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題名 | 重大災難對創傷後壓力症候群患者腦部網絡的衝擊--以莫拉克風災為例=The Impact of the Brain Network in Patients with Post Traumatic Stress Disease Caused by Major Disaster--Typhoon Morakot |
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作者 | 施冠彣; 李欣芸; 葉皖菁; 林信佑; 黃慧玲; 陳正宗; 蔡宇哲; 易寶容; 徐崇堯; 夏允中; 趙垂勳; 陳佳如; | 書刊名 | 中華放射線技術學雜誌 |
卷期 | 36:3 2012.09[民101.09] |
頁次 | 頁151-156 |
分類號 | 415.994 |
關鍵詞 | 莫拉克風災; 腦功能研究; 功能性磁振造影; 創傷後壓力症候群; 重大災難; Typhoon Morakot; Brain function study; Functional MRI; Posttraumatic stress disorder; PTSD; Disaster; |
語文 | 中文(Chinese) |
中文摘要 | 從過去研究創傷後壓力症候群(Posttraumatic Stress Disorder, PTSD)的文獻探討中,評估PTSD所造成的腦部傷害可藉由腦結構以及腦功能表現的改變得知,其中PTSD對於記憶與情緒的管理有顯著的損傷。在本研究中主要是探討有災難經驗的災民,再次面臨災難的發生時,是否會反應出腦功能的表現異常,並結合心理、生理、病理的訪談與量表分析,作綜合的評估。針對遭遇莫拉克風災的倖存者進行腦功能研究,所有受試者皆接受了心理行為量表的評估及腦功能的檢測,內容包括(a)PTSD相關量表,用以輔助精神科醫師診斷,並衡量災民的PTSD病程;(b)與壓力表現有關的血液檢測,以及,(c)在災難情境模擬狀態下的腦功能影像檢查。臨床檢驗後25位有風災經驗的災民(年齡在25-60歲之間,平均年齡50歲,標準差9.25),其中14位符合PTSD的診斷標準(PTSD組),其它11位則為有風災經驗卻無創傷徵狀者(SD組);另外亦安排27位無風災經驗的受試者(年齡在20-30歲之間,平均年齡23歲,標準差2.83)作為控制組(Control, Cont組)。最後互相比較的結果呈現,災民(PTSD+SD組)所承受的災變壓力反應在睡眠品質以及心理健康上,相較於無經驗的受試者(Cont組)是比較不好的,且生物指標性的血液檢測亦可以看出腎上腺皮質激素(Adrenocorticotropic Hormone, ACTH)的含量亦低於一般正常參考值;而在情境模擬的刺激下,PTSD組在腦島(Insula)、海馬旁迴(Parahippocampal Gyrus)、後扣帶迴(Posterior Cingulate)、尾狀核(Caudate)、額內側迴(Medial Frontal Gyrus)等情緒管理及記憶有關的區域,皆有顯著的活化反應,明顯與Cont組的受試者不同。由此可推論,PTSD所造成的損傷確實反應在記憶與情緒管理上,而這些影響就算在災後一年半,仍有超過半數的災民有此困擾。 |
英文摘要 | The brain injury caused by Posttraumatic Stress Disorder (PTSD) can be assessed by the changes of the brain structure and Function. In addition, PTSD causes significant injuries in management of memory and emotion. The purpose of this study was to investigate the PTSD related brain response combined with psycho-physiological test and functional MRI scans on the survivors of Typhoon Morakot. A11 subjects are carried out psychological scale and fMRI scan after written inform content. The tests include (a) the PTSD-related scale: supporting psychiatrists to diagnose PTSD; (b) stress-related blood tests: estimating the stress response; (c) fMRI disaster situation task: testing the emotional response, 25 experienced victims (age range: 25-60 years) and 27 non-experienced subjects were invited to join this study. After the clinical diagnosis, there are still 14 subjects meet the PTSD diagnostic criteria. Moreover, all survivors present lower score on the sleep quality and mental health and higher stress response. For the fMRI result, the experienced victims have significant activation response at the Insula, Parahippocampal Gyrus, Posterior Cingulate. Caudate, and Medial Frontal Gyrus, the memorial- and emotional-related area. In summary, the injury caused by disaster could induce a long-term damage on over half survivors even the disaster had gone for one year. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。