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强迫症患者大脑功能网络拓扑结构的改变:比较不同严重程度抑郁症状患者的差异,及其对心理社会功能的影响。

Altered brain functional network topology in Obsessive-Compulsive Disorder: A comparison of patients with varying severity of depressive symptoms and the impact on psychosocial functioning.

机构信息

The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China.

Department of Medical Psychology, The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China.

出版信息

Neuroimage Clin. 2023;40:103545. doi: 10.1016/j.nicl.2023.103545. Epub 2023 Nov 21.

Abstract

BACKGROUND

Obsessive-compulsive disorder (OCD) is associated with psychosocial impairment, which can be exacerbated by depressive symptoms. In this study, we employed graph theory analysis to investigate the association among neuroimaging, clinical features, and psychosocial functioning in OCD patients, with a specific focus on the differential impact of depressive symptoms.

METHODS

216 OCD patients were divided into two subgroups based on depressive symptoms. Resting-state functional MRI data were acquired from a subset of 106 OCD patients along with 77 matched healthy controls (HCs). We analyzed the topological characteristics of the entire brain and the cognition-related subnetworks and performed Pearson correlation analyses to further explore the relationship with psychosocial functioning.

RESULTS

OCD patients with more severe depressive symptoms exhibited greater impairment across all dimensions of psychosocial functioning. Graph theory analysis revealed more pronounced reductions in network efficiency within the entire brain, the default mode network (DMN), and the cingulo-opercular network (CON) among patients with non or mild depressive symptoms. Lower nodal efficiency and degree centrality of the right superior temporal gyrus (STG) were found in OCD patients and these variables were positively correlated with psychosocial functioning impairment.

CONCLUSIONS

This study revealed that the presence of depressive symptoms generally exacerbated psychosocial functioning impairment in OCD patients. Abnormalities in the functional integration of the entire brain, the DMN, and the CON in OCD patients may comprise the basis of cognitive deficits, while dysfunction of the right STG may affect the psychosocial functioning through its role in emotion, intention perception, and insight.

摘要

背景

强迫症(OCD)与社会心理功能障碍相关,而抑郁症状可能会使其恶化。本研究采用图论分析的方法,探究 OCD 患者的神经影像学、临床特征和社会心理功能之间的关联,重点关注抑郁症状的差异影响。

方法

根据抑郁症状,将 216 名 OCD 患者分为两组。对 106 名 OCD 患者和 77 名匹配的健康对照组(HCs)的部分患者进行静息态功能磁共振成像(rs-fMRI)数据采集。我们分析了全脑的拓扑特征以及与认知相关的子网,并进行了 Pearson 相关分析,以进一步探讨与社会心理功能的关系。

结果

抑郁症状更严重的 OCD 患者在所有社会心理功能维度上的损伤都更明显。图论分析显示,非或轻度抑郁症状的患者中,全脑、默认模式网络(DMN)和扣带前回网络(CON)的网络效率降低更为显著。OCD 患者右侧颞上回(STG)的节点效率和度中心均较低,这些变量与社会心理功能障碍呈正相关。

结论

本研究表明,抑郁症状的存在通常会加重 OCD 患者的社会心理功能障碍。OCD 患者全脑、DMN 和 CON 的功能整合异常可能构成认知缺陷的基础,而右侧 STG 的功能障碍可能通过其在情绪、意图感知和洞察力方面的作用影响社会心理功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09d6/10755823/91ed39607a10/gr1.jpg

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