肝郁证与正常人群欣赏悲伤音乐的脑功能激活模式研究

Brain Activation Patterns of Liver Depression Syndrome and Normal Subjects under Sad Music Appreciation

目的:探讨肝郁证(肝气郁结证)患者欣赏悲伤音乐时血氧水平依赖脑功能磁共振成像(BOLD-f MRI)的激活模式,从影像学角度揭示肝郁证的病理生理机制。方法:选择确诊的肝郁证患者16例,均为典型单纯肝郁证、无其他兼证夹杂患者。对照组16例。实验方法采用组块设计,所有受试者欣赏悲伤音乐同时,用BOLD-f MRI技术进行脑功能磁共振成像,经统计学处理后获取激活脑区,比较肝气郁结证和正常人群对悲伤音乐激活脑区的差异。结果:肝郁证组在欣赏悲伤音乐时显著激活了右侧额中回、左侧额上回、左侧额中回、左侧顶下小叶及左侧扣带回。左侧半球激活脑容积显著大于右侧。正常对照组激活脑区主要包括双侧额中回、左侧顶下小叶、双侧扣带回、双侧海马旁回、双侧楔叶等。肝郁证激活脑区范围较对照组显著减少。结论:研究发现肝郁证患者和正常人群欣赏悲伤音乐时脑区激活模式存在显著差异,从而进一步证实肝郁证脑功能异常模式,为肝郁证所致脑功能改变提供了客观依据。

Objective： To investigate the brain activation patterns under sad music of the liver depression syndrome patients by using the blood oxygen level dependent functional magnetic resonance imaging（ BOLD- f MRI） technique. The study aims to reveal the pathophysiology of liver depression syndrome from the perspective of imaging. Methods： Choose confirmed 16 cases of patients with liver depression syndrome and all the patients had the typical simple liver depression syndrome with no other confirmed disease. Sixteen cases were in the normal control group and the age and gender matched with those of the experiment group. By using the block design,all the participants enjoyed the sad music at the same time and then we performed BOLD f MRI examination. After statistics analysis,we acquired the activated brain regions and compared the differences of activation patterns between liver depression syndrome group and normal control group. Results： The liver depression syndrome group（ 16 cases） presented significant activation in right middle frontal gyrus,left superior and middle frontal gyrus,left inferior parietal lobule and left cingulate cortex. The normal control group presented significant activation in the bilateral middle frontal gyrus,inferior parietal lobule,bilateral cingulate cortex,bilateral parahippocampus,bilateral cuneus and other regions. The scope of activated brain regions showed significant reduction in liver depression syndrome group than normal control group. Conclusion： The study has found that liver depression syndrome patients and normal controls＇ brain present significant different activation patterns when listening to sad music,and thus further confirmed the dysfunction brain pattern of liver depression syndrome and provided objective evidence to clarify the brain dysfunction of liver depression syndrome.