| 摘要 | 内感受指的是人对身体内部状态的感知和整合。内感受的感知主要涉及后脑岛、身区体感觉皮层、躯体运动皮层等脑区，内感受的整合主要涉及前脑岛、前额叶皮层等脑区。药物滥用导致的内感受感知和整合能力失调是成瘾的重要原因。以甲基苯丙胺(Methamphetamine, MA)为例，长期滥用MA导致单胺类递质系统功能受损，进而影响外周自主神经系统，降低内感受传输能力，同时也会影响多巴胺受体分布丰富脑区活动，降低脑岛和扣带回的皮层厚度，减弱脑岛和其他脑区的连接，从而降低成瘾者的内感受感知和整合能力。此外，内感受的感知可能存在诱发线索的特异性，对于药物线索的脑岛活动(内感受中枢)增强，而非药物线索的脑岛活动降低。
当前成瘾领域对于内感受的研究主要关注物质成瘾者静息态时内感受变化，缺少对于情绪状态中内感受的研究，尤其是渴求时内感受变化的测量。此外，测量维度也不全面，缺少内感受信息传输、感知和整合的测量。在比较成瘾者与健康对照的内感受差异时，以往研究比较了两类人群在内感受单个维度的差异，缺乏对成瘾者在主观感受与客观指标之间，以及内感受感知和整合等多维度交互特征的探索。本研究以MA成瘾者为切入点，采用 HRV和EEG技术全面探索成瘾者在渴求和一般情绪时的内感受传输、感知和整合的多层次特征，特别是各个情绪状态下主客观指标的关系等问题，本研究还探索了内感受的损伤与成瘾者冲动
决策的关系。
本研究招募MA成瘾者92人(男40人，女52人)，健康被试32人(男18人，女14人)分成实验组和对照组，分两部分开展实验:
研究一包括两个实验，实验一对比了成瘾者和健康对照组静息状态时的内感受，采用心跳检测任务和内感受多维量表、准确性信心评估测量了内感受准确性、敏感性和意识。实验二对比了两组在情绪状态时的内感受，包括非药物线索诱发的一般情绪和药物线索诱发的渴求情绪，被试报告情绪效价、渴求强度作为内感受整合的评估指标，以及相应感受的身体评估作为内感受感知指标，同时采集被试在情绪状态时的心电和脑电活动，将心率变异性时域和频域特征作为衡量内感受信号传输能力的指标，将躯体感觉皮层和前额叶皮层的脑电功率谱变化作为内感受感知和整合能力的客观衡量指标。
研究二进一步探索成瘾组的内感受和冲动决策的关系，采用气球模拟风险任务和UPPS-P冲动行为量表测量冲动决策的特征，并和实验一中的成瘾组被试的内感受特征进行相关性分析。
研究一的结果发现，在静息状态时，成瘾组的内感受多维度量表得分显著高于对照组(p<0.001 }，心跳追踪任务得分和对照组没有显著区别(p=0.688)，而对于任务表现的信心评估准确性低于对照组(p<0.05 )。一般情绪状态时，成瘾组的内感受传输能力降低，HRV中的SDNN和HF变化量相比对照组显著变小(p<0.01, p<0.05 )，身区体感觉皮层的beta和gamma频段值低于对照组，身体评估面积显著低于对照组(p<0.05 )，对照组主观感知和客观测量指标显著相关(r=0.391,p<0.05 )，而成瘾组的主客观变化不相关(r=0.075。渴求状态下，成瘾组相比静息和一般情绪状态的内感受传输能力变强(s Due,p<0.OO1,HF,p<0.001 )，内感受感知和整合脑区的beta和gamma频段值也变大，主观感受的渴求分数较低，有71%的成瘾者报告没有感到明显的渴求，客观指标和主观报告不相关(r=-0.017 )。研究二的结果表明成瘾组决策受到内感受影响，身体感受越强烈，决策越好;内感受准确性和冲动量表中的感觉寻求正相关，敏感性和冲动量表的总分正相关。
综上，长期的甲基苯丙胺滥用造成了成瘾者内感受失调，这种失调表现在感知和整合两个层次上，并且存在线索特异性，对于一般情绪表现为感知减弱，对于渴求情绪感知增强。内感受是影响冲动决策的原因之一。对内感受变化的客观测量评估有助于成瘾的早期识别和干预。 |
| 其他摘要 | Interoception includes perception and integration of interoceptive signals. Misperception and decreased integration are important causes of addiction. Long-term methamphetamine abuse can impair the function of the monoamine transmitter system, affect the peripheral autonomic nervous system, reduce the interoception within the transmission capacity, and also affect the distribution of dopamine receptor rich brain activity, decrease the thickness of the insula, and the cingulate cortex, weakening the insula and connections in other regions and may affect the perception and integration ability. Interoception perception may be specific to inducing cues, with increased insula activity (interoceptive center) for drug cues and decreased insula activity for non-drug cues.
