【作者】 韩燕； 高峰； 刘倩； 樊洁； 朱熊兆；

【Author】 Yan Han;Feng Gao;Qian Liu;Jie Fan;Xiongzhao Zhu;Medical Psychological Center,The Second Xiangya Hospital,Central South University;Medical Psychological Institute of Central South University;National Clinical Research Center for Mental Disorders;

【机构】 中南大学湘雅二医院医学心理中心； 中南大学医学心理研究所； 国家精神心理疾病临床医学研究中心；

【摘要】 目的:既往研究关于强迫症(obsessive-compulsive disorde,OCD)患者在决策过程中的风险偏好以及风险相关的神经学基础尚不明确,本研究旨在进一步探索OCD患者在决策过程中的风险偏好表现以及风险相关的神经影像特征,以期为他们受损的决策功能提供更多有价值的信息。方法:本研究共纳入OCD患者51人和健康被试(Healthy control,HC)50人。通过仿真气球冒险任务(Balloon Analog Risk Task,BART)探讨个体的风险决策表现,所有被试在完成BART任务时进行功能核磁共振成像(functional magnetic resonance imaging,fMRI)扫描。计算被试在BART中的行为学表现和认知参数。探索个体在完成BART任务时受风险水平调节的脑激活特征以确定个体在决策中风险相关的神经学基础。采用ANCOVA对OCD患者和HC在决策中风险相关的行为学表现和脑激活特征进行组间比较。结果:对BART行为学指标和认知参数的分析结果表明,与HC相比,OCD患者在BART任务中出现显著增加的风险厌恶行为以及在接受负反馈后下调风险水平的程度显著增高。基于ROI的fMRI结果发现OCD患者左侧脑岛(BA13,体素数202,t=4.28,MNI坐标:-39-6 0)和右侧脑岛(BA13,体素数92,t=3.97,MNI坐标:39 3 9)受风险水平调节的激活程度显著低于HC。结论:本研究首次分离出OCD患者在决策过程中风险相关的神经学基础。OCD患者在决策时表现出更高的风险厌恶且双侧脑岛的功能异常可能是OCD患者风险厌恶增高的神经学基础。本研究发现为理解OCD患者的风险厌恶和决策功能受损提供了更多线索。更多还原

【Abstract】 Background:The risk preference during decision-making and the involved neural substrates in patients with obsessive-compulsive disorder(OCD) remined unclear.The current study was designed to evaluate the risk-taking behavior during decision-making and the neural correlates of risk taking in OCD patients,attempting to provide more insight into their impaired decision-making function.Methods:Fifty-one OCD patients and 50 healthy control(HC) were included in this study.The Balloon Analog Risk Task(BART) was used to test individuals’ risk-taking performance during decision-making.All subjects underwent functional magnetic resonance imaging(fMRI) scans during completing BART.The behavioral indicators and cognitive model parameters in BART were calculated.The neural correlates of risk taking were explored by analyzing the individuals’ brain activation modulated by risk levels in BART.The ANCOVA was used for comparison of the risk-taking related behavior and brain activation between OCD patients and HC during decision-making.Results:The analyses of behavior indicator and cognitive model parameter during BART revealed that the OCD patients performed significantly more risk-averse behaviors and adjusted down risk level after negative feedbacks during BART relative to HC.The fMRI results based on region of interest showed that the OCD patients had significantly decreased activation modulated by risk levels both in left insula(BA13,voxel size=202,peak T=4.28;Peak MNI coordinates:-39-60) and right insula(BA13,voxel size=92,peak T=3.97;Peak MNI coordinates:39 39) compared with HC.Conclusions:This study firstly dissociate the neural substrates of risk from decision-making in OCD patients.The OCD patients exhibited higher risk aversion during decision-making and the dysfunction of insula may be the neural underpinning of increased risk aversion in OCD.These findings provide more clues for understanding the risk aversion and impaired decision-making function of OCD patients.更多还原