Tükel Raşit, Aydın Kubilay, Ertekin Erhan, Özyıldırım Seda Şahin, Barburoğlu Mehmet
Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Capa, 34390, Istanbul, Turkey,
Eur Arch Psychiatry Clin Neurosci. 2015 Apr;265(3):219-26. doi: 10.1007/s00406-014-0545-1. Epub 2014 Sep 26.
Several neuroimaging studies have investigated brain metabolite abnormalities in patients with obsessive-compulsive disorder (OCD) and also explored metabolic changes after OCD treatments using proton magnetic resonance spectroscopy ((1)H-MRS). The main objective of this study was to investigate the effects of a selective serotonin re-uptake inhibitor (SSRI) treatment on the neurochemical levels in patients with OCD. In the present study, levels of N-acetylaspartate (NAA), choline, and myo-Inositol were measured in terms of their ratios with creatine (Cr) using (1)H-MRS. The ratios of metabolite levels in the three brain regions for 19 unmedicated patients with OCD, including 10 who were drug-naïve, at baseline and following 12 weeks of sertraline treatment and for 19 healthy control subjects were compared with ANOVA. In post hoc analysis, the NAA/Cr levels were significantly lower in patients with OCD at baseline than in healthy controls in the anterior cingulate and in the caudate. On the other hand, no significant differences were detected in terms of the NAA/Cr in the anterior cingulate, caudate, and putamen between the patients with OCD after 12 weeks of sertraline treatment and healthy controls. The paired t test revealed that NAA/Cr levels were significantly higher in patients with OCD after 12 weeks of sertraline treatment compared with those at baseline in the anterior cingulate and in the caudate. Our results suggest that reductions in NAA can be reversed with SSRI treatment, which may indicate an improvement in neuronal integrity.
多项神经影像学研究调查了强迫症（OCD）患者的脑代谢物异常情况，还利用质子磁共振波谱（（1）H-MRS）探索了强迫症治疗后的代谢变化。本研究的主要目的是调查选择性5-羟色胺再摄取抑制剂（SSRI）治疗对强迫症患者神经化学水平的影响。在本研究中，使用（1）H-MRS以N-乙酰天门冬氨酸（NAA）、胆碱和肌醇与肌酸（Cr）的比率来测量其水平。采用方差分析比较了19名未接受药物治疗的强迫症患者（包括10名未用过药的患者）在基线时、舍曲林治疗12周后以及19名健康对照者在三个脑区的代谢物水平比率。在事后分析中，强迫症患者在基线时前扣带回和尾状核的NAA/Cr水平显著低于健康对照者。另一方面，舍曲林治疗12周后的强迫症患者与健康对照者在前扣带回、尾状核和壳核的NAA/Cr方面未检测到显著差异。配对t检验显示，舍曲林治疗12周后的强迫症患者在前扣带回和尾状核的NAA/Cr水平显著高于基线时。我们的结果表明，SSRI治疗可逆转NAA的降低，这可能表明神经元完整性有所改善。
