未经治疗的强迫症患者脑白质体积变化的初步研究  

The alterations of brain in white matter in drug-naive patients with obsessive-compulsive disorders:a preliminary study

作　　者：罗春蓉[1,2] 程宇琪[1] 李海军[2] 杨涛[1] 刘萍萍[1] 余红军[2] 田伟[1] 许秀峰[1] 

机构地区：[1]昆明医学院第一附属医院,昆明650032 [2]昆明市第一人民医院磁共振室

出　　处：《中国神经精神疾病杂志》2011年第3期137-141,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：云南省科技厅昆明医学院联合基金项目(编号:2008C005R);云南省卫生科技计划项目(编号:2009NS096)

摘　　要：目的探讨未经治疗的强迫症患者大脑白质的体积变化。方法收集强迫症患者23例和年龄、性别与之相匹配的正常对照23名。采用GE Signa TwinSpeed 1.5T超导型磁共振成像系统获取3D脑结构图像,然后使用基于体素的形态学分析法(VBM)分析影像数据。采用t检验比较两组间脑白质体积的差异,P<0.005和体素>200的差异区域行小体积校正(small volume correction,SVC)后仍P<0.05则差异有统计学意义。结果患者组下列脑区的白质体积较正常对照组增加:右侧中央前回(t=3.58)、右侧中央后回(t=3.60)、左侧楔前叶(t=3.99)、左侧楔前叶(t=3.24)、右侧楔前叶(t=3.55)和左侧枕中回(t=3.55),差异均有统计学意义(小体积校正后P值均小于0.05);而下列脑区的白质体积减少:右侧额上回(t=3.66)、左侧额上回(t=3.31)、左侧中央后回(t=3.44)、左侧海马旁回/胼胝体(t=3.37)和右侧顶下小叶(t=3.18),差异均有统计学意义(小体积校正后P值均小于0.05)。结论未经治疗的强迫症患者存在多个脑区局部白质体积的增加或降低。Objective To investigate the abnormality of white matter volume in drug-naive patients with obsessive-compulsive disorder.Methods The study included twenty-three patients with obsessive-compulsive disorder（OCD） who met with the American psychiatric association diagnostic and statistical manual of mental disorder the fourth edition（DSM-Ⅳ）and twenty-three age-,sex-and education-matched normal controls.Each participant received whole brain scans using GE Signa TwinSpeed 1.5T MR system.The 3D brain structural MRI images were constructed after MRI scan.The difference in white matter volume between patients and controls was analyzed using voxel-based morphometry method（VBM）.Small volume correction（SVC） was used to adjust P value for those regions with voxel size less than 200 and P less than 0.005.The SVC adjusted P-value less than 0.05 was considered statistically significant.Results Compared with the normal controls,OCD patients had significant increased white matter volumes in the right precentral gyrus,right postcentral gyrus,left precuneus,right precuneus and left middle occipital gyrus（P0.05,small volume correction）,while had significant decreased white matter volumes in the right superior frontal gyrus,left superior frontal gyrus,left postcentral gyrus,left parahippocampal gyrus/corpus callosum and right inferior lobule（P0.05,small volume correction）.Conclusions These preliminary findings demonstrate obvious increase or decrease of white matter volume in the drug-naive patients with OCD.

关 键 词：强迫症 磁共振成像 白质 基于体素的形态学分析 

分 类 号：R749.7[医药卫生—神经病学与精神病学]