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学龄儿童问题行为的发展与前额叶发育的关联机制
其他题名Mechanisms linking the development of behavior problems and prefrontal development in school-age children
张青
导师左西年
2023-05
摘要科学在理解人类的认知、情绪等功能的脑机制方面已经取得了巨大的进展,但至今为止仍然面临的一个巨大挑战是揭示心理健康疾病与脑之间的联系。其他医学专业已经能将基于生理指标的检查与病人的症状联系起来用以诊断与治疗,与此形成鲜明对比的是,各类心理健康疾病的诊断工具仍然主要依赖于疾病进程中出现的问题行为表现,这大大阻碍了学龄儿童心理健康疾病的及早发现与干预。早期研究从心理健康疾病的脑机制出发,与前额叶损伤病人的临床研究不约而同地发现了心理健康疾病与前额叶异常发育或病理性变化之间的显著关联。前额叶是人类大脑皮层发育中最晚成熟的一个脑区,也是大脑皮层中最发达、最精细的一个脑区,这奠定了它在高级认知功能与情绪功能中的重要作用。然而,已有结果大多基于临床样本与健康对照样本的组间比较。这些研究大多基于横断样本,忽略了学龄期儿童问题行为发展与大脑发育的连续性与变化性,从而限制了对两者动态变化关系的推论。此外,传统诊断分类学研究可以揭示临床诊断标签下患者普遍存在的异常,但在大程度上却忽略了学龄儿童问题行为发展的个体差异。 因此,本研究聚焦健康发展的学龄儿童,使用加速纵向队列设计,在多站点收集大量包含追踪与横断数据的样本基础上,对问题行为的发展规律、个体差异及其与前额叶结构、功能发育的动态关联的脑影像机制进行深入探讨。研究内容分为以下五个部分:(1>探讨学龄儿童问题行为的发展:首先对问题行为在学龄期的发展规律与群体异质性进行了分析,在此基础上,对不同问题行为发展轨迹的儿童的认知功能发展进行了探讨,发现儿童严重的问题行为与低水平的认知功能密切相关,阐明了关注、干预儿童问题行为对促进儿童健康、认知发展的重要意义;(2)探讨学龄儿童前额叶皮层的结构发育:沿用人脑毕生发展常模使用的分区模版,对中国学龄儿童前额叶不同分区的形态学测量指标的随龄发展规律及其站点差异、性别差异进行了系统分析,结果发现形态学测量的站点效应不可忽视;与此同时,不同测量指标发育轨迹的性别差异趋势完全不同,皮层厚度指标大多没有表现出显著的性别差异,而灰质体积与皮层表面积的发育轨迹的性别差异显著。(3)探讨问题行为发展与前额叶皮层结构发育的关系:首先通过规范化建模方法分别刻画了问题行为与前额叶形态学测量指标的个体间差异,并探讨这两者之间的动态双向预测关系,结果发现了与内化问题、外化问题均存在预测关系的共性脑区一一左侧额极;还发现了分别与内外化问题有关的特异性脑区:如外化问题与右侧额下回盖部、右侧额极的形态学测量具有显著预测关系;内化问题与右侧额下回三角部、左侧嚎部前扣带回、左侧内侧眶额具有显著预测关系。此外,研究还使用线性混合模型刻画了问题行为严重程度不同的儿童,前额叶皮层结构发育的轨迹差异。(4)在研究三的基础上,选取与内化问题、外化问题有预测关系的共性或特异性脑区作为兴趣区,选用静息态功能连接与局部功能一致性指标,刻画兴趣区之间的功能连接与局部功能一致性指标的发展规律。 (5)对问题行为发展与前额叶功能发育的关系进行探讨。我们的结果发现,左侧嚎部前扣带回(默认网络)与右侧额极(边缘网络)之间功能连接、右侧额下回三角部(控制网络)的局部功能一致性,能够正向预测后第二轮测试时的内化问题;左侧额极(边缘网络)、右侧额下回三角部(腹侧注意网络、控制网络)局部功能一致性能够显著正向预测第二轮测试时的外化问题。此外,研究还使用线性混合模型刻画了严重问题组与轻度问题组的儿童前额叶功能发育的轨迹差异.。 结合以上内容,本研究探寻了学龄儿童问题行为的发展规律、个体差异及其与前额叶结构、功能发育的动态关联的脑影像机制,为学龄儿童问题行为的筛查提供了神经生物学的参考指标,有助于儿童心理健康疾病风险个体的早期识别、积极干预与正确引导,防止学龄儿童发生心理危机甚至出现极端事件,为家庭与学校层面“因材施教”的个体化养育意见提供支持。
其他摘要Cognitive neuroscience has made tremendous progress in understanding the brain mechanisms underlying human cognition, emotion, and other functions. However, one of the great challenges that remains to date is to uncover the link between mental health disorders and the brain. In contrast to other medical specialties that have been able to link physiologically based tests to patient symptoms for diagnosis and treatment, diagnostic tools for various mental health disorders (e.g., conduct disorder, depression, anxiety disorders, bipolar disorder, etc.) still rely heavily on behavior problems that occur during the course of the disorder, which greatly hinders early detection and interventions. Early studies exploring the neural mechanisms of mental health disorders, along with studies of patients with prefrontal injury, have found significant associations between mental health disorders and abnormal developmental or pathological changes in the prefrontal lobes. The prefrontal lobe is one of the most late-maturing brain regions in the developing human cerebral cortex. It is also one of the most developed and refined brain regions in the cerebral cortex, which establishes its important role in higher cognitive and emotional functions. Most of these findings, however, were based on statistics of between-group differences between clinical samples and healthy control samples. These studies are based on cross-sectional samples and ignore the continuity and variability of problem behavior development and brain development in school-aged children, thus limiting inferences about the dynamic relationship between the two changes. In addition, traditional diagnostic taxonomy studies can reveal abnormalities prevalent in patients under clinical diagnostic labels but ignore individual differences in the development of problem behaviors in children and adolescents to a large extent. Therefore, to explore the developmental patterns of problem behaviors, individual differences, and their dynamical brain imaging mechanisms in relation to prefrontal structure and functional development, the present study focused on healthy developing school-age children, based on an accelerated longitudinal design, which included a large sample containing follow-up and cross-sectional data collected at multiple sites. The present study contains the following four parts: (1) Exploring the development of