创伤后应激障碍的记忆与相关脑区的动态变化观察及叙事疗法对记忆内容的干预研究

Posttraumatic stress disorder (PTSD) is one of severe stress-related disorders.The incidence of PTSD showed an increasing trend as natural disasters, major accidents,social violence and other emergencies increased. The current research suggests that the mechanism of the occurrence of PTSD may be a persistent disease caused by a pathological memory,the changes of rain regions associated with memory are also involved in the occurrence and development of PTSD. Unfortunately, previous studies preferred to focus on the change of the memory content (increase, decrease, normal) research single aspect of the pathogenesis of PTSD rather than combined them to study change of memory,emotion and the relevant brain regions in PTSD from a longitudinal view since trauma occurred. Furthermore, the conclusions of previous studies resulted from comparing PTSD and non-PTSD rather than self-control study. Meanwhile,the study aimded at the highway traffic trauma population, to study the memory changes in acute stress by tracing the trauma exposure, the application of fMRI technology,and analyzed the changes of PTSD controls of memory and brain trauma exposure, dynamic evolution process changes and to investigate the the relevant brain regions (e.g. amygdala, hippocampus, frontal lobes,thalamus).Moreover, we will continue to intervene the research of memory on that people,to observe the effect of intervention.

创伤后应激障碍是一种严重的应激相关障碍，随着自然灾害、重大交通事故等突发事件的增多，其发病率呈逐年上升的趋势，其中交通事故增多导致的创伤后应激障碍在其中所占的比例呈逐年增多趋势。目前国内外研究认为，PTSD的发生机制之一可能是一种病理性记忆导致的持续性的疾病,记忆相关脑区的改变参与了PTSD的发生发展。但以往的研究较少从患者经历创伤事件开始进行记忆内容改变（增多、减少、正常）及相应脑区变化的研究，亦较少对PTSD的记忆进行干预研究；且结论多从创伤人群与非创伤人群对比而非自身前后对照得出脑功能损害的研究；在研究方法上较少采用纵向动态研究，结果缺乏代表性。因此，本课题针对高速公路车祸后的创伤人群，通过追踪创伤暴露者的急性应激期的记忆变化，应用fMRI技术，对创伤暴露者发生PTSD自身前后的记忆内容及相关脑区的变化进行对照比较分析，探讨PTSD发生过程中患者记忆内容的变化与其干预。

创伤后应激障碍是指人在经历车祸、火灾、亲人离世等重大创伤事件后产生的一种精神心理疾病，其发生发展的病理生理学机制尚未完全清楚。课题组前期研究发现创伤后应激障碍患者与正常对照组相比，部分脑区结构和功能发生了改变，并且其发生与记忆受损有一定关系。为了验证该推测，利用静息态核磁共振的影像学技术，结合临床相关量表及心理学治疗的方法，以车祸后的创伤暴露者为研究对象，采用纵向动态的临床研究方法。研究了车祸后发生创伤后应激障碍组与车祸后正常对照组之间3个月内大脑结构与功能、记忆、情绪及心理社会因素的动态变化，分析了大脑结构功能发生变化的相关影响因素；并且对一部分车祸后的创伤暴露者采用叙事疗法进行干预，观察该治疗方法对罹患创伤后应激障碍的防治效果。研究结果为深入理解创伤后应激障碍的神经心理学机制提供了依据，并对防治创伤后应激障碍的发生提供了思路。