强迫症患者缘上回小脑环路静息态功能磁共振研究

Resting-state functional magnetic resonance imaging of supramarginal gyrus-cerebellum circuit in obsessive-compulsive disorder

目的通过联合应用局部一致性(regional homogeneity,ReHo)和功能连接(functional connectivity,FC)对强迫症患者进行研究,探讨静息状态下强迫症的机制。方法对55例强迫症患者(强迫症组)及50例性别、年龄、民族、受教育程度相匹配的正常对照(对照组)行静息态功能磁共振(resting-state functional magnetic resonance imaging,RS-fMRI)检查。应用DPARSFA2.3和Rest软件分析筛选强迫症组的异常脑区,以异常脑区为种子点行全脑FC分析。结果与对照组相比,强迫症组右侧丘脑(MNI:x=9,y=-24,z=6,t=4.3217)、左侧缘上回(MNI:x=-45,y=-30,z=27,t=3.6320)ReHo增高,右侧尾状核(MNI:x=3,y=15,z=9,t=-3.1687)ReHo减低,差异均有统计学意义(P<0.05)。以左侧缘上回、右侧丘脑及右侧尾状核为种子点行全脑FC分析,强迫症组双侧小脑脚1/2区与左侧缘上回、右侧丘脑、右侧尾状核均存在异常功能连接(P<0.05),存在左侧缘上回-双侧小脑脚1区-右侧丘脑环路与左侧缘上回-双侧小脑脚1、2区-右侧尾状核-右侧丘脑环路。结论左侧缘上回-双侧小脑脚1区-右侧丘脑环路与左侧缘上回-双侧小脑脚1、2区-右侧尾状核-右侧丘脑环路可能在强迫症的机制中发挥重要作用。

Objective Regional homogeneity (ReHo) and functional connectivity (FC) were used to study obsessive-compulsive disorder(OCD), and to explore the mechanism of OCD in resting state. Method Resting-state functional magnetic resonance imaging (RS-fMRI) was performed in 55 patients with OCD(OCD group) and 50 normal controls (control group) matched by sex, age, nationality and education.The data and screening abnormal brain areas were analyzed and compared by DPARSFA2.3 and Rest software in OCD group.Whole brain FC analysis was performed with abnormal brain areas as seed points. Result Compared with the control group, ReHo in right thalamus (MNI: x=9, y=-24, z=6, t=4.3217) and left superior marginal gyrus (MNI: x=-45, y=-30, z=27, t=3.6320) increased and ReHo in right caudate nucleus (MNI: x=3, y=15, z=9, t=-3.1687) decreased in obsessive-compulsive disorder group, and the difference was statistically significant(P<0.05). Using left superior marginal gyrus, right thalamus and right caudate nucleus as seed voxels, the whole brain FC analysis showed that there were abnormal functional connections between bilateral cerebellar foot 1/2 area and left supramarginal gyrus, right thalamus and right caudate nucleus (P<0.05) and the left supramarginal gyrus-bilateral cerebellum feet 1 area-right thalamic circuit and left supramarginal gyrus-bilateral cerebellum feet 1, 2-right caudate nucleus-right thalamic circuit existed in OCD group. Conclusion The left supramarginal gyrus-bilateral cerebellum feet 1 area-right thalamic circuit and left supramarginal gyrus-bilateral cerebellum feet 1, 2-right caudate nucleus-right thalamic circuit may play an important role in the mechanism of OCD.