未服药强迫症患者磁共振弥散张量成像大脑白质网络节点研究  

A study of brain white matter network nodal magnetic resonance diffusion tensor imaging in drug-naive patients with obsessive-compulsive disorder

作　　者：吕丹 李平 尚婷惠子 贾翠翠 孙磊 陈云辉 王玉花 刘万强 郭宇 LYU Dan;LI Ping;SHANG Tinghuizi;JIA Cuicui;SUN Lei;CHEN Yunhui;WANG Yuhua;LIU Wanqiang;GUO Yu(Institute of Mental health,School of Psychiatry,Qiqihaer Medical University,Qiqihaer 161006,China)

机构地区：[1]齐齐哈尔医学院精神卫生学院精神卫生研究所,齐齐哈尔161006 [2]齐齐哈尔医学院精神卫生学院临床心理学教研室 [3]齐齐哈尔医学院附属第四医院精神科 [4]齐齐哈尔市精神卫生中心临床心理科

出　　处：《中国神经精神疾病杂志》2020年第10期597-602,共6页Chinese Journal of Nervous and Mental Diseases

基　　金：黑龙江省省属高等学校基本科研业务费项目(编号:2019-KYYWF-1215)。

摘　　要：目的探讨未服药强迫症患者脑白质网络节点连接属性的特点及其与强迫症状的相关性。方法纳入40例未服药强迫症患者,40名性别、年龄和受教育程度与之相匹配的健康对照,采用结构磁共振和基于图论的分析方法分析脑白质网络节点属性。采用耶鲁布朗强迫量表(Yale-Brown obsessive-compulsive scale,Y-BOCS)、汉密尔顿焦虑量表(Hamilton anxiety rating scale,HAMA)、17项汉密尔顿抑郁量表(17-item Hamilton rating scale for depression,HAMD-17)评估强迫思维和强迫行为、焦虑症状、抑郁症状。结果与对照组相比,患者组节点局部效率在左侧眶额回、后扣带回、颞中回和右侧枕上回降低(P<0.05,FDR校正);节点聚类系数在左侧眶额回、颞中回和右侧壳核降低(P<0.05,FDR校正);节点最短路径长度在左侧脑岛增高(P<0.05,FDR校正);节点中心度在左侧海马旁回降低,在左侧脑岛增高(P<0.05,FDR校正);节点全局效率两组差异无统计学意义(P=0.66,FDR校正)。患者组左侧后扣带回节点最短路径长度值与强迫思维呈负相关(r=-0.407,P<0.011,Bonferroni校正)。结论未服药强迫症患者皮质-纹状体-丘脑-皮质环路和边缘系统的大脑白质网络节点连接属性存在异常,且与强迫症状相关。Objective To explore the characteristics of white matter(WM)network nodal connection properties and its correlation with obsessive-compulsive symptom in drug-naive patients with obsessive-compulsive disorder(OCD).Methods Forty drug-naive patients and 40 age-,sex-and education-matched healthy controls(HCs)were recruited.The structure MRI and graph theory method were used to analysis the data.The Yale-Brown Obsessive Compulsive Scale(Y-BOCS),17-item Hamilton Rating Scale for Depression(HAMD-17)and Hamilton Anxiety Rating Scale(HAMA)were used to assess the obsessive compulsive,depressive and anxious symptoms.Results Compared with HCs,nodal local efficiency in left orbitofrontal cortex(OFC),posterior cingulate gyrus(PCC),middle temporal gyrus(MTG)and right superior occipital gyrus were significantly reduced(P<0.05,FDR corrected).Nodal clustering coefficient was decreased in left OFC,MTG and right putamen(P<0.05,FDR corrected).Nodal shortest path was increased in the left insula(P<0.05,FDR corrected).Nodal degree was reduced in left parahippocampal gyrus,and increased in left insula(P<0.05,FDR corrected).No significant difference in nodal global efficiency between groups(P=0.66,FDR corrected).Further,the nodal shortest path of the left PCC was negatively correlated with obsessive thought in OCD(r=-0.407,P=0.001,Bonferroni corrected).Conclusion The drug-naive patients with OCD have the abnormal properties values of WM network nodal in cortico-striato-thalamo-cortical circuitry and limbic system,which are associated with clinical symptoms of OCD.

关 键 词：强迫症 弥散张量成像 白质 网络节点 

分 类 号：R749.7[医药卫生—神经病学与精神病学]