伴或不伴感觉现象强迫症患者静息态脑功能活动差异分析  

Resting-state brain spontaneous activity in obsessive-compulsive disorder patients with or without sensory phenomena

作　　者：谢民耀 张雪迪 陈豪诚 宋莎莎 柳娜[1] 张宁[1] Xie Minyao;Zhang Xuedi;Chen Haocheng;Song Shasha;Liu Na;Zhang Ning(Department of Medical Psychology,Brain Hospital Affiliated to Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属脑科医院医学心理科,南京210029

出　　处：《中华精神科杂志》2025年第4期267-273,共7页Chinese Journal of Psychiatry

基　　金：国家自然科学基金(81901390);江苏省重点研发计划社会发展专项资金项目(BE2021616,BE2022678);南京市卫生科技发展专项资金项目医学重点科技发展项目(ZKX200029)。

摘　　要：目的探究伴或不伴感觉现象强迫症患者静息态脑功能活动的差异。方法前瞻性收集2021年8月至2022年12月在南京医科大学附属脑科医院强迫症专病门诊就诊的102例强迫症患者的临床资料,其中男60例,女42例,年龄18~50(27±8)岁。根据是否存在感觉现象分为伴感觉现象强迫症患者70例(伴感觉现象组)和不伴感觉现象强迫症患者32例(不伴感觉现象组)。同期招募年龄匹配的健康对照个体50名(对照组),其中男24名,女26名,年龄18~49(25±6)岁。基于静息态功能磁共振成像技术采集大脑功能活动信号后计算全脑低频振幅(amplitude of low frequency fluctuations,ALFF)和差异脑区间功能连接(functional connectivity,FC),采用单因素方差分析和事后检验比较3组间静息态脑功能活动差异。采用Spearman相关和二元Logistic逐步回归分析强迫症感觉现象与静息态脑功能活动的关联。结果与健康对照者相比,强迫症患者双侧额中回、左侧额上回、右侧角回、右侧缘上回ALFF值降低(F=17.29~32.99,均P<0.05);伴感觉现象组右侧额下回三角部ALFF值增高(F=23.47,P<0.05),左侧顶上回、左侧中央后回ALFF值降低(F=18.80、15.04,均P<0.05);不伴感觉现象组左侧缘上回、左侧中央后回ALFF值增高(F=19.64、15.04,均P<0.05),左侧额上回、右侧额中回、左侧角回ALFF值降低(F=17.29~35.52,均P<0.05)。与健康对照者相比,强迫症患者左侧额中回-左侧角回、左侧额中回-右侧角回、左侧角回-右侧角回FC值降低(F=17.29~23.47,均P<0.05);伴感觉现象组相较于不伴感觉现象组左侧额中回-左侧角回FC值降低(F=23.47,P<0.05)。右侧额下回三角部、左侧额上回、右侧额中回ALFF值与伴感觉现象呈正相关(r=0.40、0.35、0.31,均P<0.05);左侧缘上回、左侧顶上回、左侧中央后回ALFF值(r=-0.38、-0.47、-0.52)及左侧额中回-左侧角回、左侧额中回-右侧角回FC值(r=-0.24、-0.21)与伴感觉现象呈负相�ObjectiveTo explore the differences in resting-state brain functional activity in obsessive-compulsive disorder(OCD)patients with and without sensory phenomena(SP).MethodsClinical data from 102 OCD patients(60 males,42 females;age 18-50(27±8)years)who visited the OCD outpatient clinic at the Affiliated Brain Hospital of Nanjing Medical University between August 2021 and December 2022 were prospectively collected.Based on the presence of sensory phenomena,patients were categorized into 70 cases with sensory phenomena(Sensory Phenomena Group)and 32 cases without sensory phenomena(Non-Sensory Phenomena Group).Additionally,50 age-matched healthy controls(Control Group,24 males,26 females;age 18-49(25±6)years)were recruited.Resting-state functional magnetic resonance imaging(rs-fMRI)was analyzed using the amplitude of low-frequency fluctuations(ALFF)and functional connectivity(FC)between differential brain regions.One-way ANOVA and post-hoc tests were used to compare group differences.Spearman correlation and binary logistic stepwise regression were applied to analyze the associations between SP and brain functional activity.ResultsCompared to healthy controls,OCD patients showed decreased ALFF in bilateral middle frontal gyri,left superior frontal gyrus,right angular gyrus,and right supramarginal gyrus(F=17.29-32.99,all P<0.05).The SP group exhibited increased ALFF in the right triangular part of the inferior frontal gyrus(F=23.47,P<0.05)and decreased ALFF in the left superior parietal gyrus and left postcentral gyrus(F=18.80,15.04;both P<0.05).The non-SP group demonstrated increased ALFF in the left supramarginal gyrus and left postcentral gyrus(F=19.64,15.04;both P<0.05)and decreased ALFF in the left superior frontal gyrus,right middle frontal gyrus,and left angular gyrus(F=17.29-35.52,all P<0.05).Reduced FC was observed between the left middle frontal gyrus and left angular gyrus,left middle frontal gyrus and right angular gyrus and left and right angular gyri(F=17.29-23.47,all P<0.05).The SP group showed lower

关 键 词：强迫性障碍 感觉现象 磁共振 静息态 

分 类 号：R749.7[医药卫生—神经病学与精神病学]