首诊成人强迫症脑3D-多体素氢质子磁共振波谱分析

3D multiple voxel 1H magnetic resonance spectroscopy in evaluation of adult patients with obsessive-compulsive disorder

目的探讨强迫症(OCD)患者不同区域脑组织代谢特点。方法选择17例首诊未经治疗的成人OCD患者为研究对象,并以性别、年龄、受教育程度匹配的17例健康志愿者为对照组,采用3D-多体素氢质子磁共振波谱分析OCD患者前扣带回、中扣带回、左右额叶白质、左右丘脑和左右豆状核中大脑代谢物N-乙酰门冬氨酸(NAA)、胆碱(Cho)和肌酸(Cr)浓度变化,并分析NAA/Cr、Cho/Cr与OCD、焦虑和抑郁量表评分的相关性。结果 OCD患者中扣带回的Cho/Cr明显低于对照组(P<0.05),左额叶白质Cho/Cr明显高于对照组(P<0.05);中扣带回NAA/Cr与焦虑量表评分呈正相关(r=0.712,P<0.05)。结论 OCD患者中扣带回Cho浓度减少、左额叶白质Cho浓度增高,可能是OCD的病理现象或代偿反应;中扣带回NAA/Cr与焦虑量表评分呈正相关。

Objective To evaluate untreated adult patients with obsessive- compulsive disorder （OCD） with 3D multiple voxel 1H magnetic resonance spectroscopy （1H MRS）. Methods Seventeen untreated adult OCD patients and 17 age- and sex- matched healthy subjects were included in this study. The ratios of N- acetylaspartate （NAA） and choline（Cho） to creatine （Cr） in different brain regions were evaluated with 3D multiple voxel 1H MRS and compared between two groups. Results The Cho/Cr ratio in middle cingulated cortex of OCD patients was significantly lower than that of healthy controls （P〈0.05）. The Cho/Cr ratio in left frontal white matte of OCD patients was significantly higher than that of healthy controls （P〈0.05）. There was a positive correlation between anxiety symptoms and Cho/Cr ratio in the middle cingulated cortex of OCD patients （P〈0.05）. Conclusion There are decreased Cho level in middle cingulated cortex and increased Cho level in left frontal white matter in OCD patients, which may provide a new evidence for cortical- striatum- thalamus- cortical neuronal circuit theory.