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心理病理学评估方法再探讨:关于临床自评量表与功能磁共振成像的转化性交叉验证

Psychopathology Assessment Methods Revisited: On Translational Cross-Validation of Clinical Self-Evaluation Scale and fMRI.

作者信息

Stoyanov Drozdstoy, Kandilarova Sevdalina, Borgwardt Stefan, Stieglitz Rolf-Dieter, Hugdahl Kenneth, Kostianev Stefan

机构信息

Research Complex for Translational Neuroscience, Medical University Plovdiv (MUP), Plovdiv, Bulgaria.

Department for Psychiatry and Medical Psychology, Medical University Plovdiv (MUP), Plovdiv, Bulgaria.

出版信息

Front Psychiatry. 2018 Feb 8;9:21. doi: 10.3389/fpsyt.2018.00021. eCollection 2018.

Abstract

We present in this article a study design that combines clinical self-assessment scale, simultaneously administered with fMRI data acquisition. We have used a standard block-design with two different conditions. Each active block consisted of four text statements (items), alternating diagnostically specific (DS) blocks comprising items from von Zerssen depression scale and diagnostically neutral (DN) blocks with items from a questionnaire about general interests. All items were rated on four degree Likert scale, and patients provided responses with corresponding four buttons during the fMRI session. Our results demonstrated that in healthy controls, contrasting the two types of stimuli yielded no residual activations, e.g., the DS did not produce significantly different activations compared to the DN stimuli. Furthermore, the correlation analyses did not find a relationship between brain activations and the total score of the DS statements in this group. However, contrasting the DS stimuli to the DN stimuli in the patients produced significant residual activations in several brain regions: right pre- and postcentral gyrus (including right supramarginal gyrus), left middle frontal gyrus, triangular part of the left inferior frontal gyrus and middle temporal gyrus. The left precuneus demonstrated correlations with the patients' DS score. In the between-group comparisons, we found residual activations in the right pre- and postcentral gyrus, right supplementary motor area, medial segment of the right precentral gyrus, right superior parietal lobule, left middle frontal gyrus, left superior frontal gyrus, left occipital pole. Our results confirm the possibility of translational cross-validation of a clinical psychological test (von Zerssen's depression scale) and fMRI. At this stage, however, we can only confirm the sensitivity of the method (its ability to distinguish healthy controls from depressed patients), but we cannot conclude anything about its specificity (distinction from different psychopathology conditions).

摘要

在本文中,我们展示了一种研究设计,该设计将临床自我评估量表与功能磁共振成像(fMRI)数据采集同时进行。我们采用了具有两种不同条件的标准组块设计。每个激活组块由四个文本陈述(项目)组成,交替出现诊断特异性(DS)组块,其中包含来自冯·泽尔森抑郁量表的项目,以及诊断中性(DN)组块,其中包含来自一般兴趣问卷的项目。所有项目均采用四点李克特量表进行评分,患者在fMRI扫描过程中通过相应的四个按钮提供回答。我们的结果表明,在健康对照组中,对比这两种类型的刺激未产生残余激活,例如,与DN刺激相比,DS刺激未产生显著不同的激活。此外,相关性分析未发现该组大脑激活与DS陈述总分之间存在关联。然而,在患者中将DS刺激与DN刺激进行对比时,在几个脑区产生了显著的残余激活:右侧中央前回和中央后回(包括右侧缘上回)、左侧额中回、左侧额下回三角部和颞中回。左侧楔前叶与患者的DS评分存在相关性。在组间比较中,我们在右侧中央前回和中央后回、右侧辅助运动区、右侧中央前回内侧段、右侧顶上小叶、左侧额中回、左侧额上回、左侧枕极发现了残余激活。我们的结果证实了临床心理测试(冯·泽尔森抑郁量表)与fMRI进行转化交叉验证的可能性。然而,在现阶段,我们只能确认该方法的敏感性(其区分健康对照组与抑郁症患者的能力),但我们无法就其特异性(与不同精神病理学状况的区分)得出任何结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec9e/5809475/107a0b629aaf/fpsyt-09-00021-g001.jpg

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