Observation Of Dynamic Changes Of Emotion And Related Brain Regions In The Patients Exposed To Traffic Accident Trauma

Part ?The emotional dynamic changes and psychosocial influencing factors of car accident trauma exposureObjective To explore the emotional dynamic changes and psychosocial factors of the people exposed to car accident trauma.Methods A total of 117 traumatise-exposed patients who experienced traumatic accidents and visited the emergency department of the First Affiliated Hospital of Shihezi University School of Medicine and Shihezi People's Hospital from December 2018 to November 2019 were collected.All participants who had been exposed to the traumatic event of a car accident completed the general condition survey on day 1 after the traumatic event.The summary coping style scale(SCSQ),social support rating scale(SSRS),eysenck personality scale for adult(EPQ),hamilton anxiety scale(HAMA)and hamilton depression scale(HAMD)were completed on day 2.HAMA and HAMD questionnaires were followed up on days 7,15,30,60 and 90.Post-traumatic stress disorder(PCL-5)was used at the first,second,and third months to assess car accident trauma exposure,and was diagnosed as Post-traumatic Stress Disorder(PTSD)by 2 attending psychiatrists or above.They were divided into PTSD and non-PTSD groups based on whether or not they had PTSD.Results1.There was no significant difference in gender,age,or educational level between the PTSD group and the non-PTSD group(P > 0.05).2.The PCL-5 score of the PTSD group was higher than that of the non-PTSD group at month 1,2,and 3,and the difference was statistically significant(P<0.01).3.HAMA scores of the accident victims showed a trend of increasing and then gradually decreasing,while HAMD scores showed a trend of gradually decreasing,and the time has an effect on HAMA and HAMD scores.4.The scores of positive coping,objective support and subjective support in the PTSD group were significantly lower than those in the non-PTSD group.The scores of negative coping and mental quality were significantly higher than those of the non-PTSD group(P < 0.05).5.The PCL-5 scores in the PTSD group were negatively correlated with positive coping,objective support,and utilization of support,and positively correlated with negative coping,introversion,and neuroticism scores.Conclusions1.The stress symptoms,anxiety and depression of people exposed to car accident trauma gradually eased with the change of time.2.People exposed to trauma after the accident adopt a positive attitude towards life,fully tap the available resources around them and receive more social support from the outside world,which can reduce the adverse impact of the accident on them.Part ?Resting state f MRI was used to observe the dynamic changes of fALFF in patients exposed to car accident traumaObjective To investigate the changes of low-frequency amplitude of fractions in the functional areas of the brain after exposure to traffic accident.Methods Traumatizing patients who experienced traumatic accidents and visited the first Affiliated Hospital of Shihezi University School of Medicine and the emergency department of Shihezi People's Hospital from December 2018 to November 2019 were collected.All subjects were willing to complete the resting state f MRI test using 3.0 magnetic resonance imaging 7 days and 2 months after the event,and a total of 40 cases of trauma exposure were collected.The post-traumatic stress disorder(PTSD)test form(PCL-5)was used 2 months after the occurrence of the accident to assess the persons exposed to the accident trauma.PTSD was diagnosed by 2 attending psychiatrists or above.They were divided into PTSD group and non-PTSD group according to the occurrence of PTSD,including 17 cases of PTSD group and 23 cases of non-PTSD group.Results1.There was no significant difference in gender,age,or educational level between the PTSD group and the non-PTSD group(P > 0.05).2.Compared with the non-PTSD group,f ALFF in the PTSD group decreased in the left posterior central gyrus at 1 week after the traumatic event.f ALFF in the PTSD group decreased in the left medial frontal gyrus 2 months(P < 0.01,GRF correction).3.Compared to week 1,f ALFF increased in the right middle temporal gyrus and the left occipital lobe 2 months after the traumatic event In the PTSD group.Compared to week 1,f ALFF decreased in the left cerebellum and left cingulate gyrus and increased in the right precuneus 2months in the non-PTSD group(P < 0.01,GRF correction).No obvious abnormality was found in the residual brain area.4.There was no correlation between f ALFF and HAMA and HAMD scores in the PTSD group.Conclusions f ALFF in the left medial frontal gyrus was reduced in PTSD patients compared with the non-PTSD group,while f ALFF in the right medial temporal gyrus and the left occipital lobe was increased in those who were exposed to the accident after PTSD,suggesting that these brain regions may be involved in the formation and development of PTSD,providing new criteria and targets for further understanding the pathogenesis and diagnosis and treatment of PTSD.