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比较未经治疗的小儿强迫症患者与健康对照者的脑磁共振波谱结果。

Comparing brain magnetic resonance spectroscopy findings of pediatric treatment-naive obsessive-compulsive disorder patients with healthy controls.

作者信息

Yalçın Ozhan, Sener Sahnur, Konuş Boyunağa Oznur Leman, Sarıpınar Esin Gökçe, Oğur Törel, Güney Esra, Akın Sarı Burcu, Işeri Elvan

机构信息

Şanlıurfa Child Diseases Hospital, Child and Adolescent Psychiatry, Şanlıurfa.

出版信息

Turk Psikiyatri Derg. 2011 Winter;22(4):222-9.

Abstract

OBJECTIVE

It is believed that biochemical alterations in different brain regions are involved in the pathophysiology of obsessive-compulsive disorder (OCD) in children and adolescents. The aim of this study was to explore possible metabolic variations between pediatric OCD cases and healthy controls in brain regions which were implicated in OCD pathophysiology.

METHOD

Children and adolescents between 8 and 16 years of age with OCD (n:15) and case matched healthy controls (n:15) were recruited for the study. After detailed clinical and neuropsychological evaluations, all subjects underwent the multiregional magnetic resonance spectroscopy (MRS) procedure with a long echo time (TE:135).

RESULTS

Significantly lower n-acetylaspartate (NAA) ratios in the left inferior frontal gyrus, right occipital grey matter, left anterior cingulate cortex and lower choline (Cho) ratios in right and left anterior cingulate cortex and higher Cho ratio in left lenticular nucleus was observed in the OCD group. Also we found a negative correlation between OCD duration and left insular cortex NAA/Cho ratio.

CONCLUSION

We found significant metabolic alterations in the brain regions which were implicated in OCD pathophysiology. Lower NAA and Cho ratios in anterior cingulate cortex and lower NAA ratios in the left inferior fronyal gyrus containing lateral orbitofrontal cortex can be possibly related to higher activation in OCD patients. Also further studies of the occipital lobes and insula should be continued in OCD.

摘要

目的

人们认为,不同脑区的生化改变与儿童和青少年强迫症(OCD)的病理生理学有关。本研究的目的是探讨小儿强迫症病例与健康对照在与强迫症病理生理学相关的脑区中可能存在的代谢差异。

方法

招募8至16岁患有强迫症的儿童和青少年(n = 15)以及病例匹配的健康对照(n = 15)进行研究。在进行详细的临床和神经心理学评估后,所有受试者均接受了长回波时间(TE:135)的多区域磁共振波谱(MRS)检查。

结果

在强迫症组中,观察到左侧额下回、右侧枕叶灰质、左侧前扣带回皮质中的N-乙酰天门冬氨酸(NAA)比率显著降低,右侧和左侧前扣带回皮质中的胆碱(Cho)比率降低,左侧豆状核中的Cho比率升高。此外,我们发现强迫症病程与左侧岛叶皮质的NAA/Cho比率之间呈负相关。

结论

我们发现在与强迫症病理生理学相关的脑区存在显著的代谢改变。前扣带回皮质中较低的NAA和Cho比率以及包含外侧眶额皮质的左侧额下回中较低的NAA比率可能与强迫症患者较高的激活有关。此外,应继续对强迫症患者的枕叶和岛叶进行进一步研究。

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