Correction to: Spindle‑related brain activation in patients with insomnia disorder: An EEG‑fMRI study

Brain Imaging and Behavior -     

The influence of placebo administration on the first- night effect in patients with insomnia disorder

ObjectiveWe aimed to investigate the effects of placebo on the first-night effect (FNE) in insomniacs.MethodsIn sum, 36 patients with insomnia disorder who met the DSM-5 criteria were enrolled in this study. Sixteen patients with insomnia disorder were given two days of placebo intervention (placebo-administration group, PL). Twenty patients with insomnia disorder (drug-free group, DF) were not given any interventions. All participants underwent two consecutive nights of polysomnographic (PSG) testing in the sleep laboratory. Sleep diaries were recorded during one week at home before the PSG nights and on two subsequent nights.ResultsThe results demonstrated that compared with the DF group, sleep onset latency (SOL), time in bed (TIB) and wake after sleep onset (WASO) significantly increased and sleep efficiency (SE) significantly decreased in the first sleep lab night in the PL group (all p < 0.05). Moreover, compared with the second night, significant differences were observed in lower self-reported total sleep time (TST) and more subjective WASO during the first night in the PL group (all p < 0.05). However, no significant difference was found in the duration and percentage of N1, N2, N3 and REM between the two groups.ConclusionIn patients with insomnia disorder, placebo administration may increase the occurrence of worse sleep without causing a change in the duration and percentage of N1, N2, N3 and REM on the first sleep lab night. In some cases, a placebo may not serve as treatment but may result in a nocebo effect.     

癌症相关创伤后应激障碍与应对方式的相关研究

目的:探讨癌症相关创伤后应激障碍(PTSD)患者心理应对方式特点。方法:采用临床用创伤后应激障碍诊断量表(CAPS)对67例癌症患者进行诊断性访谈,分为PTSD组(n=37)和对照组(n=30)。完成一般情况调查表、癌症应对问卷(CCMQ)。结果:PTSD组较少采取面对(1.95±0.45)的应对方式,而多采用回避和压抑(2.30±0.44)、屈服(2.45±0.72)、幻想(2.32±0.50)、发泄(2.16±0.53)的应对方式(P<0.01或P<0.05),癌症相关PTSD症状的严重程度与面对的应对方式显著负相关(r=-0.455,P<0.01),与回避和压抑、屈服、发泄显著正相关(r=0.470,P<0.01;r=0.349,P<0.05;r=0.354,P<0.01)。结论:心理应对方式不良与癌症相关PTSD的严重程度密切相关。     

Spatiotemporal Dynamics of Covert Attention With Different Degrees of Central Visual Field Defects: An ERP and sLORETA Study

PurposeThe present study aimed to investigate the spatiotemporal dynamics of covert attention by simulating different degrees of central visual field defects in healthy subjects.MethodsAn electroencephalogram (EEG) was recorded while 40 normal-sighted subjects performed a target discrimination task. Target stimuli simulated different defect degrees of the central visual field by artificially central scotomas (5, 10, 20, and 30 degrees of visual angle) masked on the center of black-and-white checkerboards. Event-related potentials (ERPs) and standardized low-resolution brain electromagnetic tomography (sLORETA) based on ERPs were analyzed.ResultsERP results indicated that during early perceptual processes, compared with 5-degree and 10-degree defects, N1 amplitudes of 20-degree and 30-degree defects decreased, whereas P2 amplitudes significantly reduced in 30-degree defects. During later discrimination and decision processing, N2 amplitudes gradually increased from 5-degree to 30-degree defects, whereas P3 amplitudes gradually decreased. Source localization indicated that 5-degree and 10-degree defects had stronger activations than 20-degree and 30-degree defects from the occipital cortex to the ventral stream and dorsal streams. Especially, 30-degree defects primarily recruited additional activations in the ventrolateral prefrontal cortex and ventral stream and later caused the disconnection of dorsolateral prefrontal-posterior parietal cortices in the dorsal stream.ConclusionsDifferent degrees of central visual field defects differed in distinct spatiotemporal characteristics at multiple stages of covert attention, from top-down forward feedback and attentional allocation to executive controls through ventral and dorsal processing streams, suggesting that the combination of ERP and source localization can reveal the spatiotemporal control capacity of the cortex on central visual field defects.     

认知行为干预护理对抑郁症患者影响的临床对照研究

目的探讨认知行为干预护理对抑郁症患者应对方式的影响。方法采用随机数字表法将符合《中国精神障碍分类与诊断标准(第3版)》(CCMD-3)的64例抑郁症患者分为研究组和对照组各32例。两组患者均接受抗抑郁药物治疗,研究组合并认知行为干预护理,对照组仅予常规精神科护理。所有患者在入组时、治疗6周后采用汉密尔顿抑郁量表24项(HAMD-24)、抑郁自评量表(SDS)、焦虑自评量表(SAS)及简易应对方式问卷(SCSQ)进行评估。结果干预6周后研究组的HAMD-24、SDS、SAS得分较对照组低(P0.01);研究者组SCSQ中消极应对方式评分较对照组低(P0.01),积极应对方式评分则高于对照组(P0.01)。结论认知行为干预护理可能有利于改善抑郁症患者焦虑抑郁情绪和提高其积极应对能力。     

