强迫症首次发病未服药患者脑静息态低频振幅研究

Amplitude of low-frequency fluctuation in the first-episode,drug-native obsessive-compulsive disorder patient：an resting state fMRI study

目的 探讨强迫症首次发病未服药患者静息脑神经活动的特点.方法 采用磁共振成像低频振幅（ALFF）方法,对昆明医学院第一附属医院22例强迫症患者（患者组）和22名健康志愿者（对照组）静息态脑血氧水平依赖（BOLD）信号活动的改变进行分析;采用功能磁共振成像技术进行数据采集,计算出各受试者的ALFF值;采用两样本t检验,以P〈0.001水平统计患者组与对照组的差异.结果 与对照组比较,患者组BOLD信号ALFF改变只存在增高的区域,主要分布在左前扣带回和左中扣带回;未发现患者组左前中扣带回的ALFF值与病程（r=0.004,P=0.985）、年龄（r=0.090,P=0.689）和受教育程度（r=0.048,P=0.831）、Yale-Brown强迫量表总分（r=0.007,P=0.977）、强迫思维分量表分（r=0.140,P=0.530）和强迫行为分量表分（r=0.100,P=0.660）的相关性.结论 静息状态下强迫症患者脑神经活动的ALFF存在异常,ALFF增高可能反映了患者大脑异常的情绪及行为监控.

Objective To study the changes of amplitude of low-frequency fluctuation （ALFF） of the resting-fMRI in the patients with obsessive-compulsive disorder （OCD）. Methods The resting-fMRI data of 22 OCD patients and 22 healthy controls were performed ALFF analysis. The amplitude of the blood oxygenation level dependent activation of the resting-state brain was investigated. Results The increased ALFF was only found in first-episode, drug-native OCD group compared with controls. The regions with increased ALFF were the left anterior cingulate and left middle cingulate gyrus （P〈0. 001, corrected,K≥33）. No significant correlations between ALFF value in these regions and course of disease （r = 0. 004,P = 0. 985） , age （r = 0. 090, P = 0. 689） and level of education （r = 0. 048 , P =0. 831） , no significant correlations between ALFF value and Y-BOCS score （r= 0.007, P= 0.977） , obsessive score （r=0. 140,P =0.530） and compulsive score （r=0. 100, P = 0.660） were found. Conclusion Abnormal ALFF may exist in OCD in the resting-state. The increased ALFF might reflect the strengthening of the emotional management and action monitoring.