强迫症患者局部脑自发活动的改变：一项荟萃分析。
Alterations of regional spontaneous brain activity in obsessive-compulsive disorders: A meta-analysis.
作者信息
Li Huayun, Wang Yihe, Xi Hongyu, Zhang Jianxin, Zhao Mengqi, Jia Xize
机构信息
School of Psychology, Zhejiang Normal University, Jinhua, China; Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China; Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Jinhua, China.
School of Psychology, Zhejiang Normal University, Jinhua, China; Key Laboratory of Intelligent Education Technology and Application of Zhejiang Province, Zhejiang Normal University, Jinhua, China; Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Jinhua, China.
出版信息
J Psychiatr Res. 2023 Sep;165:325-335. doi: 10.1016/j.jpsychires.2023.07.036. Epub 2023 Aug 2.
BACKGROUND
Recent studies using resting-state functional magnetic resonance imaging (rs-fMRI) demonstrate that there is aberrant regional spontaneous brain activity in obsessive-compulsive disorders (OCD). Nevertheless, the results of previous studies are contradictory, especially in the abnormal brain regions and the directions of their activities. It is necessary to perform a meta-analysis to identify the common pattern of altered regional spontaneous brain activity in patients with OCD.
METHODS
The present study conducted a systematic search for studies in English published up to May 2023 in PubMed, Web of Science, and Embase. These studies measured differences in regional spontaneous brain activity at the whole brain level using regional homogeneity (ReHo), the amplitude of low-frequency fluctuations (ALFF) and the fractional amplitude of low-frequency fluctuations (fALFF). Then the Anisotropic effect-size version of seed-based d mapping (AES-SDM) was used to investigate the consistent abnormality of regional spontaneous brain activity in patients with OCD.
RESULTS
27 studies (33 datasets) were included with 1256 OCD patients (650 males, 606 females) and 1176 healthy controls (HCs) (588 males, 588 females). Compared to HCs, patients with OCD showed increased spontaneous brain activity in the right inferior parietal gyrus (Brodmann Area 39), left median cingulate and paracingulate gyri (Brodmann Area 24), bilateral inferior cerebellum, right middle frontal gyrus (Brodmann Area 46), left inferior frontal gyrus in triangular part (Brodmann Area 45) and left middle frontal gyrus in orbital part (Brodmann Area 11). Meanwhile, decreased spontaneous brain activity was identified in the right precentral gyrus (Brodmann Area 4), right insula (Brodmann Area 48), left postcentral gyrus (Brodmann Area 43), bilateral superior cerebellum and left caudate (Brodmann Area 25).
CONCLUSIONS
This meta-analysis provided a quantitative review of spontaneous brain activity in OCD. The results demonstrated that the brain regions in the frontal lobe, sensorimotor cortex, cerebellum, caudate and insula are crucially involved in the pathophysiology of OCD. This research contributes to the understanding of the pathophysiologic mechanism underlying OCD and could provide a new perspective on future diagnosis and treatment of OCD.
背景
最近使用静息态功能磁共振成像（rs-fMRI）的研究表明，强迫症（OCD）患者存在异常的区域自发性脑活动。然而，先前研究的结果相互矛盾，尤其是在异常脑区及其活动方向方面。有必要进行一项荟萃分析，以确定强迫症患者区域自发性脑活动改变的共同模式。
方法
本研究对截至2023年5月在PubMed、科学网和Embase上发表的英文研究进行了系统检索。这些研究使用区域一致性（ReHo）、低频波动幅度（ALFF）和低频波动分数幅度（fALFF）在全脑水平测量区域自发性脑活动的差异。然后使用基于种子的d映射的各向异性效应大小版本（AES-SDM）来研究强迫症患者区域自发性脑活动的一致异常情况。
结果
纳入了27项研究（33个数据集），其中包括1256名强迫症患者（男性650名，女性606名）和1176名健康对照者（HCs）（男性588名，女性588名）。与健康对照者相比，强迫症患者在右侧顶下小叶（布罗德曼区39）、左侧中央前回和中央旁小叶（布罗德曼区24）、双侧小脑下部、右侧额中回（布罗德曼区46）、左侧三角部额下回（布罗德曼区45）和左侧眶部额中回（布罗德曼区11）的自发性脑活动增加。同时，在右侧中央前回（布罗德曼区4）、右侧岛叶（布罗德曼区48）、左侧中央后回（布罗德曼区43）、双侧小脑上部和左侧尾状核（布罗德曼区25）发现自发性脑活动减少。
结论
这项荟萃分析对强迫症患者的自发性脑活动进行了定量综述。结果表明，额叶、感觉运动皮层、小脑、尾状核和岛叶的脑区在强迫症的病理生理学中起着关键作用。本研究有助于理解强迫症潜在的病理生理机制，并可为未来强迫症的诊断和治疗提供新的视角。
Zotero 插件