精神障碍的神经电生理循证医学证据
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1)四川大学华西医院放射科华西磁共振研究中心,成都610041;2)西南民族大学教育学与心理学学院,成都610041;3.2)西南民族大学教育学与心理学学院,成都 610041;4.3)四川大学公共管理学院社会学与心理学系,成都610065;5.4)四川大学华西医院心理卫生中心,成都 610041;6.5)北京师范大学心理学部,北京 100875

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国家重点研发计划项目(2018YFC1704605),国家自然科学基金 (81401398),四川省科技厅应用基础研究计划项目(2019YJ0049), 四川省卫生健康委员会普及应用项目(19PJ080),教育部人文社科 项目(17XJC190005)和西南民族大学中央高校基本科研业务费专项 资金(2018SQN36)资助项目.


Evidence-based Medicine Biomarkers of Neuroelectrophysiology for Mental Disorders
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Affiliation:

1)Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu 610041, China;2)College of Education and Psychology, Southwest Minzu University, Chengdu 610041, China;3)Department of Sociality and Psychology, School of Public Administration, Sichuan University, Chengdu 610065, China;4)Center for Educational and Health Psychology, Sichuan University, Chengdu 610041, China;5)Faculty of Psychology, Beijing Normal University, Beijing 100875, China

Fund Project:

This work was supported by grants from National Key Research and Development Project (2018YFC1704605), The National Natural Science Foundation of China (81401398), Sichuan Science and Technology Program (2019YJ0049), Sichuan Provincial Health and Family Planning Commission (19PJ080), The Ministry of Education of Humanities and Social Science project(17XJC190005)and the Fundamental Research Funds for the Central Universities, Southwest Minzu University (2018SQN36).

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    摘要:

    寻找客观标记物是精神医学研究最重要的课题之一,近期融合了循证医学的神经电生理研究为此提供了重要的途径,并取得了较为可观的研究成果,然而现有的研究结果仍然存在较多争议,难以取得一致共识. 本文全面总结和归纳了结合以元分析 (meta-analysis)为代表的循证医学方法和以脑电图(electroencephalography)为代表的神经电生理技术的精神障碍相关脑电研究成果,将事件相关电位划分为早期和晚期成分,并结合定量EEG分析,从感知加工、认知控制、情绪反应和社会认知等不同认知过程出发,系统分析和评述了精神障碍患者及高危人群的神经认知功能异常情况. 我们发现:精神分裂症患者存在从早期到晚期的各种感知、情感和社会认知方面的缺陷,注意缺陷/多动障碍(ADHD)患者存在从早期到晚期的认知控制缺陷,焦虑和强迫障碍患者则存在早期的认知控制缺陷,而孤独症谱系障碍(ASD)患者则存在早期的感知加工和社会认知缺陷. 此外,反映注意资源分配和认知加工速度的P300异常特征跨越了多个诊断类型,这表明该脑电成分可能反映了精神障碍的一般性认知缺陷. 未来研究可利用多中心大样本数据库探寻精神疾病的神经电生理客观标记物,并融合先进的多模态精神影像技术和机器学习等人工智能方法,进一步增强精神障碍生物标记物的可靠性和有效性.

    Abstract:

    Identifying the objective biological markers is one of the most important scientific goals in psychiatric research. Recently, neuroelectrophysiological studies incorporating evidence-based medicine has provided an important approach and achieved abundant results to achieve this goal. However, there are still many controversies among current evidences, and it is difficult to reach a consensus. This article comprehensively summarized the results of psychiatric studies on mental disorders which combined the method of evidence-based medicine represented by meta-analysis and the neuroelectrophysiological technique represented by electroencephalography (EEG). To systematically analyze and summarize the neurocognitive dysfunction of mental disorders and high-risk groups, event-related potential (ERP) components are divided into early and late components including different cognitive activities such as perception processing, cognitive control, emotional response, and social cognition. Evidence based on quantitative EEG analysis are also discussed. We found that schizophrenia has defects in most of cognitive processes including perception, emotion and sociality, which indexed by amplitude reduction in most of the early and late components including P50, MMN, P300 and LPP. Attention deficit/hyperactivity disorder (ADHD) has defects in cognitive control indexed by amplitude reduction in the early and late components including the ERN and Pe. Anxiety and obsessive-compulsive disorder have defects in early cognitive control, while autism spectrum disorder (ASD) has defects in early perceptual processing and social cognition indexed by amplitude reduction of N170 and FN. In addition, abnormal P300 reflexing the impaired cognitive processing speed and attention resource allocation were found across multiple diagnosis types, which indicate that this ERP component may reflect the general cognitive deficits of mental disorders. The neuroelectrophysiological studies on evidence-based medicine for mental disorders has discovered a series of valuable ERPs or EEG objective marker features, but these features still cannot be directly used in the diagnosis of personalized medicine, until these features have been identified as objective biomarkers with high accuracy and specificity in further research and clinical practice. Future research can use multi-center database to seek the electrophysiological objective markers for mental disorders, and the integrated research combining advanced technologies including multi-modal psychoradiology and artificial intelligence methods including machine learning can further enhance the reliability and validity of biological markers of mental disorders.

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汤翔嵘,王晓刚,陈桃林,张淼辰,郑重,罗跃嘉,龚启勇.精神障碍的神经电生理循证医学证据[J].生物化学与生物物理进展,2021,48(10):1157-1176

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  • 收稿日期:2020-11-05
  • 最后修改日期:2021-02-23
  • 接受日期:2021-03-26
  • 在线发布日期: 2021-11-26
  • 出版日期: 2021-10-20