Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Centre, Shanghai, China.
Aust N Z J Psychiatry. 2022 Feb;56(2):186-196. doi: 10.1177/00048674211009623. Epub 2021 May 5.
Although brain structural changes have been reported in patients with obsessive-compulsive disorder (OCD), results from previous studies have been inconsistent. A growing number of studies have focused on obsessive beliefs and impulsivity which could be involved in the occurrence and maintenance of OCD symptoms. The present study aimed to examine whether there are distinct brain structural changes in patients with different OCD subgroups.
Eighty-nine patients with OCD and 42 healthy controls were recruited to undergo structural magnetic resonance imaging brain scan. OCD patients were classified into subgroups according to scores of the Obsessive Belief Questionnaire (OBQ-44) and the Barratt Impulsiveness Scale (BIS-11) using cluster analysis. Group comparisons in cortical thickness and subcortical volumes between all OCD patients and healthy controls, as well as between subgroups of OCD patients and healthy controls, were carried out.
OCD patients with more obsessive beliefs and attentional impulsivity (OCD_OB_AT) had reduced cortical thickness at the inferior parietal gyrus, the superior and middle temporal gyrus and the insula compared with OCD patients with higher score on the non-planning impulsivity (OCD_NP, corrected < 0.05). The whole group of OCD patients and both subgroups showed reduced cortical thickness at the superior parietal gyrus compared with controls (uncorrected < 0.01, number of vertices > 100).
Our results suggest that apart from distinct phenomenology, there are distinct neural correlates of different OCD subgroups based on obsessive beliefs and impulsivity. These neural correlates may have clinical significance and should be considered in future research.
虽然强迫症（OCD）患者的大脑结构已经发生了变化，但之前的研究结果并不一致。越来越多的研究集中在强迫观念和冲动性上，这些可能与 OCD 症状的发生和维持有关。本研究旨在探讨不同 OCD 亚组患者是否存在明显的大脑结构变化。
共招募 89 例 OCD 患者和 42 例健康对照者进行结构磁共振脑扫描。采用聚类分析的方法，根据强迫症信念问卷（OBQ-44）和巴雷特冲动量表（BIS-11）的评分，将 OCD 患者分为亚组。对所有 OCD 患者和健康对照组之间，以及 OCD 患者亚组和健康对照组之间的皮质厚度和皮质下体积进行组间比较。
与非计划性冲动得分较高的 OCD 患者（OCD_NP）相比，具有更多强迫观念和注意冲动的 OCD 患者（OCD_OB_AT）的下顶叶、上颞叶和中颞叶以及脑岛的皮质厚度降低（校正后 P<0.05）。与对照组相比，OCD 患者全组和两个亚组的顶叶上回的皮质厚度均降低（未校正 P<0.01，顶点数>100）。
除了明显的临床表现外，基于强迫观念和冲动性的不同 OCD 亚组还存在明显的神经相关性。这些神经相关性可能具有临床意义，应在未来的研究中加以考虑。
