Brain Mechanism Of Implicit Cognitive Reappraisal In Depression And Preliminary Study On The Effect Of Precise Neuroregulation

Depression disorder is a common clinical serious mental disease,and its core psychological feature is emotional regulation defect.Previous studies on depression were mostly analyzed from the perspective of explicit emotional regulation.This study focused on the implicit emotional regulation disorder of depression patients,and explored the psychological and physiological mechanism of depression patients from the perspective of implicit cognitive reappraisal.In this study,the clinical psychological scale,emotional self-experience report,and functional Near-infrared spectroscopy(f NIRS)were used to deeply explore the psychology,behavior of emotional regulation,and brain oxygen metabolism of emotional regulation in patients with depression.The study also explored the efficacy of precisely regulated transcranial magnetic stimulation(TMS)on different targets in patients with depression.Part Ⅰ: Establishment of implicit cognitive reappraisal paradigm based on near-infrared optical brain imagingObjective: Previous studies mostly explored the mechanism of emotion regulation from the perspective of explicit emotion regulation.This study used f NIRS to establish and validate the implicit cognitive reappraisal paradigm of healthy people.Method: Thirty healthy subjects were enrolled in this study.The implicit cognitive reappraisal task was used to investigate the emotional regulation of subjects to different emotional pictures.At the same time,the Likert 9-point scale was used to record the subjects’ emotional self-report,and the f NIRS signal of the frontotemporal area was recorded,and the oxygen metabolism of the relevant brain areas was analyzed.Result: The 9-point scale of emotional picture pleasure found that the main effect of picture type was that the score of negative picture-negative explanation pleasure was higher than that of negative picture-neutral explanation pleasure.FNIRS results showed that in channel 39,namely the left dorsolateral prefrontal cortex(DLPFC),negative picture-neutral explanation oxy-Hb β Value is greater than negative picture-negative explanation oxy-Hb β Value,with statistical difference;In channel 50,the left orbitalfrontal cortex(OFC),negative picture-neutral explanation oxy-Hb β Value is greater than negative picture-negative explanation oxy-Hb β Value,with statistical difference.Conclusion: 1.The happiness of healthy subjects watching negative picture-neutral explanation picture is significantly higher than that of watching negative picturenegative explanation emotional picture,indicating that this experimental paradigm has successfully triggered the implicit cognitive reappraisal effect.2.Left DLPFC and left OFC participate in implicit emotion regulation,which is consistent with previous functional magnetic resonance studies,indicating the reliability of this research paradigm in f NIRS.Part Ⅱ : Brain oxygen metabolism in patients with depression based on implicit cognitive reappraisal of nearinfrared photobrain imagingObjective: To explore the brain oxygen metabolism mechanism of implicit emotion regulation in patients with depression by f NIRS technology.Method: In this study,28 patients with depression(case group),25 patients with anxiety disorder(positive control group),and 30 subjects in the healthy group(negative control group)were enrolled.The implicit cognitive reappraisal task was used to investigate the emotional adjustment of subjects to different emotional pictures.The Likert 9-point scale was used to record the subjects’ emotional self-report,and the brain oxygen metabolism of the subjects’ bilateral frontotemporal areas was recorded at the same time,which was analyzed from the level of the full temporal lobe and each channel level.Result: All three groups of subjects found the main effect of picture type found in the 9-point emotional picture pleasure scale.FNIRS results show that pictures are found in channel 39(left DLPFC)and channel 50(left OFC)× Conditional interaction.In channel 39,oxyhemoglobin(oxy-Hb)of healthy subjects β Value,(negative picture-neutral interpretation condition)-(negative picture-negative interpretation condition)is 0.016,and the two conditions β There is statistical difference in the value;Subjects in depression group oxy-Hb β Value,(negative-medium condition)-(negative-negative condition)is 0.001,and the two conditions β There was no statistical difference in the value;Anxiety group subjects oxy-Hb β Value,(negative-medium condition)-(negative-negative condition)is-0.003,and the two conditions β There was no statistical difference in the value.In channel 50,healthy group subjects oxy-Hbβ Value,(negative-medium condition)-(negative-negative condition)is 0.013,and the two conditions β There is statistical difference in the value;Subjects in depression group oxy-Hb β Value,(negative-medium condition)-(negative-negative condition)is 0.001,and the two conditions β There was no statistical difference in the value;Anxiety group subjects oxy-Hb β Value,(negative-medium condition)-(negative-negative condition)is-0.011,and the two conditions β The value has statistical difference.Conclusion: 1.The ability of implicit cognitive reappraisal was impaired in patients with depression,which was characterized by lower activation of left DLPFC and left OFC;2.Patients with generalized anxiety have abnormal implicit cognitive reappraisal,which is manifested by the opposite trend of left DLPFC,left OFC brain activation patterns and healthy people.3.The two groups of subjects with depression and anxiety disorder have different activation modes in DLPFC and OFC regions,which may become clinical differential biological indicators with application potential.Part Ⅲ : Preliminary study on the efficacy of precise navigation transcranial magnetic stimulation in the treatment of depressionObjective: To explore the efficacy of TMS with different stimulation targets in the treatment of patients with mood disorders and anxiety disorders.Method: Eight patients with depression and three patients with anxiety were treated with transcranial magnetic stimulation(TMS)for 10 times in a course of treatment.According to previous research reports,double stimulation target group and single stimulation target group(DLPFC)were respectively set up(Dorsal medial prefrontal cortex(DMPFC)+DLPFC),and the target selection of the subjects in the group was randomly assigned.Clinical psychological scale assessment and implicit cognitive reappraisal were performed before and after treatment.Result: Compared with the anxiety group,the scores of HAMD and HAMA in the depression group were significantly lower after 5 days of TBS treatment(P<0.001,P=0.018).Compared with TBS before treatment,the score reduction rate of depression double-target group and anxiety single-target group after treatment was more than 50%.Compared with those before TBS treatment,the score of 9-point emotional scale of negative-medium and negative-negative conditions of the four groups of subjects decreased after treatment,that is,after TBS treatment,all subjects’ happiness increased.Conclusion: 1.TMS has obvious effect on patients with depression.2.Whether the left DMPFC+DLPFC dual-target scheme may become a new therapeutic target for depression TMS deserves further study.