共情痛的安慰剂效应及其神经机制

PSYCH OpenIR > 健康与遗传心理学研究室

	共情痛的安慰剂效应及其神经机制
其他题名	Neural mechanism of the placebo effect of empathy for pain
	赵一力
	2016-05
摘要	大量研究表明，共情痛具有和疼痛相似的神经网络。很多研究认为共情痛可以激活表征情绪情感成分的前中扣带（aMCC）和前脑岛（AI），但关于共情痛是否能激活疼痛网络中的躯体感觉皮层以及即使存在躯体感觉皮层激活是否表征类似疼痛的疼痛感受特征一直存在争论。目前研究共情痛的主要研究方法是通过呈现共情痛和控制性的无共情痛实验刺激，然后使用fMRI或ERP等方法观测和记录共情痛的神经活动，但这种方法不能排除共情痛的躯体感觉皮层激活是由于其他非特异性的躯体感觉活动（比如在非疼痛情境下）引起的。另外一种方法可以从共情痛调控的角度研究共情痛的神经网络，这样可以在相同刺激内容条件下比较未调控和被调控的共情痛网络。本研究中，我们采用了安慰剂效应调控的方法。而且在过去安慰剂效应范式的基础上我们进行了创新，建立了随机控制和条件强化相结合的安慰剂效应范式，这个范式可以更好的兼顾安慰剂使用中存在的伦理问题和效果问题。本研究主要包括两部分：研究一：在行为上建立随机控制+条件强化的共情痛安慰剂效应的研究范式；研究二：挑选安慰反应者和研究共情痛安慰剂效应的脑活动机制。对于研究一，我们挑选了46名被试分为实验组和对照组，通过随机控制的指导语“50% 可能是接受治疗的被试，50%可能是不接受治疗的被试”，配合两种指导语“真实治疗者治疗，非治疗者不治疗”和“都不治疗”，在第一种指导语出现时给予实验组被试低强度刺激，对照被试高强度刺激；第二种指导语出现时两组都给予高强度刺激；然后通过共情痛图片检验是否建立了共情痛的安慰剂效应。结果发现，安慰剂组在针刺图片条件下存在显著的安慰剂效应，而对照组则没有建立。研究二包括两个实验：实验一：我们选取了48名被试进行行为实验，进行了第一次安慰剂信念建立，根据行为分数和事后访谈结果挑选24名安慰剂反应者进入后续的核磁实验；实验二：24名安慰剂反应者首先进行第二次安慰剂信念强化，然后进入核磁内扫描共情痛安慰剂效应的脑活动。结果发现，在共情痛条件下，中央后回，后脑岛，中央前回和杏仁核有显著激活，在安慰剂缓解的共情痛脑区中，中央后回和后脑岛活动显著；两者的联合分析发现中央后回，后脑岛和岛盖部存在共同激活；安慰剂执行调控的区域主要在眶额；对Run1和Run4的时间效应分析，发现了中部扣带和前脑岛的显著激活，证明了这两个脑区随时间变化激活显著下降。研究一结果表明，我们首次在行为上成功建立了随机控制和条件化相结合的安慰剂效应范式；研究二的结果首次发现了安慰剂缓解了共情痛的躯体感觉区（S1和S2），表明共情痛中可能存在躯体感觉成分的参与。
其他摘要	Empathy for pain had similar brain network with pain. Many studies indicated that empathy for pain could active anterior medial cingulate cortex(AMCC)and anterior insula(AI) representing emotion and affect of pain, but whther it could also active somatic regions in pain matrix had been a controversy. Although there were some studies finding that empathy for pain could induce activities in S1 and S2, whether this activation could represent somatosensory component of pain was still uncertain. The popular way of researching empathy for pain is by stimuli inducing empathy, then using fMRI, ERP or TMS to observe and record the corresponding physiological activities. But this method could not exclude that the activation of S1 and S2 found in empathy for pain was induced by other nonspecially psychological components other than pain. In this research, we used placebo effect to solve the problem. We built a new paradigm of placebo effect combing random controlled design and conditioned reinforcement, which could better balance the ethic and effective problem long-lasting in studies of placebo effect. There were two main studies in this research: (1) building up placebo effect paradigm of random controlled design and conditioned reinforcement (2) picking up place responders to scan their brain images when they are experiencing placebo effect of empathy for pain. (1) We recruited 46 subjects as experimental group and control group, the instruction was random controlled that ”you have 50% chance to be the treated one, and 50% chance to be the non-treated one ”, coorperating with the conditioned manipulation that when the reminding instruction was”the treated one gets treatment, the non-treated one gets no treatment” giving experimental group low intensity of pain and control group high intensity of pain, and when the reminding instruction was”everyone gets no treatment” giving both groups high intensity of pain. The the placebo effect was tested in pictures of empathy for pain. It was found that the experimental group showed significant placebo effect in empathy for pain condition, while the control group didn’t. (2) Experiment I:we pick up 48 new subjects to undergo the experiment in study one, building up their placebo effect. According to their behavioral scores and interview after the experiment, we picked up 24 placebo responders. Experiment II: the 24 placebo responders reinforced their placebo belief, and then came into the fMRI scanner to record their brain activation during placebo effect of empathy for pain. The results showed that, in the network of empathy for pain, postcentral gyrus, posterior insula, precentral gyrus and amagdala were significant activatied. In the relieving activation of empathy for pain by placebo effect, signicant activaties were found in postcentral gyrus and posterior insula; the combination analysis of the two conditions found similar brain activation in postcentral gyrus and posterior insula and frontal operculum. The regions of placebo effect regulation was in orbital frontal cortex.The temporal analysis of Run1 and Run4 showed that there were significant decreased activities in medial cingulate cortex and anterior insula as time passing by. The Study I indicated that for the first time we successfully build up the paradigm of placebo effect combining random control and conditioned reinforcement. The results of Study II showed that for the first time we foundthat the placebo effect relieving empathy for pain in S1 and S2 which, may represent somatosensory component in pain.
学科领域	应用心理学
关键词	共情痛安慰剂效应躯体感觉区核磁研究
学位类型	硕士
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/311026/19835
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	赵一力. 共情痛的安慰剂效应及其神经机制[D]. 北京. 中国科学院研究生院,2016.

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