工

英文摘要： The neural mechanism of psychotherapy is a new area of medical research. The regulatory mechanism of psychotherapy to emotional processing neural circuits of major depressive disorder (MDD) is not clear. In this study, on the basis of our previous imaging studies on MDD and effectiveness studies on cognitive-behavioral therapy (CBT), a prospective randomized controlled design was used. Three time points will be chosen: pre-treatment, the beginning of treatment, and stable phase of treatment. There are three groups: normal subjects as the baseline control, CBT group as psychotherapy, selective serotonin reuptake inhibitors group as intervention control. We will collect imaging data by blood oxygen level dependent functional magnetic resonance imaging (MRI), three-dimensional structure of MRI and diffusion tensor imaging technology in both resting-state and task-associated functional MRI. Then we will explore the effect targets, pathway and mechanism to emotional processing neural circuits of CBT for mild to moderate MDD by some analysis ways, such as connected analysis in single region of interest, the regional cerebral network connectivity analysis, Granger causality test. In this way, we hope we can judge the hypotheses that CBT regulates the whole emotional processing neural circuits by targeting at cognitive

英文关键词： cognitive-behavioral therapy；major depressive disorder；magnetic resonance imaging；neural circuits；emotional processing