Gao Z T, Li Y L, Xia Y H, Zhu J J, Li Y D, Xu C L, Guo S Q
Department of Ninth Psychiatry, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China.
Department of Child and Adolescent Psychiatry, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang 453002, China.
Zhonghua Yi Xue Za Zhi. 2024 Aug 27;104(33):3136-3141. doi: 10.3760/cma.j.cn112137-20240302-00468.
To investigate the topological properties of the white matter network in the drug-naive first-episode children and adolescent with obsessive-compulsive disorder (OCD). This study was a case-control study. First-episode OCD childhren and adolescents(OCD group) who were treated in the outpatient or inpatient department of the Second Affiliated Hospital of Xinxiang Medical University from July 2018 to October 2023 were collected as the research subjects. Healthy controls (control group)matched by gender, age and education level were used as controls. Deterministic tractography technique was used to construct the whole brain white matter structural network, and graph theory analysis method was used to analyze the topological attributes of the whole brain white matter structure network in OCD children and adolescents. A network-based statistical method was used to examine the inter-group differences in the functional connectivity strength of the whole brain network. Finally, 31 cases were included in the obsessive-compulsive disorder group, including 22 males and 9 females, with an age of (13.5±1.6) years; There were 34 cases in the control group, including 22 males and 12 females, with an age of (12.7±1.4) years. The global efficiency and local efficiency of the OCD group (0.62±0.03, 0.70±0.07) were significantly higher than those of the control group (0.50±0.06, 0.54±0.21) [both <0.01, false discovery rate(FDR)correction]; while the characteristic path length (1.77±0.08) was significantly smaller than that of the control group (2.10±0.23) (<0.01, FDR correction).The centrality comparison of nodal betweenness centrality showed that in the OCD group, the connections were enhanced in the left lateral orbitofrontal gyrus, right dorsal agranular insula, left dorsal granular insula, right granular insula, right posterior central gyrus main area of parietal lobe, left ventral granular insula, granular insula, left ventral granulosa, left granular insula, and left dorsal agranular insula [all <0.001, family wise error (FWE) correction], while the connection of right thalamic was weakened (<0.001, FWE correction), There were sub-networks characterized by significantly enhanced connection strength of relevant nodes in subcortical, visual network, and default mode network (<0.05, permutation test 5 000 times). The topological properties of the brain's functional network in children and adolescents with OCD exhibit abnormalities, indicating an immature state of brain functional connectivity.
为研究初发未用药的儿童及青少年强迫症（OCD）患者白质网络的拓扑特性。本研究为病例对照研究。收集2018年7月至2023年10月在新乡医学院第二附属医院门诊或住院部接受治疗的初发强迫症儿童及青少年（OCD组）作为研究对象。选取性别、年龄和教育水平相匹配的健康对照者（对照组）作为对照。采用确定性纤维束成像技术构建全脑白质结构网络，运用图论分析方法分析OCD儿童及青少年全脑白质结构网络的拓扑属性。采用基于网络的统计方法检验全脑网络功能连接强度的组间差异。最终，强迫症组纳入31例，其中男性22例，女性9例，年龄为（13.5±1.6）岁；对照组34例，其中男性22例，女性12例，年龄为（12.7±1.4）岁。OCD组的全局效率和局部效率（0.62±0.03，0.70±0.07）显著高于对照组（0.50±0.06，0.54±0.21）[均P<0.01，错误发现率（FDR）校正]；而特征路径长度（1.77±0.08）显著短于对照组（2.10±0.23）（P<0.01，FDR校正）。节点介数中心性的中心性比较显示，在OCD组中，左侧眶额外侧回、右侧背侧无颗粒岛叶、左侧背侧颗粒岛叶、右侧颗粒岛叶、右侧中央后回顶叶主要区域、左侧腹侧颗粒岛叶、颗粒岛叶、左侧腹侧颗粒、左侧颗粒岛叶和左侧背侧无颗粒岛叶的连接增强[均P<0.001，族系误差（FWE）校正]，而右侧丘脑的连接减弱（P<0.001，FWE校正），在皮质下、视觉网络和默认模式网络中存在以相关节点连接强度显著增强为特征的子网（P<0.05，5000次置换检验）。OCD儿童及青少年脑功能网络的拓扑特性存在异常，表明脑功能连接处于不成熟状态。
