Study On The Neural Mechanism Of Somatization In Patients With Emotional Disorders Based On Functional Magnetic Resonance Imaging

Objective Somatization has become an increasingly serious medical burden.Patients with somatization symptoms are often accompanied by emotional disorders,mainly anxiety and depression.Emotional disorders interact with somatization symptoms.So far,the mechanism of somatization symptoms is not very clear.Clinical diagnosis still relies on empirical diagnosis and lacks objective diagnosis basis.Functional magnetic resonance imaging(f MRI)uses changes in the strength of a magnetic resonance signal to assess changes in brain function.Therefore,the main purpose of this study is to use f MRI to explore the neural mechanism of somatization symptoms in patients with emotional disorders and to provide experimental evidence for non-drug treatment of somatization symptoms.Methods Functional magnetic resonance was used to study 33 anxious patients with with somatization symptoms and 25 normal controls.We hypothesize that somatization in patients with anxiety is related to abnormal activity in the fear circuit.The SPM12 analysis software under MATLAB(2013a)was used to preprocess the magnetic resonance data.Then,by using different imaging analysis methods,two independent sample t-tests are performed on two groups of patients.Template one selects the fear circuit,and template two selects the region of interest(ROI)based on the literatures.Observe the differences in the brain activation area between the two groups in resting state magnetic resonance imaging.Combined with general clinical data and cognitive function assessment results,we will conduct a comprehensive analysis.(2)FMRI was used to collect 23 depressed patients with somatization.We hypothesize that somatization symptoms in patients with depression and anxiety have a common neural mechanism.Functional connection analysis was performed using the subgenual ACC anterior cingulate gyrus as the seed point.The control group was 20 patients with anxiety disorder with somatization symptoms and 22 healthy subjects.Observe the common abnormal brain areas by functional connectivity.Combined with general clinical data and cognitive function assessment results,we will conduct a comprehensive analysis.Results(1)In the fear circuit,we observed a significant increase in ALFF in the left thalamus and left hippocampus of patients,which was positively related to the patient health questionnaire 15(PHQ-15)and not related to the Hamilton Anxiety Scale(HAMA)or the Hamilton Depression Scale(HAMD).The functional connection between the lateral amygdala basal nucleus and the superior temporal gyrus was weakened,and was negatively correlated with PHQ-15,but not related to either the HAMA scale or the HAMD scale.The functional connection between the posterior portion of the right insula and the supplementary motor area was weakened,and was negatively correlated with PHQ-15,but not related to either the HAMA scale or the HAMD scale.(2)The abnormally connected brain region shared by patients with depression and anxiety is the superior temporal gyrus,and the abnormally connected function is negatively correlated with the PHQ-15 scale scoreConclusion(1)The neural mechanisms of somatic symptoms of anxiety disorder may overlap with the circuit of fear.In the fear circuit,the hippocampus and thalamus are mainly involved in the generation of somatic symptoms.Abnormal activation of the functional connection between the amygdala-super temporal gyrus and insula-supplemental motor area implies activation of the core fear system.(2)The neurological mechanism of the somatization symptoms in patients with depression and anxiety may be homologous,which is closely related to neural pathways such as the geniculate gyrus below the sg ACC and the superior temporal gyrus.This study uses neuropsychological scale and functional magnetic resonance technology to reveal the neural mechanism of physical symptoms in patients with anxiety and depression,and provides a research basis for improving disease treatment and diagnosis.