未治疗强迫障碍患者尾状核及丘脑磁共振波谱成像研究  

Caudate nucleus and thalamus in untreated patients with obsessive-compulsive disorder: a magnetic resonance spectroscopy study

作　　者：李岳朋 杨祥云[1] 董杰[1] 王鹏翀[1] 张萍 赵玮玮 李占江[1] Li Yuepeng;Yang Xiangyun;Dong Jie;Wang Pengchong;Zhang Ping;Zhao Weiwei;Li Zhanjiang(The National Clinical Research Center for Mental Disorders&Beijing Key Laboratory of Mental Disorders,Beijing Anding Hospital,Capital Medical University,Beijing 100088,China;Shanghai Key Laboratory of Magnetic Resonance East China Normal University,Shanghai 200062,China)

机构地区：[1]首都医科大学附属北京安定医院临床心理中心,国家精神心理疾病临床医学研究中心,精神疾病诊断与治疗北京市重点实验室,北京100088 [2]华东师范大学上海市磁共振重点实验室,上海200062

出　　处：《中华行为医学与脑科学杂志》2023年第2期127-132,共6页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：北京市医院管理局"青苗"计划(QML20181903);北京市自然科学基金(7222084)。

摘　　要：目的:探讨强迫障碍患者尾状核及丘脑神经生化代谢产物水平及其与强迫症状的关系。方法:选取北京安定医院2019年4月至2022年1月门诊未治疗的强迫障碍患者25例,并招募性别、年龄、学历相匹配的健康对照20例纳入研究。利用氢质子磁共振波谱成像技术采集患者及正常对照的神经生化代谢物图谱,以双侧尾状核及丘脑作为感兴趣脑区,经LCModel软件拟合出N-乙酰天门冬氨酸(N-acetylaspartic acid,NAA)、谷氨酸(glutamic acid,Glu)及γ-氨基丁酸(Gamma aminobutyric acid,GABA)的相对浓度,同时用耶鲁-布朗强迫量表(Yale-Brown obsessive-compulsive scale,Y-BOCS)、汉密顿焦虑量表(Hamilton anxiety scale,HAMA)评估患者的临床症状。采用SPSS 20.0进行统计分析,应用独立样本t检验比较强迫障碍患者和健康对照不同神经生化代谢物浓度的差异,应用Pearson相关分析生化代谢物浓度与临床症状的相关性。结果:强迫障碍患者左侧丘脑的Glu浓度(3.97±0.41)高于对照组(3.66±0.55)(t=-2.11,P<0.05),而NAA浓度(4.87±0.47)低于对照组(5.15±0.44),差异有统计学意义(t=2.05,P<0.05);右侧尾状核GABA浓度(0.50±0.18)和右侧丘脑GABA浓度(0.80±0.19)低于对照组[(0.63±0.23),(0.96±0.24)],差异有统计学意义(t=2.08,2.36,P<0.05)。Pearson相关分析显示,强迫障碍患者左侧尾状核Glu浓度与Y-BOCS总分呈正相关(r=0.46,P<0.05);经Spearman相关分析显示,右侧尾状核的Glu浓度与强迫障碍患者的HAMA总分呈正相关(r=0.46,P<0.05)。结论:强迫障碍患者尾状核和丘脑的NAA、Glu、GABA代谢异常,且Glu浓度与强迫症状、焦虑症状的严重程度呈正相关。Objective To investigate the neurobiochemical metabolites of caudate nucleus and thalamus in patients with obsessive-compulsive disorder and their relationship with obsessive-compulsive symptoms.Methods From April 2019 to January 2022 in Beijing Anding Hospital,totally 25 untreated patients with obsessive-compulsive disorder were recruited,and 20 healthy controls matched with gender,age and educational background were recruited for the study.The maps of neurobiochemical metabolites of patients and normal controls were collected by hydrogen proton magnetic resonance spectroscopy.With bilateral caudate nucleus and thalamus as brain regions of interest.The relative concentrations of N-acetylaspartic acid(NAA),glutamic acid(Glu)andγ-aminobutyric acid(GABA)were fitted by LCModel software.At the same time,the clinical symptoms of patients were evaluated with Yale-Brown obsessive-compulsive scale(Y-BOCS)and Hamilton anxiety scale(HAMA).SPSS 20.0 software was used for statistical analysis.Independent double sample t-test was used to compare the differences of different nerve biochemical metabolite concentrations between patients with obsessive-compulsive disorders and healthy controls.Pearson correlation analysis was used to explore the correlation between biochemical metabolite concentrations and clinical symptoms.Results The Glu concentration in the left thalamus of patients with obsessive-compulsive disorder(3.97±0.41)was higher than that of the control group(3.66±0.55)(t=-2.11,P<0.05),while the NAA concentration was(4.87±0.47)lower than that of the control group(5.15±0.44)(t=2.05,P<0.05).The GABA concentrations in the right caudate nucleus(0.50±0.18)and thalamus(0.80±0.19)were lower than those in the control group((0.63±0.23),(0.96±0.24))(t=2.08,2.36,both P<0.05).Pearson correlation analysis showed that the Glu concentration in the left caudate nucleus of patients with obsessive-compulsive disorder was positively correlated with the total score of Y-BOCS(r=0.46,P<0.05).Spearman correlation analysis showed th

关 键 词：强迫障碍 磁共振波谱成像 尾状核 丘脑 谷氨酸 Γ-氨基丁酸 N-乙酰天门冬氨酸 

分 类 号：R749.7[医药卫生—神经病学与精神病学]