大脑皮层-杏仁核功能整合系统在垂体瘤患者情绪能力障碍中的关键作用和机制研究

Emotional disorder is an important factor affecting quality of life of patients with pituitary adenomas. Studies have shown that patients still suffer impaired emotional understanding and regulation even if they were cured with endocrine level. Underlying neural mechanisms have rarely been reported. Therefore, it is of great significance to explore the characteristics and neural mechanisms of emotional disorder in patients with pituitary tumors. The cortex-amygdala integration functional system is an important hypothesis for the neural basis of emotional processing. Our study showed that the gray matter volume in the relevant brain areas also decreased significantly in patients with pituitary adenomas. Therefore, our study intends to investigate the changes in emotional disorders in patients with pituitary tumors from different dimensions such as structure, neuro-electrophysiology, functional connectivity, and baseline physiological status (such as hormone levels). Combined with follow-up data, the characteristics and time-spatial characteristics of emotional disorder in patients with pituitary adenomas were explored from two dimensions (ERPs and fMRI), and structural and functional connectivity in the brain, and finally from the perspective of cerebral cortex-amygdala integrated functional system. The clinical-structural-functional covariation network of emotional disorder in patients with pituitary adenomas was constructed, thereby initially revealing the key role of the cerebral cortex-amygdala integrated functional system in patients with pituitary adenomas.

垂体瘤患者的情绪能力障碍是影响生存质量的重要因素。研究表明，即使内分泌水平治愈后患者仍存在情绪理解和调节功能受损，其潜在神经机制鲜有报道。因此探索垂体瘤患者的情绪能力障碍特点及神经机制意义重大。大脑皮层-杏仁核功能整合系统是情绪加工神经机制的重要假说，我们的研究表明其相关脑区灰质体积在垂体瘤患者中亦有明显下降。鉴于此，本研究拟从结构、神经电生理、功能连接、基线生理水平状态（如激素水平）等不同维度探讨垂体瘤患者情绪能力障碍的变化。结合随访数据，从时域和空间两个维度（ERPs和fMRI），从大脑结构与功能连接两个层次探讨垂体瘤患者情绪能力障碍的特点和时空特征，最终从大脑皮层-杏仁核功能整合系统的角度构建垂体瘤患者情绪能力障碍的临床-结构-功能共变网络，初步揭示大脑皮层-杏仁核功能整合系统在垂体瘤患者情绪能力障碍中的关键作用。

项目背景：垂体瘤患者的情绪、注意、执行控制等认知功能障碍是影响生存质量的重要因素。研究表明，即使内分泌水平治愈后患者仍存在诸多认知领域功能障碍，其潜在的神经电生理机制鲜有报道。因此探索垂体瘤患者认知功能障碍的神经机制意义重大。.主要研究内容：本课题从大脑皮层-杏仁核整合系统的角度，利用ERPs和fMRI技术评价垂体瘤患者诸多认知领域功能障碍的特点，结合长期随访结果，发现其功能障碍变化的时-空特征，构建垂体瘤患者认知功能障碍的临床-结构-功能公变网络，初步探讨其神经机制.重要结果：核磁相关研究发现垂体瘤患者多脑区灰质体积下降，静息态功能网络连通性改变，并与血清泌乳素水平相关，从结构层面提示内分泌作用在垂体瘤患者认知功能障碍中扮演重要角色；脑电相关研究发现垂体瘤患者在情绪、执行控制以及注意认知方面存在功能障碍，从认知加工时间进程以及功能连接层面揭示了垂体瘤患者认知功能障碍。.科学意义：以上研究成果从结构和功能、时间和空间角度揭示了垂体瘤患者存在诸多方面认知功能障碍，初步发掘了可能的神经影像和电生理神经机制，同时也初步确立了异常升高的血清泌乳素水平在患者认知功能障碍中的重要作用。