基于无损脑刺激的情绪调节干预

doi:10.3724/SP.J.1042.2023.01477

摘要/Abstract

摘要：

既往研究积累了无损脑刺激(non-invasive brain stimulation, NIBS)技术干预情绪调节以改善负性情绪的大量证据。总结NIBS的情绪调节干预效果和适用范围对于丰富情绪调节理论、促进转化研究有重要意义。通过综述文献可发现NIBS能有效影响相关脑区(例如前额叶)的活动, 从而干预外显与内隐情绪调节过程; 通过改善情绪调节功能, NIBS具有改善精神障碍症状的潜在可能性。此领域尚需解决的问题如下：首先, 研究间异质性太强导致结果不一; 其次, 情绪调节干预过程的脑神经环路机制仍不明确, 情绪调节的衡量指标单一。此外, 以往NIBS方案存在定位精度不高、单时段效果微弱、现有方案难以满足新需要, 以及具有一定的副作用等问题。据此, 未来有必要全面定量总结现有文献, 结合神经导航技术确定最优靶点, 考察干预状态下外显/内隐情绪调节的脑神经环路改变, 并从主观体验-生理指标-神经特征多层面评估NIBS干预效果。未来还可采用多靶点NIBS方案, 或结合超扫描、神经反馈等技术以提高研究效度, 为相关的转化研究和临床提供启示。

关键词: 无损脑刺激技术, 前额叶, 情绪调节, 神经环路

Abstract:

There is a large body of evidence from previous research that non-invasive brain stimulation (NIBS) can be used to improve negative emotions through emotional regulation. A summary of the effects and applicability of NIBS in emotional regulation is important for enriching emotional regulation theory and promoting translational research. Literature reviews have shown that NIBS can effectively influence the activity of relevant brain regions, such as the prefrontal cortex, and intervene in explicit and implicit emotional regulation processes. By improving emotional regulation, NIBS has the potential to improve symptoms of mental disorders. However, there are still several issues that need to be addressed in this field. Firstly, there is too much heterogeneity between studies, leading to inconsistent results. Secondly, the brain neural circuit mechanisms of emotional regulation intervention are still unclear, and the measurement indicators of emotional regulation are too singular. In addition, previous NIBS schemes have problems with low localization accuracy, weak effects in a single time period, inability to meet new needs, and some side effects. Therefore, we propose the following suggestions and outlooks: (1) adopting meta-analysis to comprehensively and quantitatively summarize the effectiveness and universality of NIBS in emotion regulation; (2) integrating brain monitoring techniques to investigate the neural circuit mechanisms underlying NIBS intervention in emotion regulation. For example, using multi-target NIBS for precise control of brain regions corresponding to emotion regulation, and combining functional magnetic resonance imaging (fMRI), electroencephalogram (EEG), and other brain monitoring techniques to observe changes in the neural mechanisms under the joint action of multi-target NIBS, in order to clarify the causal relationships among various brain regions in the process of emotion regulation (an example is using dual-coil TMS technology to explore the working sequence of different brain regions in explicit emotion regulation); (3) taking individual differences into account as much as possible to optimize NIBS intervention plans. For example, targeting the target area in the patient's PFC accurately through MRI can optimize the stimulation site and frequency for individuals who are unresponsive to TMS/tDCS treatment (no responders); (4) using a combination of multi-brain NIBS and hyperscanning techniques to explore the inter-brain synchronization in interpersonal emotion regulation is a potential research direction; (5) verifying the occurrence and intervention effects of emotion regulation by combining subjective experiences, physiological indicators, and neural characteristics; (6) Neurofeedback technology can compensate for the “side effects” of NIBS. Neurofeedback training, combined with techniques such as fMRI and functional near-infrared spectroscopy, can also be used to enhance the emotion regulation ability of mental disorders with emotion regulation disorders as the main symptoms. We believe that these measures can better address the above issues and improve the effectiveness and applicability of NIBS in emotion regulation intervention.

Key words: non-invasive brain stimulation, prefrontal cortex, emotion regulation, neural circuit

中图分类号:

B842
B845

周士人, 仇秀芙, 何振宏, 张丹丹. (2023). 基于无损脑刺激的情绪调节干预. 心理科学进展 , 31(8), 1477-1495.

ZHOU Shiren, QIU Xiufu, HE Zhenhong, ZHANG Dandan. (2023). Non-invasive brain stimulation-based emotion regulation interventions. Advances in Psychological Science, 31(8), 1477-1495.

