Zhang Yuqun, Yang Yuan, Bian Rongrong, Yin Yingying, Hou Zhenghua, Yue Yingying, Chen Huanxin, Yuan Yonggui
Department of Psychosomatics and Psychiatry, ZhongDa Hospital, School of Medicine, Southeast UniversityNanjing, China.
School of Medicine, Institute of Psychosomatics, Southeast UniversityNanjing, China.
Front Aging Neurosci. 2017 Apr 18;9:105. doi: 10.3389/fnagi.2017.00105. eCollection 2017.
Group cognitive behavior therapy (GCBT) is an effective treatment in improving self-management behaviors and quality of life for asthmatic patients. However, the mechanisms by which GCBT improves asthma-related clinical symptoms remain unknown. Previous studies have indicated that insula is an important region involved in the neuropathology of asthma. Therefore, we examined the possible alteration of functional connectivity (FC) in insula subregions after GCBT in asthmatic patients. Forty-two asthmatic patients and 60 healthy controls (HCs) received resting-state functional magnetic resonance imaging (rs-fMRI) scan and clinical assessments, 17 asthmatic patients completed GCBT treatment consisting of 8 sessions, and then received rs-fMRI scan and clinical assessments. Asthmatic patients had greater left ventral anterior insula (vAI) FC with the left cerebellum posterior lobe, right middle temporal gyrus, and bilateral anterior cingulate cortex (ACC), but less FC with bilateral postcentral gyrus, bilateral occipital lobe, and left precentral gyrus compared with HCs. FC between left posterior insula and left medial frontal gyrus also increased in the patients. In addition, right vAI showed increased FC with right caudate and left putamen. FC between right dorsal anterior insula (dAI) and left calcarine however decreased. The increase in FC in insula subregions were significantly improved following GCBT. FC between the left vAI connectivity and left postcentral gyrus was positively correlated with the percentage of improvement in 17-items Hamilton depression rating scale scores, and FC between the right dAI and left calcarine was negatively associated with the improvement percentage in asthma control test scores. This study in the first time demonstrated that GCBT led to significant improvement of FC between insula subregions and other brain regions. An investigation of therapeutic mechanism in asthmatic patients: based on the results of Group Cognitive Behavioral Therapy (Registration number: ChiCTR-COC-15007442) (http://www.chictr.org.cn/usercenter.aspx).
团体认知行为疗法（GCBT）是改善哮喘患者自我管理行为和生活质量的一种有效治疗方法。然而，GCBT改善哮喘相关临床症状的机制尚不清楚。先前的研究表明，脑岛是参与哮喘神经病理学的一个重要区域。因此，我们研究了哮喘患者接受GCBT后脑岛亚区域功能连接（FC）的可能变化。42例哮喘患者和60名健康对照者（HCs）接受了静息态功能磁共振成像（rs-fMRI）扫描和临床评估，17例哮喘患者完成了由8次治疗组成的GCBT治疗，然后接受rs-fMRI扫描和临床评估。与HCs相比，哮喘患者左侧腹侧前脑岛（vAI）与左侧小脑后叶、右侧颞中回和双侧前扣带回皮质（ACC）的FC更强，但与双侧中央后回、双侧枕叶和左侧中央前回的FC较弱。患者左侧后脑岛与左侧额内侧回之间的FC也增加。此外，右侧vAI与右侧尾状核和左侧壳核的FC增加。然而右侧背侧前脑岛（dAI）与左侧距状裂之间的FC降低。GCBT后脑岛亚区域FC的增加得到了显著改善。左侧vAI连接与左侧中央后回之间的FC与17项汉密尔顿抑郁量表评分的改善百分比呈正相关，右侧dAI与左侧距状裂之间的FC与哮喘控制测试评分的改善百分比呈负相关。本研究首次证明GCBT导致脑岛亚区域与其他脑区之间的FC显著改善。哮喘患者治疗机制的研究：基于团体认知行为疗法的结果（注册号：ChiCTR-COC-15007442）（http://www.chictr.org.cn/usercenter.aspx）。
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