Current studies in the field of addiction only focus on interoceptive changes in the resting state, and there is a lack of measurement of interoceptive changes in the emotional state, especially when craving. The measurement level is not comprehensive; there is a lack of interoceptive information transmission perception and measurement integration; Previous studies focused on the differences compared with the control group at a certain level. It is more important to focus on the addiction group than the control group in the subj ective and obj ective perception consistency and integration. This study will take MA addicts as the breakthrough point and adopt the HRV and EEG technology to fully explore addicts' interoceptive transmission within the craving and general mood. The multilevel changes of perception and integration, especially the subjective and objective consistency in various emotional states, are discussed to explore whether the impairment of interoception is one of the reasons for impulsive decision-making in addicts.
This study recruited 92 methamphetamine addicts (40 males and 52 females) and 32 control groups (18 males and 14 females). The study was divided into two parts: Study one, including two experiments; Experiment one compared the interoception of addicts and healthy controls at baseline. Interoceptive accuracy was measured by the heartbeat detection task, interoceptive sensitivity was measured by the multidimensional scale, and the confidence accuracy assessment was used to measure the interoceptive awareness. Experiment 2 compared the interoception of the two groups during emotional processing, including general emotions induced by non-drug cues and craving emotions induced by drug cues, and asked the subjects to report emotional valence, craving intensity, and corresponding bodily feelings mapping. At the same time, it collected their ECG and EEG changes during emotional processing and used heart rate variability time-domain and frequency一domain indicators and EEG frequency indicators as measurement indexes. The second study explores the relationship between interoception perception and impulsive decision-making. The risk balloon task and the UPPS impulsive behavior scale are used to measure the characteristics of impulsive decision-making, and the correlation analysis is carried out with the interoception characteristics in Experiment 1.
The results of study 1 found that in the resting state, the scores of the multidimensional interoceptive scale of the addiction group were significantly higher than those of the control group (p<0.001)，and the heartbeat tracking task scores were not significantly different from those of the control group (p=0.688). The accuracy of confidence assessment for task performance was lower than that of the control group (p<0.05).In general emotional state, the interoceptive transmission capacity of the addiction group was decreased, and the changes of SDNN and HF in HRV were significantly smaller than those in the control group (P<0.01，p<0.05), the beta and gamma bands of somatosensory cortex were lower than those of the control group, and the body map area was significantly lower than that of the control group (P<0.05), there was significant correlation between subjective perception and objective measurement indexes in the control group (r=0.391，P<0.05), while in the addiction group, the subjective and objective changes were not correlated (r=-0.075). When craving, the addiction group had stronger interoceptive transmission ability compared with resting and general emotional states (SDNN，P<0.001，HF, p<0.001)，the beta and gamma bands of the interoceptive perception and integration brain regions also increased, and the subjective perceived desire score was lower, 71%of the subjective reports did not feel obvious desire, and the objective index was not correlated with the subjective report (r=-0.017). The results of study 2 showed that the decision-making of addiction group was affected by interoception, and the stronger the physical
feelings, the better the decision-making; interoceptive accuracy was positively correlated with sensation seeking in impulsivity scale, and sensitivity was positively correlated with total scores in impulsivity scale.
In summary，long-term methamphetamine abuse caused the addict interoceptive disorder, performanced on the perception and integration, and there are clues to the specificity, for general mood of perception is abate, for craving of perception is enhanced. Interoception is one of the reasons that affect the impulse decision. Assessment the objective measurement of interoceptive change help early identification and intervention of addicts. |
修改评论