图/表 2

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作者	设计类型、样本量 n (实验组)\|n (对照组)	真刺激组刺激部位 (定位依据)	刺激频率, 脉冲(pulses) 强度选择	对照组刺激部位定位依据	NIBS 时间模式	刺激材料	任务类型	情绪调节方向, 策略	实验结果
HF-rTMS (k = 6)
He, Liu et al., 2020 Human Brain Mapping	组间设计 30\|29	rvlPFC (F8, 10-20)	10 Hz, 1170 脉冲, 90% rMT	线圈倾斜 90◦	离线	社会排斥图片	外显情绪调节	下调, 重评策略	消极情绪: 实验组 < 对照组
Li et al., 2022(I) Human Brain Mapping	组间设计 40\|40^a	rvlPFC (F8, 10-20)	10 Hz, 800 脉冲, 90% rMT	对照刺激部位 (vertex, Cz, 10-20)	离线	消极的社会反馈	外显情绪调节	下调, 重评策略	情绪感受: 实验组 = 对照组
Li et al., 2022(II) Human Brain Mapping	组间设计 40\|40^a	lvlPFC (F7, 10-20)	10 Hz, 800 脉冲, 90% rMT	对照刺激部位 (vertex, Cz, 10-20)	离线	消极的社会反馈	外显情绪调节	下调, 重评策略	情绪感受: 实验组 = 对照组
Zhao et al., 2021(I) Journal of Neuroscience	组间设计 30\|30^a	rdlPFC (F4, 10-20)	10 Hz, 624 脉冲, 90% rMT	对照刺激部位 (vertex, Cz, 10-20)	离线	社会排斥图片	外显情绪调节	下调, 分心策略重评策略	下调, 分心(消极感受: 实验组< 对照组)
Zhao et al., 2021(II) Journal of Neuroscience	组间设计 30\|30^a	rvlPFC (F8, 10-20)	10 Hz, 624 脉冲, 90% rMT	对照刺激部位 (vertex, Cz, 10-20)	离线	社会排斥图片	外显情绪调节	下调, 分心策略重评策略	下调, 重评(消极感受: 实验组< 对照组)
spTMS (k = 1)
Cao et al., 2021 Cognitive, Affective, & Behavioral Neuroscience	组内设计 15\|15	lvlPFC (F7, 10-20)	spTMS, 1 脉冲, 90% rMT	对照刺激部位 (vertex, Cz, 10-20)	在线	消极IAPS 图片	外显情绪调节	下调, 重评策略	效价: 实验组 < 对照组唤醒度: 实验组 = 对照组
iTBS (k = 1)
Deng et al., 2021 Journal of Psychiatry & Neuroscience	组内设计 16\|19	ldlPFC (F3, 10-20)	30 Hz, 1800 脉冲, 80% rMT	对照刺激部位 (vertex, Cz, 10-20)	离线	电击	恐惧消退(内隐情绪调节)	/	SCR: 实验组 = 对照组

作者	设计类型、样本量 n (实验组)\|n (对照组)	真刺激组刺激部位 (定位依据)	刺激频率, 脉冲(pulses) 强度选择	对照组刺激部位定位依据	NIBS 时间模式	刺激材料	任务类型	情绪调节方向, 策略	实验结果
HF-rTMS (k = 6)
He, Liu et al., 2020 Human Brain Mapping	组间设计 30\|29	rvlPFC (F8, 10-20)	10 Hz, 1170 脉冲, 90% rMT	线圈倾斜 90◦	离线	社会排斥图片	外显情绪调节	下调, 重评策略	消极情绪: 实验组 < 对照组
Li et al., 2022(I) Human Brain Mapping	组间设计 40\|40^a	rvlPFC (F8, 10-20)	10 Hz, 800 脉冲, 90% rMT	对照刺激部位 (vertex, Cz, 10-20)	离线	消极的社会反馈	外显情绪调节	下调, 重评策略	情绪感受: 实验组 = 对照组
Li et al., 2022(II) Human Brain Mapping	组间设计 40\|40^a	lvlPFC (F7, 10-20)	10 Hz, 800 脉冲, 90% rMT	对照刺激部位 (vertex, Cz, 10-20)	离线	消极的社会反馈	外显情绪调节	下调, 重评策略	情绪感受: 实验组 = 对照组
Zhao et al., 2021(I) Journal of Neuroscience	组间设计 30\|30^a	rdlPFC (F4, 10-20)	10 Hz, 624 脉冲, 90% rMT	对照刺激部位 (vertex, Cz, 10-20)	离线	社会排斥图片	外显情绪调节	下调, 分心策略重评策略	下调, 分心(消极感受: 实验组< 对照组)
Zhao et al., 2021(II) Journal of Neuroscience	组间设计 30\|30^a	rvlPFC (F8, 10-20)	10 Hz, 624 脉冲, 90% rMT	对照刺激部位 (vertex, Cz, 10-20)	离线	社会排斥图片	外显情绪调节	下调, 分心策略重评策略	下调, 重评(消极感受: 实验组< 对照组)
spTMS (k = 1)
Cao et al., 2021 Cognitive, Affective, & Behavioral Neuroscience	组内设计 15\|15	lvlPFC (F7, 10-20)	spTMS, 1 脉冲, 90% rMT	对照刺激部位 (vertex, Cz, 10-20)	在线	消极IAPS 图片	外显情绪调节	下调, 重评策略	效价: 实验组 < 对照组唤醒度: 实验组 = 对照组
iTBS (k = 1)
Deng et al., 2021 Journal of Psychiatry & Neuroscience	组内设计 16\|19	ldlPFC (F3, 10-20)	30 Hz, 1800 脉冲, 80% rMT	对照刺激部位 (vertex, Cz, 10-20)	离线	电击	恐惧消退(内隐情绪调节)	/	SCR: 实验组 = 对照组

