论文部分内容阅读
目的:分析抑郁发作患者愉快感缺失的临床特征及其脑电生理机制。方法:采用时间性快感体验量表（Temporal Experience of Pleasure Scale, TEPS）评估抑郁症组（20例）、双相障碍Ⅱ型抑郁发作组（14例）和健康对照组（19名）的期待性(anticipatory)愉快体验 (TEPS-A)和消费性(consummatory)愉快体验( TEPS-C)，并采用汉密尔顿抑郁量表（Hamilton Depression Scale, HAMD）、痴呆简易筛查量表（Brief Screening Scale for Dementia, BSSD）评估被试者的临床特征；3组被试者按照指导语完成赌博试验，同时记录连续脑电，分析事件相关电位中的反馈负波（feedback negativity）波幅。结果:（1）与健康对照组相比，两患者组TEPS总分、TEPS-A和TEPS-C评分均显著降低（n P<0.01）。（2）抑郁症组反馈负波波幅[（-0.138±2.562） μV]低于健康对照组[（-2.569±2.598） μV]和双相障碍Ⅱ型抑郁发作组[（-2.251±0.954） μV]，均n P<0.05；在获得货币时，抑郁症组赢钱相关的事件相关电位波幅低于双相障碍Ⅱ型抑郁发作组和健康对照组（均n P0.05）。（3）Spearman相关分析显示，抑郁症组反馈负波波幅与消费性快感缺失评分呈负相关（n r=-0.501，n P=0.024）。n 结论:抑郁发作患者存在期待性快感体验及消费性快感体验的下降；抑郁症患者对奖赏敏感度下降、反馈负波的波幅下调，双相障碍Ⅱ型抑郁发作患者反馈负波未出现类似改变，脑电改变提示了抑郁症愉快感缺失的部分机制。“,”Objective:This study aims to explore the clinical features and electrophysiological mechanism of depression through event-related potential analysis.Method:Temporal Experience of Pleasure Scale (TEPS) was used to evaluate anticipatory (TEPS-A) and consummatory (TEPS-C) pleasurable experience among 53 participants (20 patients with major depressive disorder (MDD), 14 patients with bipolar depression Ⅱ (BD) and 19 health controls (HC)). Hamilton Depression Scale (HAMD) and Brief Screening Scale for Dementia (BSSD) were used to evaluate patients’ clinical characteristics. All subjects completed gambling task according to the instructions. Meanwhile, continuous electroencephalogram （EEG) was recorded, and feedback negativity in event-related potential was analyzed.Results:Firstly, compared with HC group, the scores of TEPS, TEPs-A and TEPs-C in MDD and BD groups were decreased (n P<0.01). Secondly, the FN amplitude wave decreased significantly in MDD group ((-0.138±2.562) μV), compared with HC ((-2.569±2.598) μV) and BD group ((-2.251±0.954) μV),n P<0.05. Thirdly, in contrast to HC ((10.778±6.967) μV) and BD ((10.284±5.540) μV), the MDD group ((6.069±4.353) μV) displayed blunted responses to gain feedback; For the loss feedback, no significant difference was shown among the three groups. Moreover, correlation analysis showed that, for the MDD group, consummatory anhedonia measured by TEPS-C were associated with reduction in response to gain feedback (n r=-0.501n ，P=0.024).n Conclusions:Patients with depressive episode FN in MDD was negatively correlated with the score of consummatory pleasurable experience by having a lack of pleasure, which was manifested as the decrease of both anticipatory pleasurable experience and consummatory pleasurable experience. Patients with MDD showed decreased reward sensitivity and decreased FN amplitude, while patients with BD Ⅱ showed no similar trend. The changes in EEG indicated underpinning mechanism of anhedonia in depression.