Mental Health Center, Ningxia Medical University General Hospital, Yinchuan, China.
Mental Health Center, West China Hospital of Sichuan University, Chengdu, China.
Sci Rep. 2024 Aug 5;14(1):18111. doi: 10.1038/s41598-024-69122-y.
Obsessive-compulsive disorder (OCD) is characterized by intrusive thoughts and repetitive, compulsive behaviors, with childhood trauma recognized as a contributing factor to its pathophysiology. This study aimed to delineate brain functional aberrations in OCD patients and explore the association between these abnormalities and childhood trauma, to gain insights into the neural underpinnings of OCD. Forty-eight drug-naive OCD patients and forty-two healthy controls (HC) underwent resting-state functional magnetic resonance imaging and clinical assessments, including the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and Childhood Trauma Questionnaire-Short Form (CTQ-SF). Compared to HCs, OCD patients exhibited significantly decreased amplitude of low-frequency fluctuations (ALFF) in the right cerebellum, decreased regional homogeneity (ReHo) in the right cerebellum and right superior occipital lobes (FWE-corrected p < 0.05), which negatively correlated with Y-BOCS scores (p < 0.05). Furthermore, cerebellar ALFF negatively correlated with the CTQ emotional abuse subscale (r = - 0.514, p < 0.01). Mediation analysis revealed that cerebellar ALFF mediated the relationship between CTQ-emotional abuse and Y-BOCS (good model fit: R2 = 0.231, MSE = 14.311, F = 5.721, p < 0.01; direct effect, c' = 0.153, indirect effect, a*b = 0.191). Findings indicated abnormal spontaneous and regional cerebellar activity in OCD, suggesting childhood trauma impacts OCD symptoms through cerebellar neural remodeling, highlighting its importance for clinical treatment selection.
强迫症（OCD）的特征是存在侵入性思维和重复性、强迫性行为，且儿童创伤被认为是其病理生理学的一个促成因素。本研究旨在描绘 OCD 患者的大脑功能异常，并探讨这些异常与儿童创伤之间的关联，以深入了解 OCD 的神经基础。48 名未接受药物治疗的 OCD 患者和 42 名健康对照者（HC）接受了静息态功能磁共振成像和临床评估，包括耶鲁-布朗强迫量表（Y-BOCS）和童年创伤问卷-短式（CTQ-SF）。与 HC 相比，OCD 患者右侧小脑的低频振幅（ALFF）显著降低，右侧小脑和右侧顶叶上回的局部一致性（ReHo）降低（经 FWE 校正，p<0.05），与 Y-BOCS 评分呈负相关（p<0.05）。此外，小脑的 ALFF 与 CTQ 情绪虐待分量表呈负相关（r=-0.514，p<0.01）。中介分析显示小脑的 ALFF 介导了 CTQ-情绪虐待与 Y-BOCS 之间的关系（良好模型拟合：R2=0.231，MSE=14.311，F=5.721，p<0.01；直接效应，c'=0.153，间接效应，a*b=0.191）。这些发现表明 OCD 患者存在异常的自发性和区域性小脑活动，提示儿童创伤通过小脑神经重塑影响 OCD 症状，强调了其对临床治疗选择的重要性。
