法医学杂志

法医学杂志 ›› 2020, Vol. 36 ›› Issue (1): 52-60.DOI: 10.12116/j.issn.1004-5619.2020.01.011

• 论著 • 上一篇    下一篇

基于fNIRS技术检测脑外伤所致轻度认知功能障碍者工作记忆

昌凡1，2， 李豪喆2， 张盛宇2， 陈琛2， 刘超2， 樊慧雨2， 邢燕2， 张钦廷2， 蔡伟雄1，2   

  1. 1. 温州医科大学精神医学院，浙江 温州 325035； 2. 司法鉴定科学研究院 上海市法医学重点实验室 司法部司法鉴定重点实验室 上海市司法鉴定专业技术服务平台，上海 200063
  • 发布日期:2020-02-25 出版日期:2020-02-28
  • 通讯作者: 蔡伟雄，男，博士，主任法医师，主要从事法医精神病学研究；E-mail：caiwx@ssfjd.cn
  • 作者简介:昌凡（1993—），女，硕士研究生，主要从事精神病学研究；E-mail：2359280620@qq.com
  • 基金资助:
    “十三五”国家重点研发计划资助项目（2016YFC0800701）；国家自然科学基金资助项目（81801881）；中央级科研院所基本科研业务费资助项目（GY2018G-7）；上海市法医学重点实验室资助项目（17DZ2273200）；上海市司法鉴定专业技术服务平台资助项目（19DZ2292700）

Working Memory of Patients with Mild Cognitive Impairment due to Brain Trauma Based on fNIRS

CHANG Fan1,2, LI Hao-zhe2, ZHANG Sheng-yu2, CHEN Chen2, LIU Chao2, FAN Hui-yu2, XING Yan2, ZAHNG Qin-ting2, CAI Wei-xiong1,2   

  1. 1. School of Psychiatry, Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China; 2. Shanghai Key Laboratory of Forensic Medicine, Key Laboratory of Forensic Science, Ministry of Justice, Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai 200063, China
  • Online:2020-02-25 Published:2020-02-28

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摘要： 目的 探讨脑外伤所致轻度认知功能障碍者在执行工作记忆任务中前额叶皮质的激活特点。 方法 利用E-prime心理实验设计软件，采用N-back范式作为工作记忆的任务，应用功能性近红外光谱成像（functional near-infrared spectroscopy，fNIRS）技术检测24名脑外伤所致轻度认知功能障碍者（研究组）和年龄、性别相匹配的27名健康正常志愿者（对照组）前额叶22个通道的皮质氧合血红蛋白（oxyhemoglobin，HbO）浓度的变化，同步记录按键错误个数和反应时间等行为学数据。采用独立样本t检验、非参数检验等对各个任务下两组HbO浓度变化平均值和按键错误个数、反应时间平均值进行比较。 结果 （1）两组在1-back与2-back任务中的错误个数、反应时间差异均具有统计学意义（P<0.05）；任务负荷与组别的主效应均显著（F任务=14.11，P=0.001 1；F组别=10.39，P=0.001 5）。（2） 1-back任务过程中，两组在22个通道上的HbO变化浓度差异均无统计学意义（P>0.05）；2-back任务期间，两组在通道2、3、7、9、10、11、14、15、18、19、21、22上HbO变化浓度差异具有统计学意义（P<0.05）。（3）在1-back条件下，两组在左侧额极与背外侧前额叶区域均有激活；在2-back条件下，对照组激活区域在左侧额极区与左侧背外侧前额叶区，而研究组几乎涵盖左右大部分额极区，散在分布，且右侧区域也存在激活。 结论 脑外伤所致轻度认知功能障碍者存在明显工作记忆障碍，在执行2-back工作记忆任务中，前额叶区域激活程度减弱，但激活范围更广。

关键词: 法医精神病学, 颅脑损伤, 功能性近红外光谱成像, 认知功能障碍, 前额叶皮质, 工作记忆

Abstract: Objective To discuss the activation characteristics of the prefrontal cortex of people with mild cognitive impairment （MCI） due to brain trauma during working memory tasks. Methods The psychological experiment design software E-prime was used and N-back paradigm was adopted as working memory task. Functional near-infrared spectroscopy （fNIRS） was used to detect changes in cortical oxygenated hemoglobin concentrations of 22 channels within the prefrontal lobe of 24 people with MCI due to brain trauma （study group） and 27 healthy volunteers （control group） with matching gender and age. Behavioral data, such as the number of keystroke errors and reaction time, were recorded simultaneously. Independent samples t test and non-parametric test were used to compare the mean value of oxygenated hemoglobin concentration change, the number of key errors and the mean value of reaction time of the two groups in each task. Results （1） The differences in the number of errors and reaction time between the two groups in 1-back and 2-back tasks had statistical significance （P<0.05）.The main effects of task load and group were both significant （task F=14.11, P=0.001 1; group F=10.39, P=0.001 5）. （2） During the 1-back task, the differences in oxygenated hemoglobin concentration changes of the 22 channels between the two groups had no statistical significance （P>0.05）. During the 2-back task, the differences in oxygenated hemoglobin concentration changes of the two groups in channel 2, 3, 7, 9, 10, 11, 14, 15, 18, 19, 21 and 22 had statistical significance （P<0.05）. （3） In the 1-back task, the left frontal pole and dorsolateral prefrontal area in both groups were activated. In the 2-back task, the activation areas of the control group were the left frontal pole area and the left dorsolateral prefrontal area, while that of the study group almost covered most of the left and right frontal pole areas, which were scattered and the right area was activated, too. Conclusion Patients with MCI due to brain trauma have obvious working memory impairment, and during the 2-back working memory task, the activation of the prefrontal lobe decreased, but the activation range was wider.

Key words: forensic psychiatry, craniocerebral trauma, functional near-infrared spectroscopy, cognitive impairment, prefrontal cortex, working memory