实验作者	设计类型、样本量 n (实验组)\| n (对照组)	刺激部位 (定位依据)	电流强度, 阳极片+阴极片面积, 刺激持续时间	对照组(在 ?s后电流减弱至 0mA)	NIBS 时间模式	刺激材料	任务类型	情绪调节方向, 策略	实验结果
Hofhansel et al., 2020 Brain Stimulation	组间设计 12\|14	rdlPFC (阳极, F4; 阴极, Fp1, 10-20)	1.5 mA, 35+100 cm², 20 min	20 s	离线	IAPS消极图片	外显情绪调节	下调上调, 重评策略	效价: 实验组 = 对照组
Clarke et al., 2020 Cognitive, Affective, & Behavioral Neuroscience	组间设计 59\|57	ldlPFC (阳极, F3; 阴极, 左斜方肌, 10-20)	2 mA, 24+24 cm², 20 min	60 s	在线	IAPS消极图片	外显情绪调节	下调, 重评策略	消极感受: 实验组 = 对照组
Feeser et al., 2014 Brain stimulation	组间设计 21\|21	rdlPFC (阳极, F4; 阴极, Fp1, 10-20)	1.5 mA, 35+100 cm², 20 min	30 s	在线	IAPS消极图片	外显情绪调节	下调上调, 重评策略	下调: 唤醒度: 实验组 < 对照组 SCR: 实验组 < 对照组上调: 唤醒度: 实验组 > 对照组 SCR: 实验组 > 对照组
He et al., 2018 Social Cognitive and Affective Neuroscience	组间设计 23\|21	rvlPFC (阳极, F6; 阴极, Fp1, 10-20)	1.5 mA, 25+35 cm², 24 min	30 s	在线	社会排斥图片	外显情绪调节	下调, 重评策略	negative feeling: 实验组 < 对照组 PD: 实验组 < 对照组
He, Zhao et al., 2020 Psychological medicine	组间设计 48\|46	rvlPFC (阳极, F6; 阴极, Fp1, 10-20)	2.5 mA, 25+25 cm², 34 min	30 s	在线	社会排斥图片	外显情绪调节	下调, 重评策略	消极感受: 实验组 < 对照组 PD: 实验组 < 对照组
Marques et al., 2018 Scientific reports	组间设计 30\|30	rvlPFC (阳极, F8; 阴极, F7, 10-20)	1.5 mA, 16+16 cm², 20 min	30 s	在线	IAPS消极图片	外显情绪调节	下调上调, 重评策略	下调, 上调效价: 实验组 = 对照组唤醒度: 实验组 = 对照组
Van Dam & Chrysikou, 2021 Cognitive, Affective, & Behavioral Neuroscience	组间设计 11\|7	ldlPFC (阳极, F3; 阴极, 对侧乳突, 10-20)	1.5 mA, 25+25 cm², 20 min	10 s	在线	IAPS消极图片	外显情绪调节	下调, 重评策略	消极感受: 实验组 = 对照组
Chrysikou et al., 2019 Cognitive Neuroscience and Neuroimaging	组间设计 10\|10	ldlPFC (阳极, F3; 阴极, F4, 10-20)	1.5 mA, 25+25 cm², 20 min	10 s	在线	IAPS消极图片	外显情绪调节	下调, 重评策略	消极感受: 实验组 = 对照组
Hansenne & Weets, 2020 Polish Psychological Bulletin	组间设计 (只有女性) 20\|20	ldlPFC (阳极, F3; 阴极, Fp2, 10-20)	1.5 mA, 9 + 25 cm², 25 min	30 s	在线	IAPS消极图片	外显情绪调节	下调, 重评策略	唤醒度: 实验组 = 对照组
Dittert et al., 2018; Frontiers in behavioral neuroscience	组间设计 37\|26	lvmPFC (阳极, F7下方; 阴极, F8下方, 10-20)	1.5 mA, 16+16 cm², 20 min	10 s	离线	95dB的女性尖叫声、恐惧的面孔	内隐情绪调节(恐惧消退)	/	SCR: 实验组 = 对照组
高可翔等; 心理学报	组间设计 40\|40	vmPFC	1.5 mA, 9+9 cm², 10 min	60s	离线	IAPS消图片, 无序词句	内隐情绪调节(认知重评)	/	效价: 实验组 > 对照组消极感受：实验组 < 对照组

