强迫症患者fMRI Stroop试验脑功能异常

Functional MRI of brain dysfunction during Stroop task in obsessive compulsive disorder patients

目的应用fMRI观察强迫症(OCD)患者的脑功能异常区域。方法 OCD患者13例(OCD组),正常对照者15名(正常对照组),按年龄、性别、受教育程度相匹配。对全部受试者行fMRI,刺激采用Stroop任务,运用SPM8软件对两组平均后的脑功能图像的激活区域进行比较分析。结果 OCD患者需要激活更多脑区(左侧海马旁回、中央旁小叶、丘脑、距状回等)以完成相对简单的色字无干扰任务,激活减低的脑区主要有左侧前扣带回和左侧尾状核。在相对复杂的色字干扰任务时,OCD组并未出现激活高于正常对照组的脑区,激活减低的脑区主要有双侧眶额叶、左侧前扣带回以及左侧尾状核。结论 OCD患者可能存在眶额叶、前扣带回、尾状核等区域的功能异常,这些脑区功能异常可能在OCD发病机制方面发挥作用。

Objective To investigate brain regions of dysfunction in obsessive compulsive disorder（OCD） patients with fMRI.Methods Thirteen OCD patients and 15 healthy controls matched at age,gender and education level underwent fMRI when performing a Chinese Stroop test.The imaging data were analyzed and compared with SPM8 software to acquire the activation regions.Results OCD patients needed to activate more brain areas than normal subjects,such as left parahippocampal gyrus,paracentral lobule,thalamus,calcarine cortex,etc.to complete the simple word reading Stroop tests.Decreased activation was demonstrated in left anterior cingulate cortex and caudate nucleus in OCD patients.During the color naming Stroop tests,there were scarcely any regions that OCD patients showed stronger activation than healthy controls,while they showed decreased activation in the orbital frontal cortex,left anterior cingulate cortex and caudate.Conclusion OCD patients may have brain dysfunction in orbital frontal cortex,anterior cingulate cortex and caudate,and this might play a critical role in the pathogenesis of OCD.