不接受/禁忌思维亚型强迫障碍患者的脑白质磁共振弥散张量成像研究

摘要

Objective:To investigate the microstructural integrity of the brain white matter and its corre-lation with clinical symptoms in patients with the unacceptable/taboo thoughts subtype of obsessive-compulsive disorder by MR diffusion tensor imaging. Method:Twenty-six untreated unacceptable/taboo thoughts subtype of obsessive compulsive disorder(OCD) patients and 28 age,gender and education matched healthy controls were chosen and scanned with DTI. The Yale-Brown obsessive compulsive scale,Hamilton rating scale for de-pression 17-Item and Hamilton Anxiety Rating Scale were performed to assess the clinical symptoms. FA data were statistically compared between the two groups and the brain areas by tract based spatial statistics,then ab-normal FA values and the relationship between them and severity of clinical symptoms were determined. Results:Compared with the control,the patients had a significantly lower FA in the corpus callosum;right superior longi-tudinal fasciculus;right posterior thalamic radiation(optic radiation);right inferior fronto-occipital fasciculus. FA values showed no significant correlation with the clinical symptom scores. Conclusion:Several abnormal white matter integrity regions might be involved in the pathophysiology of OCD with unacceptable/taboo thoughts,the findings of lower FA in these regions might represent trait markers.%目的：：运用磁共振扩散张量成像技术探讨未经治疗的不接受/禁忌思维亚型强迫障碍( OCD)患者脑白质的变化及与临床症状之间的相关性。方法：对26例不接受/禁忌思维亚型OCD患者和28名性别、年龄、受教育程度相匹配的健康对照者进行弥散张量成像( DTI)扫描，采用耶鲁-布朗强迫量表(Y-BOCS)、17项汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表(HAMA)等评估临床症状，采用基于纤维束空间统计分析( TBSS)等方法比较两组全脑DTI的各向异性分数( FA)，得出有差异脑区，并分析患者组脑白质改变与临床症状严重程度之间的关系。结果：和正常对照组相比，患者组的大脑胼胝体、右侧上纵束、右侧下额-枕束、右侧丘脑后辐射(视辐射部)等部位的FA值显著降低；未发现任何脑区的FA值与临床行为学量表之间的相关性。结论：多个脑白质区的结构异常可能构成不接受/禁忌思维亚型OCD患者的病理生理基础，这些脑白质区的变化可能是此亚型OCD的特征标志。