强迫症患者全脑灰质与静息态功能影像研究  

MRI scan of whole brain gray matter and resting state functional image in patients with obsessive compulsive disorder

作　　者：唐文新[1] 朱齐丰[2] 龚向阳[3] 朱丞[1] 王奕權[1] 陈树林[2] 

机构地区：[1]杭州市第七人民医院精神科,310013 [2]浙江大学心理系 [3]浙江省人民医院放射科

出　　处：《浙江医学》2016年第10期680-683,706,共5页Zhejiang Medical Journal

基　　金：杭州市科技局重点专科专病项目(20100733Q17)

摘　　要：目的探讨强迫症患者脑结构及脑功能异常以及治疗前后的变化。方法采用3.0T核磁共振仪对18例未服药强迫症患者治疗前后进行全脑扫描,获得高分辨率3D-T结构后,采用优化的基于体素的形态测量学方法(VBM)计算全脑灰质容积;静息态功能磁共振成像(fMRI)数据采用低频振幅(ALFF)方法处理,并与16例年龄、性别相匹配的正常人群相对照。结果与对照组相比,强迫症组右侧丘脑、双侧扣带回左侧尾状核及右侧苍白球体灰质容积减少(P<0.05);小脑前叶、左侧眶额上回、右侧额中回、左侧颢中回、左楔前叶、中央前回、中央后回等皮质结构灰质容积增加(P<0.05);右侧小脑与右侧顶叶静息态fMRI过度激活,左侧扣带回、豆状核与尾状核激活减弱(P<0.05);药物治疗反应良好的强迫症患者左侧丘脑、左侧豆状核、左侧壳核、左侧前、后扣带回灰质容积均较治疗前明显增加(均P<0.05);静息态fMRI结果提示治疗前后无统计学差异(P>0.05)。结论强迫症患者存在多个脑区灰质容积和静息态脑功能异常,有效的药物治疗可部分逆转这种异常状态。Objective To study whole brain gray matter and resting state functional image with MRI scan in obsessive-compulsive disorder （OCD） patients.Methods Brain magnetic resonance imaging （MRI） and resting state functional MRI （fMRI） were performed in 18 OCD patients and 16 healthy subjects.High-resolution three-dimensional images were processed using the voxel-based morphometry method.Resting state function image data was processed by ALFF method.Results There was a decrease in gray matter volume in the right thalamus,bilateral cingulate cortex,left caudate nucleus and right globus pallidus （P＜0.05）,and an increase in gray matter volume in the cerebellum anterior lobe,left orbitofrontal gyrus,right middle frontal gyrus,left middle temporal gyrus,left precuneus,precentral gyrus and postcentral gyrus （P＜0.05） in OCD patients.OCD patients had overactivation of the right cerebellum and right parietal lobe and reduced activation of the left cingulate gyrus,putamen and caudate nucleus on resting fMRI （P＜0.05）.OCD patients whose symptoms were improved after drug treatment had a significant increase in gray matter volume in the left thalamus,left putamen,left shell nucleus,left posterior and anterior cingulate gyrus（P＜0.05）,but no significant differences were found on resting fMRI before and after treatment （P ＞0.05）.Conclusion There are abnormalities of the gray matter volume and resting fMRI in a number of brain regions in OCD patients,and the abnormalities can be partially reversed after effective drug treatment.

关 键 词：强迫症 基于体素的形态测量学方法 静息态功能磁共振 灰质 容积 

分 类 号：R445.2[医药卫生—影像医学与核医学]