基于体素的形态学mri观察未经药物治疗的强迫症患者脑灰质结构改变

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1、DOI：10.16016/j.1000-5404.201411007基于体素的形态学MRI观察未经药物治疗的强迫症患者脑灰质结构改变张杨，侯景明，武文婧，黎海涛（400038重庆，第三军医大学西南医院放射科）【摘要】目的探查未经药物治疗的强迫症患者脑灰质结构存在异常的区域，并探讨脑灰质体积改变与临床症状之间的关系。方法用基于体素的形态学方法（VBM），对比分析21例未经药物治疗的强迫症患者和21例年龄、性别及受教育程度相匹配的正常对照者大脑灰质体积存在差异的脑区，并采用耶鲁-布郎量表（Y-BOCS）、汉密顿抑郁量表（HAMD）及汉

2、密顿焦虑量表（HAMA）评估临床症状。结果强迫症患者与正常对照者相比大脑灰质结构存在明显萎缩的区域主要位于双侧眶额叶、前扣带回、右侧丘脑以及右侧小脑（P<0.05，FDR校正），患者左侧眶额叶的灰质体积与耶鲁布朗量表评分之间存在负相关（r=-0.63，P<0.001）。结论本研究证明“皮质-纹状体-丘脑-皮质”环路的结构异常在强迫症的发病机制中起着重要作用，同时表明环路外小脑等结构的异常也可能参与了强迫症的病理生理学进程。【关键词】强迫症；磁共振成像；基于体素的形态学分析；脑萎缩；灰质结构【中图法分类号】【文献标志码】AAvolu

3、metricmagneticresonanceimagingstudyofgraymatterstructuresindrug-naivepatientswithobsessivecompulsivedisorderZhangYang，HouJingming，WuWenjing，LiHaitao（DepartmentofRadiology，SouthwestHospital，ThirdMilitaryMedicalUniversity，Chongqing，400038，China）[Abstract]ObjectiveTodete

4、ctgraymatterstructuralchangesindrug-naivepatientswithobsessivecompulsivedisorder(OCD),andtoinvestigatethecorrelationsbetweenabnormalgraymattervolumeandclinicalsymptoms.MethodsTwenty-oneOCDpatientsand21normalcontrols(matchedwithage,sexandeducationlevel)underwentstructu

5、ralMRIscan.Theimagingdatawereanalyzedusingvoxel-basedmorphometrymethod.TheYale-BrownObsessive-CompulsiveScale(Y-BOCS)，HamiltonDepressionRatingScale(HAMD)andHamiltonAnxietyRatingScale(HAMA)wereusedtoassessclinicalsymptoms.ResultsComparedtonormalcontrols,theOCDpatientss

6、howedsignificantlydecreasedregionalgraymattermainlyinthebilateralorbitofrontalcortex,anteriorcingulatecortex,rightthalamusandcerebellum(P<0.05,FDRcorrected).ThevolumeofleftorbitofrontalcortexinOCDpatientsshowedanegativecorrelationwiththetotalscoreinY-BOCS(r=-0.63,P<0.0

7、01).ConclusionThisstudyverifiesthatthestructuralabnormalitiesofthe“cortical-striatal-thalamic-cortical”loopsplayavitalroleinthepathogenesisofOCD.Inaddition,thecerebellumandotherstructuralabnormalitiesmayalsobeinvolvedinthepathophysiologyofOCD.[Keywords]obsessivecompul

8、sivedisorder；magneticresonanceimaging；voxel-basedmorphometry；brainatrophy；graymatterSupportedbytheNationalNaturalScienceFoun