强迫症患者抑制功能受损的脑影像学特征  

Brain imaging characteristics of inhibition dysfunction in patients with obsessive-compulsive disorder

作　　者：钟明天 张卜文 谭长连[2] 罗兴伟[3] 朱熊兆[3] 蚁金瑶 Zhong Mingtian;Zhang Bowen;Tan Changlian;Luo Xingwei;Zhu Xiongzhao;Yi Jinyao(Center for Studies of Psychological Application,School of Psychology,South China Normal University,Guangdong key Laboratory of Mental Health and Cognitive Science,Guangzhou 510631,China;Department of Radiology,the Second Xiangya Hospital of Central South University,Changsha 410011,China;Medical Psychological Center,the Second Xiangya Hospital of Central South University,Changsha 410011,China)

机构地区：[1]华南师范大学心理学院心理应用研究中心心理健康与认知科学广东重点实验室,广州510631 [2]中南大学湘雅二医院医学放射科,长沙410011 [3]中南大学湘雅二医院医学心理中心,长沙410011

出　　处：《中华精神科杂志》2020年第2期111-116,共6页Chinese Journal of Psychiatry

基　　金：国家自然科学基金(31871112)。

摘　　要：目的分析强迫症患者是否存在抑制功能受损,及其抑制功能受损的脑影像学特征。方法16例首次发病未用药的强迫症患者(强迫症组)和18名健康对照者(对照组)完成测查抑制功能的Go-Nogo任务,同步采集被试者任务态脑影像数据。采用方差分析比较强迫症组和对照组在Go条件和Nogo条件下平均反应时和反应正确率的组间差异,以及在成功反应抑制与错误监测过程中脑激活特征的组间差异。结果在Nogo条件下,强迫症组的正确率显著低于对照组(0.85±0.08比0.93±0.51;t=-3.06,P<0.05);在错误监测过程中,2组大脑激活模式存在差异,强迫症组双侧颞下回(左侧:t=3.11;右侧:t=2.71)、右侧额中回(t=2.52)、右侧海马旁回(t=2.53)、左侧后扣带回(t=3.03)大脑活动增强(均P<0.05);双侧壳核(左侧:t=-3.03;右侧:t=-3.12)、右侧额下回(t=-3.29)、右侧额上回(t=-3.12)、右侧中央前回(t=-2.91)大脑活动显著降低(均P<0.05)。结论强迫症患者存在抑制功能受损,在错误监测过程中相关脑区的功能活动存在异常。Objective This study aims to explore whether there is impaired inhibition function and the brain imaging characteristics of inhibition dysfunction in patients with obsessive-compulsive disorder(OCD).Methods A total of 16 drug-naive OCD patients and 18 healthy controls(HC)completed the Go-Nogo task to detect the impairment of inhibition function,and the task-related brain magnetic resonance imaging were collected.The differences of average reaction time and correct response rate between OCD patients and HC under Go and Nogo conditions were compared,and the differences of brain activation between the two groups in the process of successful response inhibition and error monitoring were also compared.Results Under Nogo condition,the average correct rate in patients with OCD was significantly lower than that of HC(0.85±0.08 vs.0.93±0.51;t=-3.06,P<0.05).In error processing analysis,patients with OCD showed significantly enhanced brain activities in bilateral inferiortemporal(left:t=3.11;right:t=2.71),right middlefronta(t=2.52),right parahippocampa(t=2.53),and left posteriorcingulate(t=3.03),while decreased brain activities were found in bilateral putamen(left:t=-3.03;right:t=-3.12),right inferiorfrontal(t=-3.29),right superiorfrontal(t=-3.12),and right precentral(t=-2.91)compared with control group(P<0.05,FWE corrected,cluster size>10 voxels).Conclusion Patients with OCD have impaired inhibition function,and their abnormal brain function is mainly manifested in the process of error monitoring.

关 键 词：强迫性障碍 抑制(心理学) Go-Nogo任务 错误监测 

分 类 号：R74[医药卫生—神经病学与精神病学]