| 摘要: |
| 目的探讨强迫症患者脑结构及脑功能异常以及治疗前后的变化。方法采用3.0T核磁共振仪对18例未服药强迫症患者治疗前后进行全脑扫描，获得高分辨率3D-T结构后，采用优化的基于体素的形态测量学方法（VBM）计算全脑灰质容积；静息态功能磁共振成像（fMRI）数据采用低频振幅（ALFF）方法处理，并与16例年龄、性别相匹配的正常人群相对照。结果与对照组相比，强迫症组右侧丘脑、双侧扣带回左侧尾状核及右侧苍白球体灰质容积减少（P＜0.05）；小脑前叶、左侧眶额上回、右侧额中回、左侧颞中回、左楔前叶、中央前回、中央后回等皮质结构灰质容积增加（P＜0.05）；右侧小脑与右侧顶叶静息态fMRI过度激活，左侧扣带回、豆状核与尾状核激活减弱（P＜0.05）；药物治疗反应良好的强迫症患者左侧丘脑、左侧豆状核、左侧壳核、左侧前、后扣带回灰质容积均较治疗前明显增加（均P＜0.05）；静息态fMRI结果提示治疗前后无统计学差异（P＞0.05）。结论强迫症患者存在多个脑区灰质容积和静息态脑功能异常，有效的药物治疗可部分逆转这种异常状态。 |
| 关键词: 强迫症 基于体素的形态测量学方法 静息态功能磁共振 灰质 容积 |
| DOI： |
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| 基金项目:杭州市科技局重点专科专病项目 |
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| MRI scan of whole brain gray matter and resting state functional image in patients with obsessive compulsive disorder |
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TANG Wenxin,ZHU Qifeng,GONG Xiangyang,ZHU Cheng,WANG Yiquan,CHEN Shulin
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Hangzhou Seventh People's Hospital
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| Abstract: |
| Objective To study whole brain gray matter and resting state functional image with MRI scan in obsessive-compulsive disorder (OCD) patients. Methods Brain magnetic resonance imaging (MRI) and resting state functional MRI (fMRI) were performed in 18 OCD patients and 16 healthy subjects. High-resolution three-dimensional images were processed using the voxel-based morphometry method．Resting state function image data was processed by ALFF method. Results There wasa decrease in gray matter volume in the right thalamus, bilateral cingulate cortex, left caudate nucleus and right globus pallidus (P＜0.05), and an increase in gray matter volume in the cerebellum anterior lobe, left orbitofrontal gyrus, right middle frontal gyrus, left middle temporal gyrus, left precuneus, precentral gyrus and postcentral gyrus (P＜0.05) in OCD patients. OCD patients had overactivation of the right cerebellum and right parietal lobe and reduced activation of the left cingulate gyrus, putamen and caudate nucleus on resting fMRI (P＜0.05). OCD patients whose symptoms were improved after drug treatment hada
significant increase in gray matter volume in the left thalamus, left putamen, left shell nucleus, left posterior and anterior cingulate gyrus(P＜0.05), but no significant differences were found on resting fMRI before and after treatment (P ＞0.05). Conclusion There are abnormalities of the gray matter volume and resting fMRI in a number of brain regions in OCD patients, and the abnormalities can be partially reversed after effective drug treatment. |
| Key words: Obsessive-compulsive disorder Voxel-based morphometry Resting state functional magnetic reso- nance imaging Gray matter Volume |