problem behaviors in school-aged children: First, the general developmental pattern of problem behaviors in school-aged children and inter-individual variability were systematically analyzed. Then, the cognitive function development of children with different trajectories of problem behavior development was explored. We found that high levels of problem behaviors are closely related to low levels of cognitive functioning in children, which profoundly clarifies the importance of paying attention to and intervening in children's problem behaviors to promote healthy and appropriate development of children. (2) Exploring the structural development of the prefrontal cortex in school-aged children. We systematically analyzed the age-related developmental patterns of morphological measures of different partitions of the prefrontal lobe in Chinese school-aged children following the template used in the Brain charts for the human lifespan. The site and gender differences were also conducted. We found that the site effects of magnetic resonance scan data were not negligible. At the same time, the gender differences in the developmental trajectories of the different measures tended to be completely different, with most of the cortical thickness indicators not showing significant gender differences, while the gender differences in the developmental trajectories of gray matter volume and cortical surface area were significant. (3) Exploring the relationship between the development of problem behaviors and the development of problems were significantly predictive of morphological measures of the right inferior frontal gyros and the right frontal pole. Internalizing problems were significantly predictive of the right inferior frontal gyros triangle, the left rostral anterior cingulate gyros, and the left medial orbitofrontal. In addition, the study also used a linear mixed model to portray the trajectory of prefrontal cortex structure development in children with different problem behavior groups. (4) On the basis of the previous study, common or specific brain areas that have predictive relationships with internalizing problems and externalizing problems were selected as regions of interest (ROI), and resting-state functional connectivity indicators were chosen to portray the developmental patterns and individual differences in functional connectivity between ROI. (5) Then, we explored the relationship between problem behavior development and prefrontal functional development. Our results found that functional connectivity between the left rostral anterior cingulate gyros (default network) and the right frontal pole (limbic network), the regional homogeneity of the right inferior frontal gyros-triangle (control network) positively predicted internalizing problems at the latter time point; The regional homogeneity of the left frontal pole (limbic network), and the right inferior frontal gyros-triangle (ventral attention network, control network) positively predict the externalizing problem at the latter time point. In addition, the study also used a linear mixed model to portray the trajectory differences in prefrontal functional development in children with different problem behavior groups. In summary, this study explores the developmental patterns, individual differences of problem behaviors, and the brain imaging mechanisms of their dynamic associations with prefrontal structure and functional development in school-aged children, providing neurobiological reference indicators for the screening of problem behaviors in school-aged children, contributing to the early identification, positive intervention and proper guidance of individuals at risk for mental health disorders in children, preventing psychological crises and even extreme events in children and adolescents. It also provides support for individualized parenting advice at the family and school levels.
关键词学龄儿童 问题行为 前额叶 形态学测量 静息态功能磁共振
学位类型博士
语种中文
学位名称理学博士
学位专业认知神经科学
学位授予单位中国科学院大学
学位授予地点中国科学院心理研究所
文献类型学位论文
条目标识符http://ir.psych.ac.cn/handle/311026/46151
专题认知与发展心理学研究室
推荐引用方式
GB/T 7714
张青. 学龄儿童问题行为的发展与前额叶发育的关联机制[D]. 中国科学院心理研究所. 中国科学院大学,2023.
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