静息状态下强迫症患者脑自发神经活动和功能连接的初步观察

A preliminary observation of spontaneous neural activities and resting-state functional connectivity in patients with obsessive-compulsive disorder

目的探讨强迫症患者静息状态下大脑局部自发神经活动及全脑功能连接模式。方法对符合ICD-10诊断标准的40例未服药强迫症患者(强迫症组)及性别、年龄、受教育程度相匹配的38名对照者(对照组)进行静息态功能磁共振成像扫描;采用比率低频振幅(fractional amplitude of low-frequency fluctuations,fALFF)算法探讨强迫症患者大脑局部自发神经活动,以自发神经活动异常脑区(右侧眶额回)为种子点进行全脑功能连接分析;采用偏相关分析方法探究强迫症组异常局部神经活动和全脑功能连接模式与临床症状的相关性。结果与对照组相比,强迫症组右侧眶额回和右侧背外侧前额叶fALFF增高(t=4.45,5.25;P<0.05,GRF校正);右侧眶额回与左侧眶额回、左侧小脑脚Ⅱ功能连接增强(t=5.39,4.94;P<0.05,GRF校正);强迫症组右侧眶额回、左侧小脑脚Ⅱ之间的功能连接值与17项汉密尔顿抑郁量表和汉密尔顿焦虑量表评分呈正相关(r=0.401,P=0.015;r=0.389,P=0.019;未校正)。结论静息状态下,强迫症患者的皮质-纹状体-丘脑-皮质环路和眶额回-小脑环路存在局部自发神经活动和功能连接的异常。

Objective To investigate the spontaneous neural activities and the whole-brain functional connectivity(FC)patterns at rest in patients with obsessive-compulsive disorder(OCD).Methods 40 drug-naive patients with OCD matched the diagnostic criteria of ICD-10(OCD group),and 38 genders,age,education-matched healthy controls(controls group)underwent resting-state functional magnetic resonance imaging scan.The fractional amplitude of low-frequency fluctuations(fALFF)approach was used to explore spontaneous neural activities.The brain region with abnormal fALFF value(right orbitofrontal cortex(OFC))was used as the interested region to carry out the whole-brain FC analysis.We analyzed the correlation of clinical symptoms with the abnormal fALFF and FC values by partial correlation analysis in patients with OCD.Results Compared with controls group,increased fALFF were found in the right OFC and right dorsolateral prefrontal gyrus(t=4.45,5.25;P<0.05,GRF corrected),and increased FC were observed between the right OFC and left OFC,and left cerebellum crus Ⅱ(t=5.39,4.94;P<0.05,GRF corrected)in OCD group.The increased FC between right OFC and left cerebellum crus Ⅱ positively correlated with 17-Items Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale scores(r=0.401,P=0.015;r=0.389,P=0.019;uncorrected).Conclusions The local spontaneous neural activities and FC in the cortical-striatal-thalamic-cortical and OFC-cerebellar circuits were abnormal at rest in patients with OCD.