难治性抑郁症停药清洗合并MECT一周及后续治疗反应

目的探讨对难治性抑郁症患者,停药清洗1周并同期合并无抽搐电休克治疗(MECT)的效果,并评价1周后续用先前抗抑郁药的治疗反应。方法将符合《中国精神障碍分类与诊断手册(第3版)》(CCMD-3)抑郁症诊断标准的40例难治性抑郁症患者,予1周的清洗,清洗期停用除苯二氮艹卓类药物以外的所有精神科药物,同期合并MECT治疗,清洗期结束后继续使用原抗抑郁药物,共观察6周。在MECT治疗前及治疗后第1、2、4、6周末分别采用汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表(HAMA)评定疗效,用副反应量表(TESS)评定不良反应。结果①6周末痊愈14例,显效17例,进步7例,无效2例。有效率77.5%。②治疗第1周末(清洗期合并MECT后)HAMD-17、HAMA评分较治疗前差异有统计学意义(P均0.01)。治疗第4周末(即重新开始续用原抗抑郁药后第3周)和第6周末HAMD-17、HAMA评分与第1周末比较差异均有统计学意义(P0.05或0.01)。结论停药清洗1周合并MECT对难治性抑郁症效果良好,经过清洗合并MECT后可提高原抗抑郁药物的疗效。     

石杉碱甲片治疗阿耳茨海默病的临床疗效

目的；观察石杉碱甲片治疗阿耳茨海默病（ＡＤ）临床疗效。方法：选择符合ＩＣＤ－１０诊断标准的４１例ＡＤ患者，随机给其中治疗组（２３例）投用石杉碱甲０．１５ｍｇｂｉｄ对照组（１８例）投用砒啦西坦１．２ｇｂｉｄ，８ｗｋ为一疗程，疗前，疗后分别进行韦工记忆量表（ＷＭＳ）和简明智力量表（ＭＭＳＥ）的检测和评分比较，结果：两组治疗前，后ＷＭＳ的记忆商（ＭＱ）和ＭＭＳＥ总评分，自身比较有显著性差异（治疗组Ｐ〈０     

从58例住院精神病人意外死亡看安全用药

目的调查住院精神病人意外死亡情况,以指导临床治疗。方法回顾性调查我院精神科36年间出院病案,对符合意外死亡的病案进行详细统计分析。结果我院36年(1966～2001)来住院精神病人意外死亡58例,占出院病人总数的1.75‰。意外死亡主要为药物治疗中原因不明的猝死17例(29.31%)、自杀12例(20.69%)、意外窒息9例(15.52%)、过度镇静7例(12.07%)、恶性综合征(NMS)6例(10.35%)。意外死亡主要由抗精神病药毒副作用所致,与联合用药、高剂量有关,而氯氮平单一较低剂量治疗中也发生较多猝死。结论单一用药,中小剂量,慎用氯氮平,选用新型抗精神病药,做好心血管监护,加强责任心,提高应急处理能力是避免意外死亡发生的良策。     

海洛因依赖稽延性戒断症状的多因素回归分析

目的探讨海洛因依赖稽延性戒断症状的影响因素。方法以一般人口学资料、汉密顿焦虑量表(HAMA)、稽延性戒断症状评定量表(PWSRS)、症状自评量表(SCL-90)、人格诊断问卷(PDQ)、药物成瘾者生命质量量表(QOL-DA)、社会支持评定量表(SSRS)为评估工具,评估120例海洛因依赖者稽延性戒断症状的心理、社会因素;并测定去甲肾上腺素(NE)、多巴胺(DA)、5-羟色胺(5-HT)浓度,进行动态心电图24小时心率变异分析(HRV),评估生物学因素。结果海洛因依赖稽延性戒断症状主要受复吸、SCL-90躯体化、PDQ回避型、动态心电图RR间期的标准差(SDNN)、动态心电图低频功率与高频功率之比(LF/HF)、5-HT的影响,标准回归系数依次为:0.241、0.388、0.109、0.213、0.183、0.077。结论海洛因依赖者稽延性戒断症状受生物、心理、社会三方面的影响,因此治疗需采取综合治疗措施。     

阿尔茨海默病患者血清Aβ1-42和血小板聚集功能联合测定的临床意义

目的：探讨血清β-淀粉样蛋白（Aβ-42）、血小板聚集功能（PAgT）在阿尔茨海默病（AD）诊疗中的临床意义。方法：采用双抗体夹心酶联免疫吸附法（ELISA）检测26例AD患者和28例健康对照者血清中Aβ1-42蛋白水平,采用比浊法检测其PAsT水平。结果：AD患者Aβ1-42水平为（38．5±12．4）Pg／ml明显低于于对照组（56．6±14．2）Pg／ml（P〈0．01）,PA盯水平为为（64．2±13．5）％则明显高于对照组（53．6±7．6）％（P〈0．01）。Pearson相关分析显示简易智能状态检查量表（MMSE）评分与PAgT呈明显负相关（r=-0．439,P〈0．05）。结论：动态检测AD患者血清AB1-42、PAgT水平的变化,在AD临床诊疗中有着重要意义。