静息状态下双侧楔前叶相关的动态功能连接与强迫症的关联研究  

Association of dynamic functional connectivity with bilateral precuneus at resting-state with obsessive-compulsive disorder

作　　者：丁振宁 李平 吕丹 陈云辉[2] 尚婷惠子 白晓宇 孙正海 肖健 张广凤 刘万强 郭宇 Ding Zhenning;Li Ping;Lyu Dan;Chen Yunhui;Shang Tinghuizi;Bai Xiaoyu;Sun Zhenghai;Xiao Jian;Zhang Guangfeng;Liu Wanqiang;Guo Yu(Institute of Mental Health,School of Psychiatry,Qiqihar Medical University,Qiqihar 161006,China;Department of Clinical Psychology,School of Psychiatry,Qiqihar Medical University,Qiqihar 161006,China;CAS Key Laboratory of Behavioral Science,Institute of Psychology,Chinese Academy of Sciences,Beijing 100101,China;Department of Psychiatry,School of Psychiatry,Qiqihar Medical University,Qiqihar 161006,China;Department of Radiology,the Third Affiliated Hospital of Qiqihar Medical University,Qiqihar 161006,China;Department of Psychiatry,the Fourth Affiliated Hospital of Qiqihar Medical University,Qiqihar 161006,China;Department of Clinical Psychology,Qiqihar Mental Health Center,Qiqihar 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教研室,齐齐哈尔161006 [3]中国科学院行为科学重点实验室(中国科学院心理研究所),北京100101 [4]齐齐哈尔医学院精神卫生学院精神医学教研室,齐齐哈尔161006 [5]齐齐哈尔医学院附属第三医院磁共振科,齐齐哈尔161006 [6]齐齐哈尔医学院附属第四医院精神科,齐齐哈尔161006 [7]齐齐哈尔市精神卫生中心临床心理科,齐齐哈尔161006

出　　处：《中华精神科杂志》2022年第2期106-114,共9页Chinese Journal of Psychiatry

基　　金：黑龙江省自然科学基金(LH2019H064)。

摘　　要：目的探讨强迫症患者在静息状态下双侧楔前叶动态功能连接(dynamic functional connectivity,dFC)的模式。方法对符合ICD-10诊断标准的50例强迫症患者(患者组)和50名健康对照者(对照组)进行全脑静息态功能磁共振成像(functional magnetic resonance imaging,fMRI)扫描。采用基于全脑体素的dFC分析强迫症患者静息状态下双侧楔前叶dFC模式;采用皮尔逊相关分析方法,探讨强迫症患者异常dFC值与临床症状之间的关系;采用支持向量机分析方法,探索异常的dFC值是否可以用于识别强迫症。结果与健康对照组比较,患者组左侧楔前叶与左侧内侧前额叶皮质(0.23±0.02与0.26±0.03,t=-6.23,P<0.05,GRF校正)、左侧楔叶(0.24±0.03与0.28±0.04,t=-5.30,P<0.05,GRF校正)、左侧中央旁小叶(0.23±0.03与0.27±0.04,t=-5.36,P<0.05,GRF校正)dFC值降低,右侧楔前叶与左侧中央后回(0.23±0.04与0.27±0.04,t=-5.12,P<0.05,GRF校正)dFC值降低;患者组降低的左侧楔前叶与左侧内侧前额叶皮质dFC值(r=0.289,P<0.05,未校正)与Y-BOCS总分呈正相关,降低的右侧楔前叶与左侧中央后回dFC值与Y-BOCS总分(r=0.292,P<0.05,未校正)、强迫思维因子分(r=0.304,P<0.05,未校正)呈正相关;降低的右侧楔前叶与左侧中央后回dFC值的受试者操作特征曲线的曲线下面积为0.856,约登指数为0.52,敏感度为100%,特异度为52%。结论静息状态下,强迫症患者双侧楔前叶dFC降低;降低的右侧楔前叶与左侧中央后回dFC值可能对于强迫症的识别有提示作用。Objective To investigate the dynamic functional connectivity(dFC)of bilateral precuneus at resting-state in obsessive-compulsive disorder(OCD).Methods Fifty patients with OCD who matched the criteria of ICD-10 and 50 healthy controls(HCs)were examined by the resting-state functional magnetic resonance imaging scanning.Voxel-based whole-brain dFC method was used to analyze the dFC of bilateral precuneus at resting-state in OCD;Pearson correlation analyses was used to analyze the relationship between the abnormal dFC values and clinical symptoms in OCD;support vector machine analyses was used to explore whether abnormal dFC could be used to identify OCD.Results Compared with HCs,patients with OCD showed decreased dFC values between left precuneus and left medial prefrontal cortex(MPFC)(0.23±0.02 vs.0.26±0.03,t=-6.23,P<0.05,GRF corrected),left cuneus(0.24±0.03 vs.0.28±0.04,t=-5.30,P<0.05,GRF corrected),and left paracentral lobule(0.23±0.03 vs.0.27±0.04,t=-5.36,P<0.05,GRF corrected);and decreased dFC values between right precuneus and left postcentral gyrus(0.23±0.04 vs.0.27±0.04,t=-5.12,P<0.05,GRF corrected).The decreased dFC values between left precuneus and left MPFC was positively correlated with the total score of Yale-Brown obsessive compulsive scale(Y-BOCS)(r=0.289,P<0.05,uncorrected);the decreased dFC values between right precuneus and left posterior central gyrus was positively correlated with Y-BOCS total scores(r=0.292,P<0.05,uncorrected)and obsessive subscale scores(r=0.304,P<0.05,uncorrected).The area under the curve value of the decreased dFC values between right precuneus and left posterior central gyrus was 0.856;the Youden Index was 0.52;the sensitivity was 100%,and the specificity was 52%.Conclusions The dFC of bilateral precuneus decreases at resting-state in patients with OCD.The abnormal dFC value between the right precuneus and the left posterior central gyrus may have implications to identify OCD.

关 键 词：强迫性障碍 磁共振成像 楔前叶 动态功能连接 静息态 

分 类 号：R749.7[医药卫生—神经病学与精神病学]