首诊成人强迫症脑3D-多体素氢质子磁共振波谱分析

摘要

Objective To evaluate untreated adult patients with obsessive- compulsive disorder (OCD) with 3D multiple voxel 1H magnetic resonance spectroscopy (1H MRS). Methods Seventeen untreated adult OCD patients and 17 age- and sex- matched healthy subjects were included in this study. The ratios of N- acetylaspartate (NAA) and choline(Cho) to creatine (Cr) in different brain regions were evaluated with 3D multiple voxel 1H MRS and compared between two groups. Results The Cho/Cr ratio in middle cingulated cortex of OCD patients was significantly lower than that of healthy controls (P<0.05). The Cho/Cr ratio in left frontal white matte of OCD patients was significantly higher than that of healthy controls (P<0.05). There was a positive correlation between anxiety symptoms and Cho/Cr ratio in the middle cingulated cortex of OCD patients (P<0.05). Conclusion There are decreased Cho level in middle cingulated cortex and increased Cho level in left frontal white matter in OCD patients, which may provide a new evidence for cortical- striatum- thalamus- cortical neuronal circuit theory.%目的：探讨强迫症（OCD）患者不同区域脑组织代谢特点。方法选择17例首诊未经治疗的成人OCD患者为研究对象，并以性别、年龄、受教育程度匹配的17例健康志愿者为对照组，采用3D-多体素氢质子磁共振波谱分析OCD患者前扣带回、中扣带回、左右额叶白质、左右丘脑和左右豆状核中大脑代谢物N-乙酰门冬氨酸（NAA）、胆碱（Cho）和肌酸（Cr）浓度变化，并分析NAA/Cr、Cho/Cr与OCD、焦虑和抑郁量表评分的相关性。结果 OCD患者中扣带回的Cho/Cr明显低于对照组（P＜0.05），左额叶白质Cho/Cr明显高于对照组（P＜0.05）；中扣带回NAA/Cr与焦虑量表评分呈正相关（r=0.712，P＜0.05）。结论 OCD患者中扣带回Cho浓度减少、左额叶白质Cho浓度增高，可能是OCD的病理现象或代偿反应；中扣带回NAA/Cr与焦虑量表评分呈正相关。