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一项功能磁共振成像研究:神经性厌食症患者的大脑处理自我形象与非自我形象的方式不同。

Brains of anorexia nervosa patients process self-images differently from non-self-images: an fMRI study.

作者信息

Sachdev Perminder, Mondraty Naresh, Wen Wei, Gulliford Kylie

机构信息

School of Psychiatry, University of New South Wales, Sydney, Australia.

出版信息

Neuropsychologia. 2008;46(8):2161-8. doi: 10.1016/j.neuropsychologia.2008.02.031. Epub 2008 Mar 18.

Abstract

The central disturbance in anorexia nervosa (AN) is a distorted body image. This perceptual error does not extend to judging others' body shapes. We used fMRI to examine if the brain processing of an image of self is different in the brains of AN patients. The sample comprised 10 patients with AN and 10 healthy control women. In a controlled epoch design, subjects were presented with images of self and non-self, matched for body mass index (BMI), in a counter-balanced fashion, and echoplanar images with blood oxygenation level dependent (BOLD) contrast were obtained on a 3T Philips scanner. Processing of non-self-images by control subjects activated the inferior and middle frontal gyri, superior and inferior parietal lobules, posterior lobe of the cerebellum and the thalamus. Patients had a similar pattern of activation with greater activation in the medial frontal gyrus. When the two groups were contrasted for the differential activation with self vs. non-self-images, control subjects had greater activation than patients in the middle frontal gyri, insula, precuneus, and occipital regions while the patients did not have greater activation in any region. AN patients had no significant regions of activation with self-images compared to baseline. We conclude that AN patients process non-self-images similarly to control subjects, but their processing of self-images is quite discrepant, with a lack of activation of the attentional system or the insula. Such discrepant emotional and perceptual processing may underlie the distortion of self-images by AN patients.

摘要

神经性厌食症(AN)的核心障碍是身体意象扭曲。这种感知错误并不延伸至对他人身体形状的判断。我们使用功能磁共振成像(fMRI)来研究AN患者大脑中对自我形象的处理是否与正常人不同。样本包括10名AN患者和10名健康对照女性。在一个对照时段设计中,以平衡的方式向受试者呈现与体重指数(BMI)匹配的自我和非自我图像,并在3T飞利浦扫描仪上获得血氧水平依赖(BOLD)对比的回波平面图像。对照受试者对非自我图像的处理激活了额下回和额中回、顶叶上下小叶、小脑后叶和丘脑。患者有类似的激活模式,但额内侧回的激活更强。当对比两组对自我与非自我图像的差异激活时,对照受试者在额中回、岛叶、楔前叶和枕叶区域的激活比患者更强,而患者在任何区域都没有更强的激活。与基线相比,AN患者对自我图像没有显著的激活区域。我们得出结论,AN患者对非自我图像的处理与对照受试者相似,但他们对自我图像的处理却大不相同,注意力系统或岛叶缺乏激活。这种不同的情绪和感知处理可能是AN患者自我形象扭曲的基础。

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