【摘要】 目的 结合情绪面孔Stroop任务与功能性磁共振成像(fMRI)技术，探究抑郁障碍患者抑制控制能力的行为学特征及脑功能激活模式，揭示其反应抑制能力与临床症状的关联。方法 选取23例抑郁障碍患者为研究组，同时期招募30名年龄与性别相匹配的健康对照纳入对照组，两组于基线时分别进行抑郁自评量表(SDS)评估，在fMRI扫描下进行情绪面孔Stroop任务，记录任务态下的脑区表现，并通过测定静息态下感兴趣区的功能连接值来共同测定大脑活动状态。结果 两组SDS得分、受教育年限比较，差异均有统计学意义(P<0.05)。研究组在高兴一致、高兴不一致、悲伤一致、悲伤不一致条件下的平均反应时间均大于对照组(P<0.05)。对照组在四种条件下的平均反应时间比较差异有统计学意义(P<0.05),而研究组在四种条件下的平均反应时间比较差异无统计学意义(P>0.05);但研究组识别悲伤情绪面孔的反应时间大于识别高兴情绪面孔的平均反应时间(P<0.001)。与对照组比较，研究组左/右前扣带回与右侧直回功能连接降低，与左侧额下回功能连接增加；左/右额中回与左侧小脑、右侧额上回功能连接降低；左丘脑与右侧颞中回、右侧中央后回、左/右中央前回、右侧辅助运动区功能连接降低(经GRF矫正，voxel P<0.001,cluster size>20)。与对照组比较，研究组面对高兴情绪面孔时，右侧楔前叶激活增强，左侧额中回、右侧中央前回激活减弱；面对悲伤情绪面孔时，左侧额中回、右侧中央前回激活减弱，右侧楔前叶激活增强(经GRF矫正，voxel P<0.01,cluster size>10)。结论 抑郁障碍患者在情绪面孔Stroop任务中反应时间延长且情绪区分能力下降，伴有认知-情绪调控相关脑区功能连接减弱及楔前叶异常激活，提示其抑制控制功能受损与神经环路失调密切相关。更多还原

【Abstract】 Objective To explore the behavioral characteristics and brain functional activation patterns of patients with depressive disorders by integrating emotional face Stroop tasks with fMRI technology, revealing the relationship between their response inhibition ability and clinical symptoms. Methods 23 patients diagnosed with depressive disorders were selected as study group, alongside 30 age-and gender-matched healthy individuals recruited as control group. Both groups were assessed with Self-Rating Depression Scale(SDS) at the baseline. Brain region performance under emotional face Stroop tasks was recorded using fMRI,and the functional connectivity(FC) values of regions of interest at rest were measured to jointly determine the state of brain activity. Results There existed significant differences in SDS scores and educational levels between two groups(P<0.05). The average reaction time in happy congruent, happy incongruent, sad congruent and sad incongruent conditions in study group were all significantly longer than those in control group(P<0.05). The control group showed significant differences in average reaction time across all four conditions(P<0.05),whereas the study group did not(P>0.05). However, the mean reaction time for identifying sad facial expressions was significantly longer than that for happy facial expressions in study group(P<0.001). Compared with control group, study group showed decreased FC in the left/right anterior cingulate with the right rectus gyrus, and increased FC with the left inferior frontal gyrus; decreased FCs in the left/right middle frontal gyrus with the left cerebellum and right superior frontal gyrus; and decreased FCs in the left thalamus with the right middle temporal gyrus, right postcentral gyrus, left/right precentral gyrus and right supplementary motor area(GRF adjusted, voxel P<0.001,cluster size>20). Compared with control group, the study group exhibited increased activation in the right precuneus and decreased activations in the left middle frontal gyrus and right precentral gyrus when viewing happy facial expressions. Under sad facial expressions, similar patterns were observed, including reduced activations in the left middle frontal gyrus and right precentral gyrus, along with enhanced activation in the right precuneus(GRF adjusted, voxel P<0.01,cluster size>10). Conclusion Depressed patients show slowed responses and impaired emotional discrimination in the face Stroop task, with reduced FCs in cognition-emotion networks and aberrant precuneus activation, indicating inhibitory control deficits linked to neural circuit dysregulation.更多还原