Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China.
Department of Internal Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, China.
Depress Anxiety. 2018 Aug;35(8):742-751. doi: 10.1002/da.22758. Epub 2018 May 7.
Cerebral morphological abnormalities may play a key role in pathogenesis of obsessive-compulsive disorder (OCD). However, few studies have used multimodal imaging strategies to investigate alterations of cortical morphometry and white matter (WM) integrity. This study aimed to evaluate cortical thickness, cortical and subcortical volume, and WM integrity characteristics in OCD patients comprehensively.
We acquired magnetic resonance imaging (MRI) scans from 52 OCD patients and 46 well-matched healthy controls (HCs). Cortical thickness and cortical and subcortical volume were measured using the surface-based morphometry (SBM) approach. We also evaluated fractional anisotropy (FA) and mean diffusivity (MD) derived from diffusion tensor imaging (DTI) using tract-based spatial statistics (TBSS). The disease severity was evaluated by score of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). For those brain regions exhibiting altered structure, correlations between alterations and clinical symptoms severity were analyzed in all patients and medication-naïve patients, respectively.
Compared with controls, OCD patients exhibited cortical thinning in right posterior cingulate cortex (PCC), as well as significantly decreased FA values in the genu and body of corpus callosum (CC). In medication-naïve patients group, the total Y-BOCS score and obsession score were significantly negative correlated with right PCC cortical thickness.
OCD patients demonstrated symptom-related reduced cortical thickness structural alteration of the right PCC, and altered WM integrity in the genu and body of CC. Medication seems could alleviate the alteration of cortical thickness but not WM integrity. Combined multimodal neuroimaging methods may provide a more comprehensive perspective to clarify the pathological mechanism of OCD.
大脑形态异常可能在强迫症（OCD）的发病机制中起关键作用。然而，很少有研究使用多模态成像策略来研究皮质形态和白质（WM）完整性的改变。本研究旨在全面评估 OCD 患者的皮质厚度、皮质和皮质下体积以及 WM 完整性特征。
我们从 52 名 OCD 患者和 46 名匹配良好的健康对照者（HCs）中获取磁共振成像（MRI）扫描。使用基于表面的形态测量法（SBM）测量皮质厚度和皮质和皮质下体积。我们还使用基于束的空间统计学（TBSS）评估来自弥散张量成像（DTI）的各向异性分数（FA）和平均弥散度（MD）。使用耶鲁-布朗强迫症量表（Y-BOCS）评分评估疾病严重程度。对于那些表现出结构改变的脑区，分别在所有患者和未用药患者中分析改变与临床症状严重程度之间的相关性。
与对照组相比，OCD 患者右后扣带回皮质（PCC）皮质变薄，胼胝体膝部和体部 FA 值显著降低。在未用药患者组中，总 Y-BOCS 评分和强迫评分与右 PCC 皮质厚度呈显著负相关。
OCD 患者表现出与症状相关的右侧 PCC 皮质厚度结构改变，以及胼胝体膝部和体部 WM 完整性改变。药物治疗似乎可以减轻皮质厚度的改变，但不能减轻 WM 完整性的改变。联合多模态神经影像学方法可能为阐明 OCD 的病理机制提供更全面的视角。
