Riffkin Jem, Yücel Murat, Maruff Paul, Wood Stephen J, Soulsby Bridget, Olver James, Kyrios Michael, Velakoulis Dennis, Pantelis Christos
Melbourne Neuropsychiatry Centre, University of Melbourne and Sunshine Hospital, Melbourne, Victoria, Australia.
Psychiatry Res. 2005 Feb 28;138(2):99-113. doi: 10.1016/j.pscychresns.2004.11.007.
Functional imaging and neuropsychological data suggest that interconnected brain structures including the orbito-frontal cortex (OFC), anterior cingulate cortex (ACC) and caudate nucleus (CN) are involved in the pathophysiology of obsessive-compulsive disorder (OCD), but structural imaging studies investigating these regions have yielded inconclusive results. This may be due to inconsistencies in the identification of anatomical boundaries and methodologies utilised (i.e. automated vs. manual tracing). This magnetic resonance imaging study used manual tracing to measure volumes of selected brain regions (OFC, ACC and CN) in OCD patients and compared them with samples of healthy (HC) and psychiatric (schizophrenia; SCZ) controls (n=18 in each group). Concurrently, automated voxel-based analysis was also used to detect subtle differences in cerebral grey and white matter. For the OCD vs. HC comparison, there were no significant volumetric differences detected using the manual or the automated method (although the latter revealed a deficit in the subcortical white matter of the right temporal region). A direct comparison of the two patient groups showed no significant differences using the manual method. However, a moderate effect size was detected for OFC grey matter (reduced in SCZ), which was supported by findings of reduced OFC volume in the automated analysis. Automated analyses also showed reduced volumes in the dorsal (white matter) and ventral ACC (grey and white matter), as well as the left posterior cingulate (grey and white matter) in SCZ. The findings suggest that in contrast to findings in SCZ, there are very few (if any) gross structural anomalies in OCD.
功能成像和神经心理学数据表明，包括眶额皮质（OFC）、前扣带回皮质（ACC）和尾状核（CN）在内的相互连接的脑结构参与了强迫症（OCD）的病理生理过程，但对这些区域进行研究的结构成像研究结果尚无定论。这可能是由于所采用的解剖边界识别方法和技术（即自动追踪与手动追踪）不一致所致。这项磁共振成像研究采用手动追踪法测量强迫症患者选定脑区（OFC、ACC和CN）的体积，并将其与健康对照（HC）和精神疾病对照（精神分裂症；SCZ）样本进行比较（每组n = 18）。同时，还采用基于体素的自动分析来检测脑灰质和白质的细微差异。对于强迫症与健康对照的比较，无论是采用手动还是自动方法，均未检测到显著的体积差异（尽管后者显示右侧颞叶皮质下白质存在缺陷）。对两组患者进行直接比较，采用手动方法未发现显著差异。然而，检测到眶额皮质灰质存在中等效应量（精神分裂症患者减少），自动分析中眶额皮质体积减少的结果支持了这一发现。自动分析还显示，精神分裂症患者背侧（白质）和腹侧前扣带回（灰质和白质）以及左侧后扣带回（灰质和白质）体积减少。研究结果表明，与精神分裂症的研究结果相反，强迫症中几乎没有（如果有的话）明显的结构异常。
