强迫障碍患者静息态脑功能网络节点中心度的异常

Abnormael degree centrality of resting state brain functionel network in patient with obsessive compulsive disorder

目的:应用基于体素的节点中心度(degree centrality,DC)方法探讨强迫障碍患者静息态下脑功能网络连接属性的改变。方法:纳入符合美国精神障碍诊断与统计手册第4版修订版(DSM-IVTR)强迫障碍诊断标准的30例门诊和住院患者,以及30名性别、年龄和受教育程度相匹配的健康对照。采用耶鲁-布郎强迫量表、汉密顿抑郁量表、汉密顿焦虑量表评估强迫障碍患者强迫思维和强迫行为以及抑郁焦虑症状。所有被试进行全脑静息态功能磁共振成像扫描,采用DPARSFA分析软件计算被试的DC值。结果:与正常对照相比,强迫障碍患者右侧眶额回[(-0.22±0.45)vs.(-0.57±0.22)]和左侧前扣带回[(0.14±0.48)vs.(-0.21±0.33)]的DC值升高(P<0.001);右侧岛叶的DC值降低[(-0.12±0.37)vs.(0.35±0.54)](P<0.001);右侧眶额回的DC值与耶鲁-布郎强迫量表总分正相关(r=0.68,P<0.05)。结论:静息状态下,大脑执行控制网络和突显网络重要节点/脑区连接属性的异常可能与强迫障碍的病理生理机制有关。

Objective:To investigate the value of degree centrality(DC) in voxel-wise whole-brain functional networks analysis in patients with obsessive-compulsive disorder(OCD) at resting state.Methods:Thirty outpatients and inpatients with OCD meeting the criteria of Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-IV-TR) and 30 gender-age-education-matched healthy subjects participated in the resting state brain functional magnetic resonance imaging scan.The Yale-Brown Obsessive-Compulsive Scale(YBOCS) Hamilton Depression Rating Scale(HAMD) and Hamilton Anxiety Rating Scale(HAMA) were used to assess clinical symptoms(i.e.,obsessive,compulsive,depressive and anxiety symptoms).DPARSFA software was used to calculate the value of DC.Results:Compared with healthy controls,significantly increased DC values were found in the right orbitofrontal cortex[(-0.22 ± 0.45) vs.(-0.57 ±0.22),P < 0.001]and left anterior cingulate cortex[(0.14 ±0.48) vs.(-0.21±0.33),P < 0.001].Significantly decreased DC value was found in the right insula[(-0.12 ±0.37) vs.(0.35 ±0.54),P <0.001].The increased DC in the right orbitofrontal cortex positively correlated with the Y-BOCS total scores(r = 0.68,P < 0.05).Conclusion:The altered DC in the executive control network and salience network at resting state may be related with the mechanisms of OCD.