强迫症患者脑结构异常的多模态研究

Structural abnormalities in patients with obsessive-compulsive disorder:a multimodal study

目的探讨强迫症患者脑灰质和白质结构改变是否在同一样本中反映了相同环路的异常。方法对54例强迫症患者(强迫症组)和54名健康对照(对照组)进行3D结构磁共振成像扫描和弥散张量成像扫描。基于SPM分析软件,采用基于体素的形态学分析方法分析强迫症组全脑灰质体积与对照组的差异;基于FSL软件,采用基于纤维束示踪的空间统计学探讨强迫症组各向异性分数(fractional anisotropy,FA)与对照组的差异。结果与对照组相比,强迫症组左侧额中回、左侧前扣带和旁扣带脑回、左侧中央前回及右侧颞下回灰质体积减小(P<0.05,Alphasim校正),胼胝体体部和胼胝体膝部FA值减小(P<0.05,FWE校正)。结论强迫症患者的灰质体积和白质完整性均存在异常,且异常区域多位于皮质-纹状体-丘脑-皮质环路相关脑区,强迫症的灰、白质结构异常可能同时出现。

Objective To explore whether gray matter and white matter presented abnormalities in neural circuit in patients with OCD by using multimodal imaging strategies.Methods Magnetic resonance imaging(MRI)scans from 54 OCD patients and 54 healthy controls(HC)were acquired.Gray matter volume was compared using the voxel-based morphometry(VBM)approach based on the SPM software.Fractional anisotropy(FA)difference was also evaluated using tract based spatial statistics(TBSS)based on the FSL software.Results Compared with the HC,Patients with OCD showed decreased gray matter volume in the left middle frontal gyrus,left anterior cingulate and paracingulate gyri,left precental gyrus and right inferior temporal gyrus(P<0.05,Alphasim corrected);meanwhile,decreased FA values in the body and genu of corpus callosum were found.Conclusions Patients with OCD demonstrated widespread gray matter and white matter alterations especially in the incortico-striatal-thalamic-cortical(CSTC)circuit.Therefore,Patients with OCD might present altered gray and white matter structures simultaneously.