抑郁障碍患者未来自我投射异常的认知神经机制研究

Depression is a hidden killer. The high risk of suicide in depressive patients is believed to be associated with lack of positive expectancy of future and the hopelessness about the future in this population. These prominent features strongly suggest a more fundamental deficit in the patients - a deficit in projection of the self into the future. However, no study has yet been conducted to explore the neural correlates of such deficit. The current project will systematically address this issue for the first time, by a set of functional magnetic resonance imaging (fMRI) studies in patients with major depressive disorder (MDD) and healthy controls. Study 1 will examine behavioral and neural differences between the future self and the present self. Study 2 will characterize the deficit of positive and negative expectancy of future. Study 3 will investigate whether MDD patients will generalize the deficit of their negative expectancy of future to other people. Study 4 will compare common and distinct neural responses to the future envisioning and the past remembering. Study 5 will address whether the deficit in the future projection of the self is a state or trait-related feature of depressive disorder. These five studies cover most aspects of projection of the self into the future in MDD. The results therefore will not only strengthen the understanding of abnormalities of the self, but also have potential significance for improvements of detection, prediction, control and intervention of suicide in depressive disorder.

抑郁是人类的隐形杀手。抑郁症患者的高自杀风险与他们缺乏积极未来预期和对未来的绝望感密切相关。这两种重要特征强烈提示，抑郁症可能存在更本质的异常：未来自我投射的异常。但迄今为止，尚无研究对抑郁症患者未来自我投射异常的神经机制进行考察。本项目将以重性抑郁症和健康对照组为研究对象，首次利用功能磁共振成像技术对上述问题进行系统研究。研究一比较抑郁症患者未来自我和当前自我的差异，研究二考察抑郁症患者未来积极和消极预期的异常，研究三考察抑郁症患者的未来消极自我投射异常是否会泛化到他人投射，研究四比较抑郁症患者想象未来与回忆过去的异同，研究五探究未来自我投射的异常是抑郁症患者的一种状态性特征还是一种特质性特征。本项目试图从以上五个方面较全面地揭示抑郁症患者未来自我投射异常的脑机制。研究结果不仅对揭示抑郁症患者自我异常的机制具有重要科学意义，而且对抑郁症患者自杀风险的检测、预防、控制和干预也有应用潜力。

抑郁症患者的高自杀风险与他们缺乏积极未来预期和对未来的绝望感密切相关。本项目首次对抑郁人群未来自我投射异常的内在神经机制进行了考察。本项目采用量表测量、认知行为和fMRI技术，进行了5个研究，包括：（1）抑郁人群未来自我与当前自我的对比研究；（2）抑郁人群对未来积极预期和消极预期异常的研究；（3）抑郁人群消极未来自我投射和他人投射的对比研究；（4）抑郁人群想象未来与回忆过去的对比研究；（5）抑郁人群静息态脑活动对想象未来异常的预测作用研究。从抑郁人群未来自我与当前自我的对比、想象未来与回忆过去的对比、对未来积极预期和消极预期异常的对比、对消极未来自我投射和他人投射的对比、静息态脑活动异常等方面，对抑郁人群未来自我投射异常的认知神经机制进行了系统的研究，从不同方面揭示了抑郁者未来自我投射异常的内在机制。本项目发表了期刊论文12篇（10篇为第一或通讯作者），其中SCI论文1篇（影响因子：13.177），CSSCI论文8篇。另外，还发表了会议论文2篇，培养了硕士毕业生3人。本项目的研究结果，不仅对揭示抑郁症患者自我异常的内在机制具有重要科学意义，而且对抑郁症人群自杀风险的检测、预防、控制和干预具有重要的参考价值。