未经治疗的强迫障碍患者静息态磁共振脑功能局部一致性研究

Abnormal regional homogeneity in untreated obsessive-compulsive disorder patients : a resting-state functional magnetic resonance imaging study

目的 :采用静息态功能磁共振成像(resting-state functional magnetic resonance imaging,RS-f MRI)技术,探讨未经治疗的强迫障碍(obsessive-compulsive disorder,OCD)患者脑局部一致性(regional homogeneity,Re Ho)的变化以及与强迫症状严重程度的相关性。方法:对46例OCD患者和31例性别、年龄、受教育程度相匹配的健康对照进行静息态功能磁共振扫描,使用SPM8、DPARSF、REST等软件对影像学数据进行处理分析,比较两组间全脑Re Ho的改变;采用耶鲁-布朗强迫量表(the YaleBrown Obsessive Compulsive Scale,Y-BOCS)、17项汉密尔顿抑郁量表(17-Item Hamilton Rating Scale for Depression,HAMD-17)、汉密尔顿焦虑量表(Hamilton Anxiety Rating Scale,HAMA)等评估临床症状,并分析OCD患者脑Re Ho值与临床现象之间的关系。结果:和对照组相比,OCD患者左侧前额叶的Re Ho值显著升高,左侧颞枕部和双侧梭状回的Re Ho值显著降低,以上脑区的Re Ho改变均未发现与Y-BOCs量表的相关性。结论:未经治疗的OCD患者在静息态下存在局部脑区的神经元活动一致性异常,这些异常改变可能与OCD的病理机制有关。

Objective：To investigate the changing of regional homogeneity （ReHo） and its relationship with the severity of the symptom in untreated obsessive-compulsive disorder（OCD） patients using resting-state functional magnetic resonance imaging （RS- fMRI） technology. Methods： A total of 46 obsessive-compulsive disorder patients and 31 age-sex-education matched healthy adults were scanned with RS-fMRI for ReHo analysis using SPM8, DPARSF and REST toolbox. The Yale-Brown Obsessive Compulsive Scale（Y-BOCS）, 17-Item Hamilton Rating Scale for Depression（HAMD-17） and Hamilton Anxiety Rating Scale （HAMA） were performed to assess the clinical symptoms. And then, the relationship between the changing of ReHo and severity of clinical symptoms was determined. Results： Compared with the controls, the patients showed higher ReHo in the left prefrontal lobe, and lower in the left occipitotemporal regions and bilateral fusiform gyrns. However, no significant correlation was found between the different areas and the clinical symptom scores. Conclusion： Resting-state fMRI witnessed abnormal brain areas activity in untreated obsessive- compulsive disorder patients. The functional changes suggest that the abnormal synchrony of brain regional shortage functional connectivity probably plays an important role pathophysiologically.