强迫症患者静息态功能磁共振低频振幅和功能连接改变

Changes in the amplitude of low-frequency fluctuation and functional connectivity of resting fMRI in patients with obsessive-compulsive disorder

目的探讨强迫症患者静息态下脑神经元自发活动情况。方法纳入强迫症患者48例及年龄、性别、受教育年限相匹配的正常对照者50名,使用3.0 T功能磁共振采集静息态脑影像,分析患者与对照低频振幅(amplitude of low-frequency fluctuation, ALFF)有统计学差异的脑区,以差异脑区为种子点分析全脑功能连接(functional connectivity, FC),对ALFF和FC分析中的差异脑区与强迫症状进行相关分析。结果与对照组相比,强迫症患者左侧背外侧额上回的ALFF值增高(t=4.305,P<0.01)。以左侧背外侧额上回为兴趣区全脑FC分析(基于MNI模板)示,与对照相比,患者左侧背外侧额上回与右侧眶部额下回(t=3.897,P<0.001)、左侧扣带回前部(t=3.37,P<0.001)、右侧扣带回前部(t=4.299,P<0.001)、左侧扣带回中部(t=3.220,P<0.001)、右侧扣带回中部(t=4.607,P<0.001)FC强度增强;患者左侧背外侧额上回与左侧岛盖部额下回(t=-4.630,P<0.001)FC强度减弱。强迫症患者左侧背外侧额上回与左侧岛盖部额下回的FC强度与耶鲁-布朗强迫症状量表强迫思维因子分(r=-0.369,P=0.014)、强迫行为因子分(r=-0.392,P=0.009)以及量表总分(r=-0.393,P=0.008)呈负相关。结论强迫症患者静息状态下左侧背外侧额上回自发神经元活动增强,与多个脑区间的FC异常;并且左侧背外侧额上回与左侧岛盖部额下回的FC强度与强迫症状相关。

Objective To investigate the spontaneous activity of brain neurons in patients with obsessive-compulsive disorder(OCD)under resting state.Methods Forty-eight OCD patients and 50 age-,gender-and year of education-matched normal controls were enrolled.All the subjects underwent 3.0 T fMRI to acquire resting state brain image.The brain regions with significant differences in amplitude of low-frequency fluctuation(ALFF)between patients and controls were analyzed.Whole-brain functional connectivity(FC)were analyzed using the brain regions with significant differences as seed points,and the correlation between brain regions with significant differences in ALFF and FC analysis and obsessive-compulsive symptoms was analyzed.Results Compared to the control group,the ALFF of left dorsolateral prefrontal cortex increased in patients with OCD(t=4.305,P<0.001).Compared to the controls,the analysis of whole-brain FC(based on MNI template)with the left dorsolateral prefrontal cortex as the regions of interest showed that the FC strength between the left dorsolateral prefrontal cortex and right orbital inferior frontal cortex(t=3.897,P<0.001),left anterior cingulate cortex(t=3.370,P<0.001),right anterior cingulate cortex(t=4.299,P<0.001),left middle cingulate cortex(t=3.220,P<0.001),right middle cingulate cortex(t=4.607,P<0.001)enhanced;the FC strength between the left dorsolateral prefrontal cortex and the left opercular part of inferior frontal gyrus(t=-4.630,P<0.001)weakened in patients with OCD.The FC between the left dorsolateral prefrontal cortex and the left opercular part of inferior frontal gyrus was negatively correlated with obsessions score(r=-0.369,P=0.014),compulsions score(r=-0.392,P=0.009)and total score(r=-0.393,P=0.008)of the Yale-Brown obsessive compulsive scale(Y-BOCS).Conclusion In patients with OCD,spontaneous neural activity of the left dorsolateral prefrontal cortex is enhanced in resting state,and the FC with multiple brain regions is abnormal.The FC strength between the left dorsolateral prefrontal cortex and the left opercular part of inferior frontal gyrus is associated with obsessive-compulsive symptoms.