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强迫症患者静息状态下小脑-大脑功能连接的改变。

Altered resting-state cerebellar-cerebral functional connectivity in obsessive-compulsive disorder.

机构信息

Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,PR China.

Department of Psychiatry and South African Medical Research Council Unit on Risk & Resilience in Mental Disorders,University of Cape Town,Cape Town,South Africa.

出版信息

Psychol Med. 2019 May;49(7):1156-1165. doi: 10.1017/S0033291718001915. Epub 2018 Jul 30.

Abstract

BACKGROUND

The role of the cerebellum in obsessive-compulsive disorder (OCD) has drawn increasing attention. However, the functional connectivity between the cerebellum and the cerebral cortex has not been investigated in OCD, nor has the relationship between such functional connectivity and clinical symptoms.

METHODS

A total of 27 patients with OCD and 21 healthy controls (HCs) matched on age, sex and education underwent magnetic resonance imaging (MRI). Seed-based connectivity analyses were performed to examine differences in cerebellar-cerebral connectivity in patients with OCD compared with HCs. Associations between functional connectivity and clinical features in OCD were analyzed.

RESULTS

Compared with HCs, OCD patients showed significantly decreased cerebellar-cerebral functional connectivity in executive control and emotion processing networks. Within the OCD group, decreased functional connectivity in an executive network spanning the right cerebellar Crus I and the inferior parietal lobule was positively correlated with symptom severity, and decreased connectivity in an emotion processing network spanning the left cerebellar lobule VI and the lingual gyrus was negatively correlated with illness duration.

CONCLUSIONS

Altered functional connectivity between the cerebellum and cerebral networks involved in cognitive-affective processing in patients with OCD provides further evidence for the involvement of the cerebellum in the pathophysiology of OCD, and is consistent with impairment in executive control and emotion regulation in this condition.

摘要

背景

小脑在强迫症(OCD)中的作用引起了越来越多的关注。然而,小脑与大脑皮层之间的功能连接在 OCD 中尚未得到研究,也没有研究这种功能连接与临床症状之间的关系。

方法

共纳入 27 例 OCD 患者和 21 例年龄、性别和教育程度相匹配的健康对照者(HCs)进行磁共振成像(MRI)检查。采用基于种子的连通性分析方法,比较 OCD 患者与 HCs 之间小脑与大脑连接的差异。分析 OCD 患者中功能连接与临床特征之间的关系。

结果

与 HCs 相比,OCD 患者在执行控制和情绪处理网络中表现出小脑-大脑功能连接明显减少。在 OCD 组中,横跨右侧小脑 Crus I 和下顶叶的执行网络中功能连接的减少与症状严重程度呈正相关,横跨左侧小脑 lobule VI 和舌回的情绪处理网络中功能连接的减少与疾病持续时间呈负相关。

结论

OCD 患者小脑与参与认知-情感处理的大脑网络之间的功能连接改变,进一步证明了小脑在 OCD 病理生理学中的参与作用,与该病症中执行控制和情绪调节的损伤一致。

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