下丘脑分泌素缺乏性嗜睡症患者在处理幽默时大脑激活异常。
Hypocretin-deficient narcolepsy patients have abnormal brain activation during humor processing.
机构信息
Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias (NevSom), Department of Rare Disorders, Oslo University Hospital, Ullevål, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
出版信息
Sleep. 2019 Jul 8;42(7). doi: 10.1093/sleep/zsz082.
STUDY OBJECTIVES
To assess brain activation patterns in response to fun-rated and neutral-rated movies we performed functional magnetic resonance imaging (fMRI) during a humor-paradigm in narcolepsy type 1 (NT1) patients with cataplexy (muscle atonia triggered by emotions) and controls.
METHODS
The fMRI-humor-paradigm consisted of short movies (25/30 with a humorous punchline; 5/30 without a humorous punchline [but with similar build-up/anticipation]) rated by participants based on their humor experience. We included 41 NT1 patients and 44 controls. Group-level inferences were made using permutation testing.
RESULTS
Permutation testing revealed no group differences in average movie ratings. fMRI analysis found no group differences in brain activations to fun-rated movies. Patients showed significantly higher activations compared to controls during neutral-rated movies; including bilaterally in the thalamus, pallidum, putamen, amygdala, hippocampus, middle temporal gyrus, cerebellum, brainstem and in the left precuneus, supramarginal gyrus, and caudate. We found no brain overactivation for patients during movies without a humorous punchline (89.0% neutral-rated). Group analyses revealed significantly stronger differentiation between fun-rated and neutral-rated movies in controls compared with patients (patients showed no significant differentiation), including bilaterally in the inferior frontal gyrus, thalamus, putamen, precentral gyrus, lingual gyrus, supramarginal gyrus, occipital areas, temporal areas, cerebellum and in the right hippocampus, postcentral gyrus, pallidum, and insula.
CONCLUSION
Patients showed significantly higher activations in several cortical and subcortical regions during neutral-rated movies, with no differentiation from activations during fun-rated movies. This lower threshold for activating the humor response (even during neutral-rated movies), might represent insight into the mechanisms associated with cataplexy.
研究目的
为了评估脑激活模式对搞笑-rated 和中性-rated 电影的反应，我们在发作性睡病 1 型（NT1）患者和对照组中进行了功能磁共振成像（fMRI）幽默范式。
方法
fMRI 幽默范式由短电影组成（25/30 个有幽默笑点；5/30 个没有幽默笑点[但有类似的构建/预期]），参与者根据他们的幽默体验进行评分。我们纳入了 41 名 NT1 患者和 44 名对照组。使用置换检验进行组水平推论。
结果
置换检验显示，平均电影评分无组间差异。fMRI 分析发现，搞笑-rated 电影的脑激活无组间差异。与对照组相比，患者在中性-rated 电影中表现出显著更高的激活；包括双侧丘脑、苍白球、壳核、杏仁核、海马、颞中回、小脑、脑干以及左楔前叶、缘上回和尾状核。我们发现患者在没有幽默笑点的电影中没有脑过度激活（89.0%为中性-rated）。组分析显示，对照组中 fun-rated 和 neutral-rated 电影之间的分化明显强于患者（患者无显著分化），包括双侧额下回、丘脑、壳核、中央前回、舌回、缘上回、枕叶区、颞叶区、小脑以及右侧海马、中央后回、苍白球和岛叶。
结论
患者在中性-rated 电影中表现出几个皮质和皮质下区域的显著更高激活，与搞笑-rated 电影中的激活无差异。这种对幽默反应的激活阈值较低（甚至在中性-rated 电影中），可能代表了对与猝倒相关的机制的深入了解。
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