实验作者	设计类型、样本量 n (实验组)\| n (对照组)	刺激部位 (定位依据)	电流强度, 阳极片+阴极片面积, 刺激持续时间	对照组(在 ?s后电流减弱至 0mA)	NIBS 时间模式	刺激材料	任务类型	情绪调节方向, 策略	实验结果
Hofhansel et al., 2020 Brain Stimulation	组间设计 12\|14	rdlPFC (阳极, F4; 阴极, Fp1, 10-20)	1.5 mA, 35+100 cm², 20 min	20 s	离线	IAPS消极图片	外显情绪调节	下调上调, 重评策略	效价: 实验组 = 对照组
Clarke et al., 2020 Cognitive, Affective, & Behavioral Neuroscience	组间设计 59\|57	ldlPFC (阳极, F3; 阴极, 左斜方肌, 10-20)	2 mA, 24+24 cm², 20 min	60 s	在线	IAPS消极图片	外显情绪调节	下调, 重评策略	消极感受: 实验组 = 对照组
Feeser et al., 2014 Brain stimulation	组间设计 21\|21	rdlPFC (阳极, F4; 阴极, Fp1, 10-20)	1.5 mA, 35+100 cm², 20 min	30 s	在线	IAPS消极图片	外显情绪调节	下调上调, 重评策略	下调: 唤醒度: 实验组 < 对照组 SCR: 实验组 < 对照组上调: 唤醒度: 实验组 > 对照组 SCR: 实验组 > 对照组
He et al., 2018 Social Cognitive and Affective Neuroscience	组间设计 23\|21	rvlPFC (阳极, F6; 阴极, Fp1, 10-20)	1.5 mA, 25+35 cm², 24 min	30 s	在线	社会排斥图片	外显情绪调节	下调, 重评策略	negative feeling: 实验组 < 对照组 PD: 实验组 < 对照组
He, Zhao et al., 2020 Psychological medicine	组间设计 48\|46	rvlPFC (阳极, F6; 阴极, Fp1, 10-20)	2.5 mA, 25+25 cm², 34 min	30 s	在线	社会排斥图片	外显情绪调节	下调, 重评策略	消极感受: 实验组 < 对照组 PD: 实验组 < 对照组
Marques et al., 2018 Scientific reports	组间设计 30\|30	rvlPFC (阳极, F8; 阴极, F7, 10-20)	1.5 mA, 16+16 cm², 20 min	30 s	在线	IAPS消极图片	外显情绪调节	下调上调, 重评策略	下调, 上调效价: 实验组 = 对照组唤醒度: 实验组 = 对照组
Van Dam & Chrysikou, 2021 Cognitive, Affective, & Behavioral Neuroscience	组间设计 11\|7	ldlPFC (阳极, F3; 阴极, 对侧乳突, 10-20)	1.5 mA, 25+25 cm², 20 min	10 s	在线	IAPS消极图片	外显情绪调节	下调, 重评策略	消极感受: 实验组 = 对照组
Chrysikou et al., 2019 Cognitive Neuroscience and Neuroimaging	组间设计 10\|10	ldlPFC (阳极, F3; 阴极, F4, 10-20)	1.5 mA, 25+25 cm², 20 min	10 s	在线	IAPS消极图片	外显情绪调节	下调, 重评策略	消极感受: 实验组 = 对照组
Hansenne & Weets, 2020 Polish Psychological Bulletin	组间设计 (只有女性) 20\|20	ldlPFC (阳极, F3; 阴极, Fp2, 10-20)	1.5 mA, 9 + 25 cm², 25 min	30 s	在线	IAPS消极图片	外显情绪调节	下调, 重评策略	唤醒度: 实验组 = 对照组
Dittert et al., 2018; Frontiers in behavioral neuroscience	组间设计 37\|26	lvmPFC (阳极, F7下方; 阴极, F8下方, 10-20)	1.5 mA, 16+16 cm², 20 min	10 s	离线	95dB的女性尖叫声、恐惧的面孔	内隐情绪调节(恐惧消退)	/	SCR: 实验组 = 对照组
高可翔等; 心理学报	组间设计 40\|40	vmPFC	1.5 mA, 9+9 cm², 10 min	60s	离线	IAPS消图片, 无序词句	内隐情绪调节(认知重评)	/	效价: 实验组 > 对照组消极感受：实验组 < 对照组