摘要
目的通过对比不同焦虑状态及焦虑特质大学生受到瞬时疼痛刺激和触觉刺激所诱发的功能磁共振成像(functional magnetic resonance imaging,fMRI)脑响应,研究焦虑状态及焦虑特质对疼痛诱发脑神经活动的特异性调控。方法2017年4~9月在天津医科大学总医院对62名大学生进行试验,试验前采用状态特质焦虑量表(state-trait anxiety inventory,STAI)评估被试焦虑特质和焦虑状态。试验过程中采用磁共振扫描仪获取被试每次受到痛觉或触觉刺激时的功能磁共振脑影像数据,并在每次刺激后采用视觉模拟量表(visual analogue scale,VAS)评估被试对每次刺激的感知强度。比较不同状态焦虑水平和不同特质焦虑水平被试痛触觉脑响应激活值。统计分析时使用一般线性模型检测fMRI脑激活;采用双因素方差分析检测焦虑水平和刺激模态对脑响应是否存在交互作用,并进行事后双样本t检验以分析各脑区的具体交互作用形式。结果状态焦虑与刺激模态对双侧后顶叶、背外侧前额叶等脑区的激活强度的影响存在交互作用(cluster-level FWE校正后P<0.05):中焦虑组这些脑区的触觉激活强度(5.66±0.65)显著高于痛觉激活强度(1.24±0.55)(P<0.001),而在低、高焦虑组差异无统计学意义(均P>0.05)。特质焦虑与刺激模态之间在双侧枕中部皮质等脑区表现出显著交互作用(cluster-level FWE校正后P<0.05):高焦虑组这些脑区的触觉激活强度(8.38±1.00)显著高于痛觉激活强度(3.19±1.12)(P=0.001),而在低、中焦虑组差异均无统计学意义(均P>0.05)。结论状态及特质焦虑水平对痛觉和触觉诱发脑激活的调控并不一致,为揭示焦虑对疼痛特异性调控的脑机制提供了重要证据,提示临床处理疼痛症状时应考虑病人的焦虑特质及当时的焦虑状态。
Objective To investigate whether anxiety state and anxiety trait modulate specifically pain-induced brain responses by comparing the brain activations induced by painful stimulation and those by tactile stimulation in college students with different levels of anxiety state or anxiety trait.Methods From April 2017 to September 2017,sixty-two college students were tested in Tianjin Medical University General Hospital.Each subject’s anxiety trait and anxiety state were assessed by the state-trait anxiety inventory(STAI)prior to the fMRI experiment.During the fMRI experiment,each subject received painful and tactile stimuli.Their brain responses to each stimulus were collected by the MRI scanner,and the perceived intensity rating of each stimulus was collected using the visual analogue scale(VAS).The pain and tactile brain activation values of subjects with different state anxiety levels and different trait anxiety levels were compared.The fMRI brain activation was detected using general linear model.For each type of anxiety(state or trait),two-way ANOVA was performed to detect the interaction between anxiety level and stimulus modality on brain responses and two-sample t-tests were performed to analyze the specific form of interaction in each brain region.Results There were interactions between state anxiety and stimulation modality on the activation intensity of bilateral posterior parietal lobe,dorsolateral prefrontal lobe and other brain regions(P<0.05,cluster-level FWE corrected).The brain responses to tactile stimuli(5.66±0.65)in these areas were significantly stronger than those to painful stimuli(1.24±0.55)in the group of middle-level anxiety state(P<0.001),but no significant difference was found in the other two groups(both P>0.05).For anxiety trait,a few brain areas in bilateral occipital cortex showed significant interactions between anxiety level and stimulus modality.The brain responses to tactile stimuli(8.38±1.00)in these areas were significantly stronger than those to painful stimuli(3.19±1.12)i
作者
魏露莉
宋颖超
苏乾
杨青青
张欣欣
梁猛
Wei Luli;Song Yingchao;Su Qian;Yang Qingqing;Zhang Xinxin;Liang Meng(School of Medical Imaging,Tianjin Medical University,Tianjin 300203,China)
出处
《中华行为医学与脑科学杂志》
CAS
CSCD
北大核心
2021年第9期817-823,共7页
Chinese Journal of Behavioral Medicine and Brain Science
基金
国家自然科学基金项目(81971694)。
关键词
焦虑
疼痛
功能磁共振成像
脑激活
Anxiety
Pain
Functional magnetic resonance imaging
Brain activation
