强迫症模糊情境下决策能力的事件相关电位研究

Impairment of Decision Making under Ambiguity in Obsessive-compulsive Disorder——An ERP Study

目的:探讨强迫症在模糊情境下的决策能力及自我监控能力。方法:28例强迫症患者接受爱荷华博弈测验(the revised Iowa Gambling Task,IGT),同时利用Neuroscan 64导脑电仪追踪记录其事件相关电位,并与28例正常对照者作比较。结果:(1)IGT总净得分对照组高于强迫症组,组别效应显著(F=4.15,P=0.047);强迫症组在block4上的净得分显著低于对照组(t=-2.03,P=0.048),block5(P=0.067)和block6(P=0.052)上得分低于对照组,但未达到统计学差异;(2)强迫症组FRN原始波(F=4.782,P=0.033)和差异波(输-赢)(F=4.022,P=0.05)波幅均低于对照组,反馈相关脑区活动异常。结论:模糊情境下,强迫症的决策能力及自我监控能力受损;负性反馈后,其自上而下的自我调整能力降低。

Objective： To explore the decision-making ability and self-monitoring ability under ambiguity in patients with obsessive-compulsive disorder（OCD）. Methods： Twenty-eight patients with obsessive-compulsive disorder and twen- ty-eight healthy controls, were enrolled in the revised Iowa Gambling Task（IGT）, and the event-related potentials were re- corded using the Neuroscan system. Results： The control group was significantly higher than OCD group in IGT net score （F=4.15, P=0.047）. The net score of the OCD group on the block 4 was significantly lower than that of the control group（t=- 2.03, P=0.048）, the group-differences of the net score showed a significant trend on the block5（P=0.067） and block6（P=- 0.052）. In OCD group, the amplitude of the original wave（F=4.782, P=0.033） and differential wave（loss and loss） （F=4.022, P=-0.05） of FRN were lower than that in the control group, suggesting that feedback related brain activity abnormalities. Conclusion： OCD patients show decision-making ability and self-monitoring ability impairment under ambiguity. After the error response, the self-adjustment ability of the top-down is dropped.