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目的利用功能磁共振技术结合比率低频振幅(fractional amplitude of low-frequency,f ALFF)与功能连接(functional connectivity,FC)的方法探索抑郁症心理干预治疗早期大脑自发活动的改变以及相关的神经机制。方法采用引导下的意象疗法对纳入的23名抑郁症患者进行4周的心理干预治疗,并在治疗前后采集被试的磁共振数据。采用f ALFF及FC的分析方法并进行基于全脑体素的统计分析。结果 4周的干预治疗后86.9%的患者症状减轻。与健康对照比较,抑郁症患者两侧眶额叶及右侧中央旁小叶的f ALFF显著升高,治疗后未降低。治疗后患者背侧前扣带回、膝下扣带的自发活动明显下降,其中背侧前扣带回与右侧背外侧前额叶、膝下扣带与左侧辅助运动区的功能连接治疗后显著增强。此外,治疗后膝下扣带f ALFF值与治疗后的HDRS正相关(r=0.498,P=0.015)。结论心理治疗通过调节重要的节点间功能的耦合及连接来重塑情感调节环路,在此过程中前扣带回是抑郁症患者功能网络改变的核心区域,大脑网络自上而下的调节模式可能是心理治疗通路中的重要机制。
Objective To explore the alteration of spontaneous brain activity and its related neurological mechanism by psychological intervention of fractional amplitude of low-frequency (f ALFF) and functional connectivity (FC) using functional magnetic resonance imaging (MRI). Methods The guided imagery therapy was used to treat the 23 depressed patients for 4 weeks, and the MRI data of the subjects were collected before and after treatment. Using f ALFF and FC analysis methods and based on whole-brain voxel statistical analysis. Results After 4 weeks of intervention, 86.9% of the patients relieved their symptoms. Compared with healthy controls, f ALFF was significantly increased in patients with depressions orbiting the frontal lobe of both sides of the right paranasal lobe, and not decreasing after treatment. After treatment, the dorsal anterior cingulate gyrus and the knee cingulate spontaneous activity decreased significantly. The dorsal cingulate gyrus and the right dorsolateral prefrontal cortex, the knee cingulate and the left ancillary exercise area were significantly increased after functional connection . In addition, the value of f ALFF in the knee ligament positively correlated with post-treatment HDRS (r = 0.498, P = 0.015). Conclusions Psychotherapy regulates the affective regulatory loop by regulating the coupling and linkage of important inter-nodal functions during which anterior cingulate refers to the core area of functional network change in depressed patients. The top-down regulatory model of the brain network May be an important mechanism in the psychotherapy pathway.