躯体痛苦障碍患者基于言语流畅性任务下近红外脑功能成像研究

A Study on Near-Infrared Spectroscopy (NIRS) Brain Functional Imaging in Patients with Somatic Symptom Disorder during Verbal Fluency Tasks

摘要: 目的：运用fNIRS检测技术，比较躯体痛苦障碍(Bodily Distress Disorder, BDD)患者和健康对照组(Healthy Control Group, HC)患者，在基于言语流畅性任务(Verbal Fluency Task, VFT)期间前额叶激活是否存在差异，以及基于ROI感兴趣区，比较BDD患者与压力知觉是否相关。方法：通过近红外光谱脑功能成像(functional near infrared spectroscopy, fNIRS)技术，比较14例BDD患者与20例HC患者，在VFT下前额叶氧合血红蛋白(oxyhemoglobin, Oxy-Hb)浓度变化以及基于感兴趣脑区与压力知觉的关系研究。结果：基于ROI感兴趣脑区分析发现VFT任务下，BDD组在背外侧前额叶皮质(Z = −2.62, P < 0.05)和额极区域(Z = −4.27, P < 0.01)的血流动力学变化明显小于HC组。压力知觉与前额叶皮层，尤其是背外侧前额叶(r = −0.599, P < 0.05)以及额极区(r = −0.551, P < 0.05)存在显著负相关。结论：与HC患者相比，BDD患者在前额叶皮质区域功能相对减退，其脑区集中在背外侧前额叶皮质和额极区域；前额叶皮层的功能减退与BDD个体高压力感知有关。

Abstract: Objective: To utilize functional near-infrared spectroscopy (fNIRS) technology to compare differences in prefrontal activation between patients with bodily distress disorder (BDD) and healthy control subjects (Healthy Control Group, HC) during the verbal fluency task (VFT), as well as to investigate the correlation between BDD and stress perception based on regions of interest (ROI). Methods: Through functional near-infrared spectroscopy (fNIRS) technology, we compared changes in oxyhemoglobin (Oxy-Hb) concentration in the prefrontal cortex of 14 BDD patients and 20 HC subjects during the VFT, and explored the relationship between brain regions of interest and stress perception. Results: ROI-based analysis revealed that during the VFT, the BDD group exhibited significantly smaller hemodynamic changes in the dorsolateral prefrontal cortex (Z = −2.62, P < 0.05) and the frontal pole region (Z = −4.27, P < 0.01) compared to the HC group. There was a significant negative correlation between stress perception and the prefrontal cortex, particularly the dorsolateral prefrontal cortex (r = −0.599, P < 0.05) and the frontal pole region (r = −0.551, P < 0.05). Conclusion: Compared to HC subjects, BDD patients showed relatively reduced function in prefrontal cortical regions, specifically in the dorsolateral prefrontal cortex and the frontal pole region. This reduction in prefrontal cortical function is associated with heightened stress perception in individuals with BDD.