摘要目的 观察神经性贪食(BN)患者加工食物图片时的脑功能特点,探讨BN的精神病理机制.方法 BN患者7例,均为女性,符合中国精神障碍分类和诊断标准第三版(CCMD-3)神经性贪食诊断标准;健康对照7例.2组性别、年龄匹配.所有受试者完成汉密尔顿焦虑量表(HAMA)、17项汉密尔顿抑郁量表(HAMD-17)、视觉模拟量表(VAS)评估和fMRI检查.功能成像为组块设计,包括食物图片序列和非食物图片序列,均来自国际情绪图片系统(1APS),计算机自动呈现.结果 BN患者食物图片VAS评分高于对照组(P<0.05);BN患者食物图片平均脑激活强度(7.86±0.78)、平均激活体积(557 voxels),主要激活双侧前额叶、右尾状核、左杏仁核和小脑;对照组食物图片平均脑激活强度(9.89±1.03),平均激活体积均(1340 voxels),主要激活双侧舌回、楔前叶、右梭状回.2组食物图片下激活差异有显著性(P<0.05),非食物图片下激活差异无显著性.结论 前额叶-纹状体-杏仁核-中脑通路功能异常可能是BN的主要神经病理机制.

abstractsObjective To observe the brain activation performance of bulimia nervosa (BN) patients and to investigate the possible mental mechanisms of BN. Method Seven female BN cases which met criteria of the 3rd version Chinese Criteria of Mental Diseases (CCMD-3) and seven matched health girls were enrolled. All sub-jects were evaluated by Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD-17), and visual ana-logue scale (VAS). Then fulfill functional magnetic resonance imaging (fMRI) examination. It was block-design. Food or non-food pictures selected from International Affective Picture System (IAPS) independently composed the food and non-food task run of fMRI and were showed by computer automatically. Result VAS-food score was higher in BN group than in control (P<0.05). The average intensity activated of BN under food pictures was 7.86 ±0.78 ,average volume activated was 557 voxels; main activation showed in bilateral prefrontal cortex, right cau-date,left amygdala and left cerebellum. The average intensity activated of control group under food pictures was 9.89±1.03, average volume activated was 1340 voxels;main activation showed in bilateral lingual gyrus, precune-us and fight fusiform gyms. Activation under food pictures was significantly different between two groups (P<0.05). Activation under nonfcod pictures did not show difference between two groups. Conclusion Dysfunction of prefrontal-striatum-amygdala-midbrain path may play a critical role in the psycho mechanisms of BN.