强迫症患者的临床症状与其脑功能活动的相关性

Correlation between the clinicai symptoms and the activation pattern of brain neurons in patients with obsessive-compulsive disorder

目的探讨强迫症患者的不同临床症状与其脑功能活动的关系。方法选取2013年8月至2014年12月于郑州大学第一附属医院就诊的26例首次发作未服药强迫症患者，进行静息态功能磁共振扫描。使用SPM8、DPARSFA和REST软件处理磁共振数据，以年龄作为协变量，采用Pearson相关分析分别探讨患者的临床症状中强迫思维和强迫行为与其全脑局部一致性（ReHo）的相关性。结果患者的强迫思维与其全脑ReHo值呈正相关的脑区如下：双侧岛叶、双侧小脑、左侧距状回、左侧楔回。患者的强迫思维与其全脑ReHo值呈负相关的脑区如下：左侧丘脑、左侧楔前叶、左侧尾状核、右侧扣带回、右侧额中回。患者的强迫行为与其全脑ReHo值呈正相关的脑区如下：左侧颞叶、双侧眶额叶、左侧额中回、右侧中央前回。患者的强迫行为与其全脑ReHo值呈负相关的脑区如下：双侧扣带回、左侧尾状核。结论不同的强迫症状具有不同的神经影像学基础，扣带回处的功能紊乱对强迫思维和强迫行为的发生发展都有重要影响。

Objective To explore the correlation between clinical symptoms of patients with obsessive-compulsive disorder （OCD） and the activation pattern of brain neurons at resting. Methods A total of 26 patients diagnosed with fist-episode OCD were selected and underwent functional magnetic resonance imaging （fMRI） scanning at resting state. The fMRI data were processed by statistical parametric mapping （SPM8）, Data Processing Assistant for Resting-State fMRI Analysis Toolkit （DPARSFA）, and Resting State fMRI Data Analysis Toolkit （REST） software. With age as concomitant variable, Pearson Correlation Analysis was adopted to study the correlation between clinical symptoms （obsessive thoughts and compulsive behavior） of patients and their regional homogeneity （ReHo） values of whole brain. Results The positive correlation between obsessive thoughts score of patients with OCD and ReHo value lied in insular_L, insular_ R, cerebellum_L, cerebellum_R, calcarine_L, cuneus_L. The negative correlation between obsessive thoughts score of patients with OCD and ReHo value lied in thalamus_L, precuneus_L, caudate_L, cingulum_R, frontal_R. The positive correlation between compulsive behavior score of patients with OCD and ReHo value lied in temporal_L, frontal_inf orb_l, frontal inf orb_R, frontal_mid_L, precentral_R. The negative correlation between compulsive behavior score of patients with OCD and ReHo value lied in cingulum-L, cingulum-R, caudate_L. Conclusion Different obsessive-compulsive symptoms has different image foundation, and the dysfunction of cingulate has a major impact on the incidence of both obsessive thoughts and compulsive behavior of OCD patients.