强迫症眶额叶-小脑连接的相关分析

摘要

目的 探讨小脑局部脑区与大脑局部脑区间的功能连接在强迫症发病中的作用.方法 纳入2014年6月至2016年1月河南省精神病医院门诊及住院收治的首发强迫症患者55例(强迫症组),以及50例性别、年龄、民族、受教育程度与之相匹配的正常健康对照者(对照组).所有受试者均接受全脑静息态功能磁共振(rs-fMRI)检查、采集数据.利采用rs-fMRI处理辅助软件(DPARSFV2.3)和数据分析软件(REST)处理两组数据后,采用双样本t检验对两组局部一致性(ReHo)图进行分析,得出强迫症组的异常脑区,以异常脑区为感兴趣区(ROI)行全脑功能连接分析.结果 (1)与对照组相比,强迫症组左侧小脑8区(t=3.473 2)、右侧丘脑(t=4.321 7)ReHo值增高,左内侧眶部额上回(t=-4.582 6)ReHo值减低,差异均有统计学意义(P＜0.05,Alphasim校正,簇集大小＞40个体素);(2)功能连接分析显示左内侧眶部额上回、左侧小脑8区、右侧丘脑之间存在异常功能连接(P＜0.05,Alphasim校正,簇集大小＞20个体素).结论 强迫症存在左内侧眶部额上回-左侧小脑8区-右丘脑环路,左侧小脑8区可能通过此环路参与强迫症的发病.%Objective To explore the role of local cerebellar region in the pathogenesis of obsessive-compulsive disorder (OCD).Methods A total of 55 naive OCD patients and 50 normal controls (NC) matched with sex,age,ethnicity and education level were examined by using rs-fMRI and the image signals were analyzed and compared by Data Processing Assisstant for Resting-State fMRI V2.3 (DPARSF V2.3) and Rest Resting-state fMRI data analysis toolkit (Rest software).Two groups of regional homogeneity (ReHo) data were aralyzed by two sample t test,obtaine the abnormal brain regions of OCD group.The abnormal brain regions in OCD group,defined as regions of interest (ROI) by comparing with the NC group,were calculated in the whole brain functional connectivity (FC) analysis.Results (1) Compared with NC group,ReHo in OCD group significantly increased in left cerebellum region 8 (t=3.473 2) and right thalamus (t=4.321 7),while ReHo in OCD group significantly decreased in left medial orbital frontal gyrus (t=-4.582 6),the differences were all statistically significant (P＜0.05,Alphasim-corrected for multiple comparisons,cluster size＞40).(2) Abnormal functional connections were detected in the left medial orbital frontal gyrus,the left cerebellum region 8,and the right thalamus (P＜0.05,Alphasim-corrected for multiple comparisons,cluster size＞20).Conclusion OCD patients present a special circuit connecting the left medial orbitofrontal gyrus,the left cerebellum region 8,and the right thalamus,among which the left cerebellum region 8 may play an important role.