Các mối tương quan thần kinh của các quá trình nhận thức cụ thể theo RDoC ở một bệnh nhân tự kỷ chức năng cao: một báo cáo trường hợp được xác thực bằng thống kê

Journal of Neural Transmission - Tập 128 Số 6 - Trang 845-859 - 2021
Laura Daedelow1, Anne Beck2, Lydia Romund1, Lea Mascarell-Maricic1, Isabel Dziobek3,4, Nina Romanczuk-Seiferth1, Torsten Wüstenberg5,1, Andreas Heinz1
1Department of Psychiatry and Psychotherapy CCM, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
2Health and Medical University Potsdam, Potsdam, Germany
3Berlin School of Mind and Brain, Berlin, Germany
4Department of Psychology, Humboldt-University of Berlin, Berlin, Germany
5Department of Clinical Psychology and Psychotherapy, Psychological Institute, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany

Tóm tắt

Tóm tắtMức độ hoạt động của các cá nhân mắc rối loạn phổ tự kỷ (ASD) rất đa dạng. Để hiểu rõ hơn về cơ chế thần kinh sinh học liên quan đến ASD chức năng cao, chúng tôi đã nghiên cứu một trường hợp hiếm gặp của một bệnh nhân nữ có sự nghiệp chuyên môn xuất sắc trong lĩnh vực học thuật Toán học đầy cạnh tranh. Theo cách tiếp cận Tiêu chí Lĩnh vực Nghiên cứu (RDoC), đề xuất mô tả các chiều cơ bản của chức năng bằng cách tích hợp các cấp độ thông tin khác nhau, chúng tôi đã tiến hành bốn thí nghiệm fMRI nhắm vào (1) lĩnh vực quá trình xã hội (Lý thuyết tâm trí (ToM) và ghép mặt), (2) lĩnh vực giá trị tích cực (xử lý phần thưởng), và (3) lĩnh vực nhận thức (N-back). Dữ liệu của bệnh nhân được so sánh với dữ liệu của 14 đối chứng khỏe mạnh (HC). Thêm vào đó, chúng tôi đã đánh giá trải nghiệm chủ quan của trường hợp này trong quá trình thí nghiệm. Bệnh nhân cho thấy thời gian phản ứng tăng lên trong khi ghép mặt và đạt được tổng điểm cao hơn trong nhiệm vụ phần thưởng, trong khi hiệu suất của cô trong N-back và ToM tương tự như HC. Chức năng não của cô khác biệt chủ yếu trong lĩnh vực giá trị tích cực và nhận thức. Trong quá trình xử lý phần thưởng, cô cho thấy hoạt động giảm trong một mạng lưới vỏ não ở bán cầu trái và các cấu trúc giữa vỏ não, nhưng lại tăng cường sự kết nối trong mạng lưới này. Trong nhiệm vụ bộ nhớ làm việc, hoạt động và kết nối não của bệnh nhân trong các vùng tạm thời - trán ở bán cầu trái đã tăng lên. Trong nhiệm vụ ToM, hoạt động ở vỏ não cingulate sau và giao điểm tạm thời - thái dương giảm. Chúng tôi đề xuất rằng mức độ chức năng cao của bệnh nhân của chúng tôi liên quan nhiều hơn đến các tác động trong kết nối não hơn là xử lý thông tin vỏ não cục bộ và rằng báo cáo chủ quan cung cấp một khung lý thuyết hữu ích cho việc giải thích.

Từ khóa

#tự kỷ chức năng cao #RDoC #mối tương quan thần kinh #nhận thức #xử lý phần thưởng #lý thuyết tâm trí

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