用于抑郁症认知康复的脑电神经反馈：新技术及其脑影像机制研究

Depression is a common and serious mental disorder, cognitive impairment is one of its core symptoms, which can lead to severe impairment of patients' social function and hinder the overall recovery of the disease. However, there is a lack of effective treatments for cognitive impairment of patients with depression. In recent years, EEG neurofeedback has been gradually used in cognitive rehabilitation because of its advantages of non-invasive and non-side effects. But existing EEG neurofeedback methods are not customized for cognitive rehabilitation of patients with depression, and there are great individual differences in the clinical efficiency. Besides, its related neuroimaging mechanisms remain unclear. In order to develop more effective EEG neurofeedback training system for cognitive rehabilitation in patients with depression, the contents of this study include: (1) extraction of brain network signature for cognitive impairment of patients with depression in order to develop new EEG neurofeedback training system; (2) conducting clinical controlled experiment to assess the learning effect of feedback training as well as the effect on cognitive function rehabilitation; (3) investigation of clinical efficiency related neuroimaging mechanisms. This study is expected to reveal more comprehensive neurological markers related to cognitive impairment in patients with depression, develop a more effective EEG neurofeedback training system, and clarify the relevant neuroimaging mechanisms, so as to provide a solid basis for clinical application in future.

抑郁症是一种常见且严重的精神疾病，认知功能障碍是其核心症状之一，会极大损害患者社会功能，并阻碍疾病整体康复。然而，目前针对抑郁症患者认知障碍的有效康复手段仍十分缺乏。近年来，脑电神经反馈因其无创无副作用等特点，被逐步用于认知功能康复；但现有技术并非为抑郁症认知康复定制，其效果存在极大个体差异，而且神经机制不清晰。本研究的目标是发展用于抑郁症认知康复的脑电神经反馈新技术、进行临床验证和脑影像机制研究。主要内容包括：（1）识别抑郁症认知障碍相关的脑电标记，基于此发展新型神经反馈训练技术；（2）应用新发展的神经反馈技术开展临床对照实验，评估训练效果和认知功能康复效果；（3）进一步利用磁共振功能结构特征探索学习效果和康复效果相关的脑神经机制。本研究有望更全面地揭示与抑郁症认知功能障碍相关的神经活动标记、发展一种更有效的脑电神经反馈训练技术、并阐明其相关的脑神经机制，从而为临床的应用推广提供依据。

情绪障碍疾病抑郁症的认知障碍的神经机制仍不明，且缺乏针对患者情绪认知调控异常的有效干预手段。脑电神经反馈作为一种新型的脑调控技术，被逐步用于情绪认知功能训练，但现有技术并非为情绪障碍疾病患者定制，反馈训练的调控学习效果存在极大个体差异，且神经机制不明。因此，本项目针对脑电神经反馈用于情绪认知障碍训练干预的技术和机制问题，借助多模态神经影像技术，开展了以下研究内容：1）揭示了情绪认知障碍患者静息态功能脑网络动态特性异常，及情绪信息加工任务态的脑网络模式的异常，结果提示不适合通过单一靶点的脑电神经反馈范式来对患者进行干预。2）构建了结合情绪诱发和实时解码的个体化情绪调控脑电神经反馈训练系统，实验结果显示该新型脑电反馈训练范式可用于改善情绪障碍患者对中性和低强度正性情绪刺激的负性认知偏差。3）结合功能结构的多模态、局部和脑网络的多尺度脑影像特征，对目前脑电反馈训练效果存在较大个体差异的问题进行了分析，为优化脑电反馈训练效果奠定了理论基础。本研究更全面地揭示与抑郁症情绪认知功能障碍相关的神经活动标记，为康复干预提供了一种更有针对性的脑电神经反馈训练技术，为临床的应用推广提供依据。