基于纵向数据的青少年网络成瘾并发抑郁神经机制研究

Concurrent depression can lead to the attempt and behavior of suicide in the adolescents with Internet addiction disorder (IAD), which produce incredible adverse effects on the physical and mental health among young people, as well as the family stability and social harmony. Due to the unknown mechanism, the prevention, diagnosis and treatment of IAD concurrent with depression is mainly established on the basis of hypotheses from both doctors and patient, which will be influenced by their subjective feelings. The lack of objective assessment of the indicators makes it difficult to make effective treatment for IAD. Therefore, the neuropathological basis and epigenetic mechanism of IAD concurrent with depression is the critical problem to be solved. In order to determine the effects of IAD with depression on the brain and behavior among adolescents, we used a 2-year longitudinal experiment design. The human connectome and imaging genomics methods were employed in the present study. The brain strucutral and functional networks were compared between the before and after the IAD with depression group suffering from depression. The difference between the IAD with depression and IAD without depression at the enrolling stage was also investigated. The genetic information, neuroimaging findings and the cognitive tasks performance were integrated to reveal the accurate neuroimaging biomarkers and neuromechanism of the high risk for IAD with depression among adolescents. It is hoped that our findings could provide scientific evidence for prevention, intervention and treatment for the IAD with depression.

并发抑郁容易导致青少年网络成瘾患者产生自杀企图和行为，对家庭稳定、社会安定和谐产生难以估量的不良影响。然而网络成瘾并发抑郁的神经机理至今不明，现阶段治疗很大程度上受医患双方主观因素所左右，缺乏客观的评估指标，使得其治疗变得十分困难。因此，网络成瘾并发抑郁的神经病理基础、遗传学发病机制都是亟待解决的具有挑战性的前沿问题。本研究采用为期2年的纵向跟踪实验设计，使用连接度组学和影像基因组学方法，将影像学、遗传学信息与行为学数据相结合，通过比较网络成瘾并发抑郁患者并发抑郁前后的大脑结构和功能网络异常，网络成瘾并发抑郁患者与未并发抑郁患者初始阶段大脑结构和功能网络差异，考察网络成瘾患者中易发抑郁的影像学标记，探讨网络成瘾患者随病情发展并发抑郁的神经影像学和遗传学机制，确定并发抑郁对网络成瘾青少年大脑造成的可塑性变化及生物学意义，为网络成瘾患者并发抑郁的预防、诊疗提供科学依据和循证基础。

并发抑郁容易导致青少年网络成瘾患者产生自杀企图和行为，对家庭稳定、社会安定和谐产生难以估量的不良影响。网络成瘾并发抑郁的神经机理至今不明，现阶段治疗很大程度上受医患双方主观因素所左右，缺乏客观的评估指标。鉴于此，项目组开展了以下几方面工作：1）评价了青少年网络成瘾患者大脑可塑性及行为学异常改变相关性，揭示了前额叶、纹状体、脑岛等脑区的结构和静息状态功能连接度的异常、凸显网络的结构与功能的异常、大脑静息状态网络之间的结构与功能的异常、前额叶纹状体回路之间的功能连接度异常、大脑两半球间功能连接度的异常等。2））评价了青少年抑郁患者功能网络异常改变，解析了结构损伤与功能异常的耦合关系相关性，发现杏仁核是杏仁核在抑郁症发生发展中起重要的作用,有关杏仁核的神经网络络拓扑结构异常可能是潜在的青少年抑郁症患者抑郁易感性，疾病发展的生物学标记。3）评价了青少年网络成瘾合并抑郁患者的大脑形态、功能异常及与行为学改变相关性，初步分析了网络成瘾患者随病史时间延长，大脑形态、功能及行为学的改变，发现青少年网络成瘾患者发展成合并抑郁患者的过程中前额叶、杏仁核出现了明显的结构和功能变化。4）设计了一套心理学行为测试装置、增加行为学采集工作效率和准确度。解决了行为学数据采集繁杂、统计中容易出现错误，影响实验精度的难题， . 综上，本项目的执行，揭示了青少年网络成瘾、抑郁神经机制， 为网瘾青少年并发抑郁的发展过程提供了客观的影像学标记，为网络成瘾患者并发抑郁的预防、诊疗提供科学依据和循证基础。