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强迫症患者及其健康一级亲属的静息态功能连接异常。

Resting-state functional connectivity abnormalities in patients with obsessive-compulsive disorder and their healthy first-degree relatives.

作者信息

Hou Jing-Ming, Zhao Ming, Zhang Wei, Song Ling-Heng, Wu Wen-Jing, Wang Jian, Zhou Dai-Quan, Xie Bing, He Mei, Guo Jun-Wei, Qu Wei, Li Hai-Tao

机构信息

Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China.

Department of Clinical Psychology, Southwest Hospital, Third Military Medical University, Chongqing, China.

出版信息

J Psychiatry Neurosci. 2014 Sep;39(5):304-11. doi: 10.1503/jpn.130220.

Abstract

BACKGROUND

Obsessive-compulsive disorder (OCD) is a common, heritable neuropsychiatric disorder, hypothetically underpinned by dysfunction of brain cortical-striatal-thalamic-cortical (CSTC) circuits; however, the extent of brain functional abnormalities in individuals with OCD is unclear, and the genetic basis of this disorder is poorly understood. We determined the whole brain functional connectivity patterns in patients with OCD and their healthy first-degree relatives.

METHODS

We used resting-state fMRI to measure functional connectivity strength in patients with OCD, their healthy first-degree relatives and healthy controls. Whole brain functional networks were constructed by measuring the temporal correlations of all brain voxel pairs and further analyzed using a graph theory approach.

RESULTS

We enrolled 39 patients with OCD, 20 healthy first-degree relatives and 39 healthy controls in our study. Compared with healthy controls, patients with OCD showed increased functional connectivity primarily within the CSTC circuits and decreased functional connectivity in the occipital cortex, temporal cortex and cerebellum. Moreover, patients with OCD and their first-degree relatives exhibited overlapping increased functional connectivity strength in the bilateral caudate nucleus, left orbitofrontal cortex (OFC) and left middle temporal gyrus.

LIMITATIONS

Potential confounding factors, such as medication use, heterogeneity in symptom clusters and comorbid disorders, may have impacted our findings.

CONCLUSION

Our preliminary results suggest that patients with OCD have abnormal resting-state functional connectivity that is not limited to CSTC circuits and involves abnormalities in additional large-scale brain systems, especially the limbic system. Moreover, resting-state functional connectivity strength abnormalities in the left OFC, bilateral caudate nucleus and left middle temporal gyrus may be neuroimaging endophenotypes for OCD.

摘要

背景

强迫症(OCD)是一种常见的遗传性神经精神疾病,据推测其发病机制是大脑皮质-纹状体-丘脑-皮质(CSTC)回路功能障碍;然而,强迫症患者大脑功能异常的程度尚不清楚,且该疾病的遗传基础也了解甚少。我们确定了强迫症患者及其健康的一级亲属的全脑功能连接模式。

方法

我们使用静息态功能磁共振成像(fMRI)来测量强迫症患者、其健康的一级亲属和健康对照者的功能连接强度。通过测量所有脑区体素对之间的时间相关性构建全脑功能网络,并使用图论方法进行进一步分析。

结果

我们的研究纳入了39例强迫症患者、20名健康的一级亲属和39名健康对照者。与健康对照者相比,强迫症患者主要在CSTC回路内的功能连接增加,而枕叶皮质、颞叶皮质和小脑的功能连接减少。此外,强迫症患者及其一级亲属在双侧尾状核、左侧眶额皮质(OFC)和左侧颞中回表现出重叠的功能连接强度增加。

局限性

潜在的混杂因素,如药物使用、症状簇的异质性和共病,可能影响了我们的研究结果。

结论

我们的初步结果表明,强迫症患者存在静息态功能连接异常,这种异常不仅限于CSTC回路,还涉及其他大规模脑系统的异常,尤其是边缘系统。此外,左侧OFC、双侧尾状核和左侧颞中回的静息态功能连接强度异常可能是强迫症的神经影像学内表型。

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