基于低频振幅的人格解体-现实解体障碍认知功能损害神经机制分析

doi:10.3969/j.issn.1006-7795.2026.03.020

首都医科大学学报 ›› 2026, Vol. 47 ›› Issue (3): 569-578.doi: 10.3969/j.issn.1006-7795.2026.03.020

• 精神科中西医结合临床及认知神经基础 • 上一篇下一篇

基于低频振幅的人格解体-现实解体障碍认知功能损害神经机制分析

宋楠¹,郑思思^2，3*#,贾竑晓^2，3*#

1.厦门市仙岳医院厦门医学院附属仙岳医院福建省精神医学中心福建省精神疾病临床医学研究中心，福建厦门 361012；2.首都医科大学附属北京安定医院国家精神疾病医学中心精神心理疾病国家临床医学研究中心精神疾病创新药智能研发北京市重点实验室, 北京 100088；3.人脑保护高精尖创新中心，首都医科大学，北京 100069

收稿日期:2026-02-02 修回日期:2026-03-10 出版日期:2026-06-21 发布日期:2026-06-26
通讯作者: 郑思思, 贾竑晓 E-mail:zhengsisi@ccmu.edu.cn, jhxlj@ccmu.edu.cn
基金资助:
北京市自然科学基金项目（L2510128），首都卫生发展科研专项项目（首发2024-4-21211）。

An analysis of the neural mechanisms underlying cognitive impairment in depersonalization-derealization disorder based on low-frequency fluctuation

Song Nan¹, Zheng Sisi^2,3*#, Jia Hongxiao^2,3*#

1. Xiamen Xianyue Hospital, Xianyue Hospital Affiliated with Xiamen Medical College, Fujian Psychiatric Center, Fujian Clinical Research Center for Mental Disorders, Xiamen 361012, Fujian Province, China; 2. Beijing Anding Hospital, Capital Medical University;National Center for Mental Disorders;National Clinical Research Center for Mental Disorders;Beijing Key Laboratory of Intelligent Drug Research and Development for Mental Disorders, Beijing 100088, China; 3. Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China

Received:2026-02-02 Revised:2026-03-10 Online:2026-06-21 Published:2026-06-26
Supported by:
This study was supported by Beijing Natural Science Foundation(L2510128), Capital Health Development Scientific Research Special Project (2024-4-21211).

摘要/Abstract

摘要： 目的研究人格解体-现实解体障碍（depersonalization-derealization disorder，DPRD）患者脑区自发活动特征，探究其与认知功能损害的相关性。方法纳入就诊于首都医科大学附属北京安定医院门诊的48例患者及32例健康对照，评估临床症状，精神分裂症认知功能成套测验及Stroop色词测验等认知功能，采集静息态功能磁共振数据，并进行低频振幅（low-frequency fluctuation，ALFF）分析及与临床表征的相关分析。结果患者的左右侧丘脑、左侧脑岛、左侧舌回、左侧小脑、左右侧梭状回、左侧颞上回、右内侧和旁扣带回ALFF值显著降低；右侧脑岛、右侧三角部额下回ALFF值升高。右侧脑岛ALFF值与词语学习及视觉记忆测验呈负相关；左侧小脑、右内侧和旁扣带回ALFF值与自我非真实感评分呈负相关；右侧三角部额下回及右侧脑岛ALFF值与时间解体评分呈正相关。结论 DPRD患者的脑功能异常主要涉及自我加工、情绪调节、感觉整合及认知控制相关脑区，这些异常可能共同参与其认知功能损害和核心临床症状的形成。

关键词: 人格解体-现实解体障碍, 低频振幅, 静息态功能磁共振, 认知功能, 脑岛, 感觉整合, 自我参照加工

Abstract: Objective To investigate the characteristics of spontaneous brain activity in patients with depersonalization-derealization disorder (DPRD) and explore their correlation with cognitive impairment.Methods Forty-eight patients from Beijing Anding Hospital, Capital Medical University, with DPRD and thirty-two healthy controls were included in the study. Clinical symptoms were assessed, and cognitive functions were evaluated by using the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB) and the Stroop Color-Word Test. Resting-state functional magnetic resonance imaging (rs-fMRI) data were acquired. Amplitude of low-frequency fluctuation (ALFF) analysis was performed, followed by correlation analyses between ALFF values and clinical characteristics.Results Compared to healthy controls, DPRD patients exhibited significantly reduced ALFF values in the bilateral thalamus, left insula, left lingual gyrus, left cerebellum, bilateral fusiform gyrus, left superior temporal gyrus, and right medial and paracingulate gyri. Conversely, ALFF values were increased in the right insula and the right inferior frontal gyrus (pars triangularis). Correlation analyses revealed that ALFF values in the right insula were negatively correlated with scores on verbal learning and visual memory tests. ALFF values in the left cerebellum and the right medial and paracingulate gyri were negatively correlated with self-unreality scores. ALFF values in the right inferior frontal gyrus (pars triangularis) and the right insula were positively correlated with temporal disintegration scores.Conclusion Brain functional abnormalities in DPRD primarily involve regions associated with self-processing, emotion regulation, sensory integration, and cognitive control. It may collectively underlies the cognitive impairment and core clinical symptoms observed in these patients.

Key words: depersonalization-derealization disorder, low-frequency fluctuation, rest-state functional magnetic resonance imaging, cognition function, insula, sensory integration, self-referential processing

中图分类号:

宋楠, 郑思思, 贾竑晓. 基于低频振幅的人格解体-现实解体障碍认知功能损害神经机制分析[J]. 首都医科大学学报, 2026, 47(3): 569-578.

Song Nan, Zheng Sisi, Jia Hongxiao. An analysis of the neural mechanisms underlying cognitive impairment in depersonalization-derealization disorder based on low-frequency fluctuation[J]. Journal of Capital Medical University, 2026, 47(3): 569-578.

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基于低频振幅的人格解体-现实解体障碍认知功能损害神经机制分析

An analysis of the neural mechanisms underlying cognitive impairment in depersonalization-derealization disorder based on low-frequency fluctuation

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