Hans Gagan, Sharma Uma, Gupte Novy, Ganesh Ragul, Patil Vaibhav, Sharan Pratap
Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
Department of Nuclear Magnetic Resonance and MRI Facility, All India Institute of Medical Sciences, New Delhi, India.
Indian J Psychiatry. 2023 Nov;65(11):1151-1157. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_663_23. Epub 2023 Nov 24.
Obsessive-compulsive disorder (OCD) is a common psychiatric disorder whose underlying pathophysiology is insufficiently understood. The pathophysiology of OCD may be related to abnormalities in the biochemistry of neurotransmitters.
The aim of the present study was to measure the absolute concentration of various metabolites in the right dorsolateral prefrontal cortex (DLPFC) and caudate nucleus (CN) in treatment-naive patients with OCD and compare it with healthy controls (HCs).
The present study investigated the metabolic profile of two brain regions, namely right DLPFC and CN, by using single voxel in-vivo proton magnetic resonance spectroscopy (H MRS) in drug-naive patients with OCD (n = 17, mean age = 30.71 ± 10.104 years) and compared it with healthy controls (n = 13, mean age = 30.77 ± 5.449 years). The patients with OCD were recruited after appropriate psychometric assessments. The H-MRS experiments were performed using the 3 Tesla (3T) human MR scanner, and absolute concentrations of metabolites were estimated using the LC model.
Significantly lower concentration of tNAA in the right DLPFC was observed in the patients with OCD compared to the controls, which may be indicative of neurodegeneration in this region. However, no significant differences were observed in the concentrations of the metabolites between the patients and controls in the CN region. The level of tNAA in DLPFC significantly correlated with the disability level (WHO-DAS) of the patients.
The present study demonstrates abnormalities in the metabolic profile of an important region, DLPFC of the CSTC circuit, which is suggestive of neurodegeneration in the region in OCD patients.
强迫症（OCD）是一种常见的精神疾病，其潜在的病理生理学机制尚未得到充分理解。强迫症的病理生理学可能与神经递质生物化学异常有关。
本研究的目的是测量未经治疗的强迫症患者右侧背外侧前额叶皮质（DLPFC）和尾状核（CN）中各种代谢物的绝对浓度，并与健康对照者（HCs）进行比较。
本研究采用单体素质子磁共振波谱（H MRS）对未经药物治疗的强迫症患者（n = 17，平均年龄 = 30.71 ± 10.104岁）的右侧DLPFC和CN这两个脑区的代谢谱进行研究，并与健康对照者（n = 13，平均年龄 = 30.77 ± 5.449岁）进行比较。强迫症患者在经过适当的心理测量评估后入选。H-MRS实验使用3特斯拉（3T）人体磁共振扫描仪进行，代谢物的绝对浓度使用LC模型进行估算。
与对照组相比，强迫症患者右侧DLPFC中的N-乙酰天门冬氨酸（tNAA）浓度显著降低，这可能表明该区域存在神经退行性变。然而，患者和对照组在CN区域的代谢物浓度未观察到显著差异。DLPFC中tNAA的水平与患者的残疾程度（世界卫生组织残疾评定量表，WHO-DAS）显著相关。
本研究证明了CSTC回路重要区域DLPFC的代谢谱存在异常，这提示强迫症患者该区域存在神经退行性变。
