广泛性焦虑障碍患者的错误相关负电位研究

目的 探讨广泛性焦虑障碍(generalized anxiety disorder,GAD)患者错误相关负电位(errorrelated negativity,ERN)的变化特点.方法 符合DSM-Ⅳ诊断标准的广泛性焦虑障碍患者30例(GAD组),同时入组年龄、性别、受教育情况与之匹配的健康受试者30例(NC组).评定2研究组受试者的汉密尔顿焦虑量表(HAMA)和状态-特质焦虑问卷(STAI),采用视觉Eriksen Flanker刺激模式诱发ERN,记录被试头皮60导EEG信号及应答行为数据,应用Brain Analyzer软件对EEG信号进行离线分析.结果 2组在年龄、性别构成、利手、受教育情况方面均无显著差异(P＞0.05);广泛性焦虑障碍组的HAMA评分、SAI评分、TAI评分(22.29±10.30)分,(41.00±15.44)分,(56.14±14.35)分]均高于正常对照组(1.61±1.58)分,(27.77±6.14)分,(33.87±7.66)分],差异有显著性(t=8.225,P＜0.01;t=4.093,P＜0.01;t=6.742,P＜0.01);两研究组的应答行为指标比较,广泛性焦虑障碍组的无应答率(15.29±18.18)%]高于正常对照组(7.23±7.99)%],差异具有显著性(t=2.184,P=0.035),其他指标无显著差异(P＞0.05);广泛性焦虑障碍组的ERN波幅FCz:(-8.76±5.74)μV]高于正常对照组FCz:(-6.91±3.07)μV],差异有显著性(F=6.924,P=0.012),两组的ERN潜伏期无显著差异(P＞0.05);广泛性焦虑障碍患者的ERN波幅和ERN潜伏期与HAMA评分之间缺乏显著性相关(-0.3＜r＜0.3).结论 广泛性焦虑障碍患者的ERN波幅异常增高,可能反映了他们内在错误监控机制过度活跃.

Changes of error-related brain activity in generalized anxiety disorder patients

Objective To explore the traits of error-related negativity (ERN) in generalized anxiety disorder (GAD) patients. Methods Thirty GAD patients and thirty normal controls were enrolled in this study. Use the Hamilton Anxiety Scale and State-Trait Anxiety Inventory to assess the severity of symptoms. Error-related negativity was elicited by the modified Eriksen Flanker task, recorded by Brain Products' EEG/ERP recording system,and the EEG signals were analyzed off line by Brain Analyzer software. Results There were no significant differences between two groups at age, gender composition, handedness and education (P ＞ 0.05 ), the scores of HAMA, SAI and TAI were significantly higher in GAD group than NC group( t = 8.225, P ＜ 0.001; t = 4.093, P ＜0.001; t = 6.742, P ＜ 0.001 ) ,there were no significant difference in behavioral reactions between two groups (P ＞0.05) except for non-response rate(GAD:(15.29 ± 18.18)% ,NC:(7.23 ±7.99)%; t=2.184, P=0.035).The ERN amplitudes of GAD group were larger than these of NC group( FCz: GAD: ( -8.76 ±5.74) μV,NC:( -6.91 ± 3.07 )μV, F = 6.924, P = 0.012), yet the ERN latency did not show any significant group difference.There were no significant correlations between HAMA scores and ERN amplitudes/latencies. Conclusion The increased amplitudes of ERN possibly reflect the abnormally activated internal error monitoring process in GAD patients.