Dept. of Psychiatry, Ruhr University Bochum, LWL-Universitätsklinikum, Alexandrinenstr. 1, 44791 Bochum, Germany.
J Psychiatr Res. 2013 Nov;47(11):1642-8. doi: 10.1016/j.jpsychires.2013.07.020. Epub 2013 Aug 8.
There is convergent evidence that basal ganglia structures are involved in the pathogenesis of obsessive-compulsive disorder (OCD). It has been also assumed that OCD is caused by a central serotonergic dysfunction. Transcranial sonography (TCS) has become a reliable, sensitive and non-invasive diagnostic tool concerning the evaluation of extrapyramidal movement disorders. This study used TCS to examine the alterations in different parenchymal regions, especially concerning serotonergic brainstem raphe nuclei as well as basal ganglia in OCD. Thirty-one OCD patients were compared with 31 matched healthy controls. Echogenecities were investigated according to the examination protocol for extrapyramidal disorders using a Siemens Sonoline(®) Elegra system. Obsessive-compulsive disorder patients showed reduced echogenity of the serotonergic brainstem raphe nuclei (32.3%) compared with healthy controls (16.1%). In nine OCD-patients (31%), but only in 2 control subjects (6.2%), a hyperechogenicity of the caudate nucleus was found. Patients with OCD significantly more often reveal a hypoechogenic brainstem raphe possibly reflecting altered serotonergic neurons there and a hyperechogenicity of caudate nucleus indicating structural or molecular cell changes. Further research is warranted to examine, whether TCS is useful in order to classify OCD and its subtypes.
已有大量证据表明基底神经节结构与强迫症（OCD）的发病机制有关。人们还假设 OCD 是由中枢 5-羟色胺能功能障碍引起的。经颅超声（TCS）已成为评估锥体外系运动障碍的一种可靠、敏感和非侵入性的诊断工具。本研究使用 TCS 检查 OCD 患者不同脑实质区域的变化，特别是涉及 5-羟色胺能脑干中缝核以及基底神经节的变化。将 31 名 OCD 患者与 31 名匹配的健康对照进行比较。使用西门子 Sonoline(®) Elegra 系统按照锥体外系疾病的检查方案研究回声强度。与健康对照组（16.1%）相比，强迫症患者的 5-羟色胺能脑干中缝核回声强度降低（32.3%）。在 9 名 OCD 患者（31%）中，但仅在 2 名对照受试者（6.2%）中发现尾状核高回声。强迫症患者更常出现脑干中缝核低回声，可能反映那里的 5-羟色胺能神经元发生改变，以及尾状核高回声，表明结构或分子细胞发生变化。需要进一步研究 TCS 是否有助于 OCD 及其亚型的分类。
