疼痛相关信息过度警觉的行为和神经机制研究

PSYCH OpenIR > 健康与遗传心理学研究室

	疼痛相关信息过度警觉的行为和神经机制研究
其他题名	Behavioral and neural mechanisms for hypervigilance of pain-related information
	何春红
	2013-10
摘要	疼痛对于个体生存的重要意义使它能够优先捕获注意。因此疼痛的出现常常会干扰正在进行的认知活动。能优先捕获注意的不仅是疼痛，与疼痛相关信息也具有这样的特点。研究者们把对疼痛或疼痛相关信息的过分注意称为过度警觉。这种过度警觉可能在慢性痛的形成和维持中发挥重要作用。另外，对疼痛相关信息的过度警觉占用认知资源干扰其他认知活动，可能是慢性痛患者出现认知损伤的原因。虽然研究者们对这一问题日益重视，涌现出大量的实证研究，但是还是有一些问题有待解决。首先，已有的研究大多是对健康被试在注意状态下的过度警觉进行行为研究，而鲜有对持续性疼痛或慢性痛人群的研究。其次，在前注意加工阶段，疼痛相关信息能否比其他非伤害性的刺激更快地吸引注意目前也没有人研究。最后，对疼痛相关信息的过度警觉干扰其他认知加工的神经机制是什么？为了探索这些问题我们开展了3项研究。研究1招募了三叉神经病人及其家属和健康志愿者，使用点探测范式研究三类被试对疼痛表情和疼痛条件刺激的过度警觉或者说注意偏向。首先，我们发现三叉神经痛患者不仅对疼痛表情而且对预示疼痛的信号有注意偏向。其次，患者家属只对不确定疼痛信号有注意偏向，对疼痛表情和确定的疼痛信号没有注意偏向。第三，无论是患者还是家属对疼痛相关信息的注意偏向都与对疼痛的恐惧相关。研究2使用经典的被动oddball范式探讨多年痛经经历的女性与没有痛经经历的女性相比，前注意加工能力是否会出现损伤及是否会在前注意阶段表现出对疼痛信号的过度警觉。研究2的结果表明虽然有多年痛经经历的成年女大学生的前注意加工能力没有出现损伤。痛经被试在前注意加工阶段表现出对疼痛相关刺激的过度警觉。而且这种前注意阶段的过度警觉是疼痛特异性的，与非伤害性的感觉刺激相关的信息不会引发过度警觉。研究3采用功能性磁共振成像技术（fMRI）通过对脑活动及其与行为指标相关性的研究，考察实验任务的认知负荷水平是否会调控疼痛条件刺激的干扰效应以及干扰效应产生的神经机制。结果显示：1）疼痛信号的出现会降低视觉搜索的效率。如果搜索任务的认知负荷增加，被试对疼痛信号的注意有减少的趋势。2）额中回可能在对疼痛信号的过度警觉的加工中发挥作用。3）疼痛信号产生的干扰效应与额中回的激活成正相关。综上所述，本论文使用行为学，ERP和fMRI等方法研究了慢性痛、痛经和健康被试对疼痛相关信息的过度警觉现象及其产生的原因，以及过度警觉干扰认知加工的神经机制。这些研究结果不仅加深了我们对疼痛的认识，也可以为疼痛特别是慢性痛的治疗认知行为疗法提供理论基础。
其他摘要	Pain is significant for our survival that makes pain has priority in capturing attention and usually interferes with other ongoing cognitive task. Like pain, pain-related information also can easily draw attention. We call this phenomenon as hypervigilance for pain or pain-related information which may play an important role in the developing and maintain of chronic pain. Furthermore, hypervigilance for pain or pain-related information will occupy cognitive recourse at expend of other cognitive activity probably cause deficit in cognitive ability in people suffering from chronic pain. Hypervigilance for pain and pain-related information get more and more attention. Also a lot of studies focus on it. There were three questions still need clarify. First most of former research just employed pain-free subjects to study whether they had hypervigilance for signal of impending pain. But research included subjects with chronic pain or persistent pain were rare. Second, no study investigate whether hypervigilance for pain signal display in pre-attention process. Finally, we still neural mechanism of how hypervigilance for pain signal disturbing other cognitive process. We demonstrated to exploring these questions. In study 1, twenty-one patients diagnosed with trigeminal neuralgia (TN) and sixteen family members and twenty-one pain-free volunteers were included to find out if they show hypervigilance towards or in other words attentional biases towards pain-related information. Two dot probe tests were performed, one that used pictures of painful versus neutral faces as cues, and another that presented three types of CS as cues that predicted certain, uncertain, or no pain. Our results demonstrate that the TN patients showed attentional biases towards painful faces and the CSs that signaled either certain or uncertain pain. Meanwhile, the ratings of negative emotion about their pain conditions correlated significantly with the presence of attentional biases. In study 2, the classical oddball paradigm was used to investigate comparing to menstrual matched controls, whether women with dysmenorrhea have deficit in pre-attention process ability and demonstrate hypervigilance for pain signal in pre-attention phase. The results showed no deficit in pre-attention process ability in women with dysmenorrhea, However women with dysmenorrhea do show hypervigilance for pain signal in pre-attention phase. This kind of hyperviglance was nociceptive-specific, because women with dysmenorrhea didn’t show hyperviglance for signal of impending nonpain stimuli. In study 3, we used fMRI to investigate how cognitive load of task mediate the interference effects of the pain signal on task. And what is the neural mechanism of how hypervigilance for pain signal disturbing other cognitive process. The results showed that the present of the pain signal impair the efficiency of visual searching. Higher cognitive load of task means less attention pay to task irrelated pain signal. We also found medial frontal gyrus may play a role in hypervigilance for pain signal. And activity of medial frontal gyrus had positive correlation with the interference effects of the pain signal. In summary, in this thesis, behavioural task, ERP and fMRI were used to explore why chronic pain patients, women with dysmenorrhea and pain-free subjects show hypervigilance for pain-related information and neural mechanism of it. Our research not only helps us learn more about pain, but also provide theory foundation for cognitive behavior therapy of pain.
学科领域	认知神经科学
关键词	疼痛过度警觉注意偏向恐惧条件化
学位类型	博士
语种	中文
学位专业	心理学
学位授予单位	中国科学院研究生院
学位授予地点	北京
文献类型	学位论文
条目标识符	http://ir.psych.ac.cn/handle/311026/19521
专题	健康与遗传心理学研究室
作者单位	中国科学院心理研究所
推荐引用方式 GB/T 7714	何春红. 疼痛相关信息过度警觉的行为和神经机制研究[D]. 北京. 中国科学院研究生院,2013.

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