基于ICA-fMRI的首发未用药强迫症患者的静息态脑网络研究
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摘要
目的:分析首发未用药强迫症患者静息态脑网络的特点及差异,探讨首发未用药强迫症患者的静息态脑功能状态。方法:对24例首发强迫症患者(强迫症组)及24例年龄、性别、受教育年限相匹配的健康志愿者(对照组)采用3.0T磁共振扫描仪行静息态脑功能磁共振成像(fMRI)检查,采用独立成分分析(ICA)法分离静息态脑网络成分并进行统计学分析,首先采用单样本t检验制作网络成分模板,再采用双样本t检验进行组间不同功能网络内异常脑区的比较;采用耶鲁-布朗强迫量表(YBOCS)、24项汉密尔顿抑郁量表(HAMD-24)、汉密尔顿焦虑量表(HAMA)等评估临床症状。结果:通过首发强迫症患者与正常对照组数据分析获得10个静息态脑网络模板,分别为前默认网络、后默认网络、背侧注意网络、突显网络、左额顶网络、右额顶网络、内侧视觉网络、外侧视觉网络、枕极视觉网络、听觉网络。静息态脑网络内功能连接分析结果显示后默认网络中双侧楔叶功能连接增强(T=3.822,P<0.05),右额顶网络中右侧顶下小叶功能连接增强(T=5.291,P<0.05),外侧视觉网络中右侧枕中回功能连接增强(T=4.614,P<0.05)。右侧额顶网络的右侧顶下小叶功能连接值与Y-BOCS总分呈负相关(r=-0.470,P<0.05)。结论:首发强迫症患者较健康志愿者存在多个静息态脑网络异常,主要表现为功能连接的增强;强迫症患者可能存在一定的认知功能代偿。
Objective:This study was performed to investigate the changes of resting-state networks of first-episode and treatment-naive patients with obsessive-compulsive disorder(OCD)by using resting-state functional magnetic resonance imaging(RS-fMRI)technology.Methods:A total of 24 patients with OCD and 24 age-sex-handedness-education matched healthy adults were scanned with RS-fMRI.Independent component analysis was employed for the data analysis.Statistical analysis was carried out on isolated components.One-sample t-test was performed to make the mask of networks components.And then two sample t-test was performed to explore the difference between OCD patients and healthy controls in functional networks.The Yale-Brown Obsessive Compulsive Scale(YBOCS),24-item Hamilton Rating Scale for depression(HAMD-24)and Hamilton Anxiety Rating Scale(HAMA)were performed to assess the clinical symptoms.Results:Ten masks of resting-state networks were found in all groups.There was anterior default-mode network(aDMN),posterior default-mode network(pDMN),dorsal attention network(DAN),salience network(SN),left frontoparietal network(LFP),right frontoparietal network(RFP),lateral visual network(lVN),medial visual network(mVN),occipital pole visual network(pVN)and auditory network(AN).It was found that the pDMN functional connectivity(FC)in OCD patients was higher than that of healthy controls in bilateral cuneus(T=3.8222,P<0.05),also the RFP FC increased in the right inferior parietal lobule(T=5.291,P<0.05)and the lVN FC increased in right middle occipital lobule(T=4.614,P<0.05).There was a negative correlation between the activated right parietal lobule and Y-BOCS total score(r=-0.470,P<0.05).Conclusions:Some abnormal resting-state networks in first-episode and treatment-naive OCD patients were found,presenting increased functional connections.Certain cognitive function compensation might occur in those patients.
Objective:This study was performed to investigate the changes of resting-state networks of first-episode and treatment-naive patients with obsessive-compulsive disorder(OCD)by using resting-state functional magnetic resonance imaging(RS-fMRI)technology.Methods:A total of 24 patients with OCD and 24 age-sex-handedness-education matched healthy adults were scanned with RS-fMRI.Independent component analysis was employed for the data analysis.Statistical analysis was carried out on isolated components.One-sample t-test was performed to make the mask of networks components.And then two sample t-test was performed to explore the difference between OCD patients and healthy controls in functional networks.The Yale-Brown Obsessive Compulsive Scale(YBOCS),24-item Hamilton Rating Scale for depression(HAMD-24)and Hamilton Anxiety Rating Scale(HAMA)were performed to assess the clinical symptoms.Results:Ten masks of resting-state networks were found in all groups.There was anterior default-mode network(aDMN),posterior default-mode network(pDMN),dorsal attention network(DAN),salience network(SN),left frontoparietal network(LFP),right frontoparietal network(RFP),lateral visual network(lVN),medial visual network(mVN),occipital pole visual network(pVN)and auditory network(AN).It was found that the pDMN functional connectivity(FC)in OCD patients was higher than that of healthy controls in bilateral cuneus(T=3.8222,P<0.05),also the RFP FC increased in the right inferior parietal lobule(T=5.291,P<0.05)and the lVN FC increased in right middle occipital lobule(T=4.614,P<0.05).There was a negative correlation between the activated right parietal lobule and Y-BOCS total score(r=-0.470,P<0.05).Conclusions:Some abnormal resting-state networks in first-episode and treatment-naive OCD patients were found,presenting increased functional connections.Certain cognitive function compensation might occur in those patients.
引文
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[16]Cheng B,Cai W,Wang X,et al.Brain gray matter abnormalities in first-episode,treatment-naive children with obsessive-compulsive disorder[J].Front Behav Neurosci,2016,30(10):141.
[17]陈惠娟,孔祥,文吉秋,等.肾移植术后脑默认网络和认知功能变化的研究[J].放射学实践,2015,30(5):513-518.
[18]庄丽频,史尧胜,陈毓颤,等.强迫症和精神分裂症患者的听及视信患加工过程中感觉性脑诱发电位特征比较[J].中国临床康复,2004,8(30):6782-6784.
[19]Liu H,Liu Z,Liang M,et al.Decreased regional homogeneity in schizophrenia:a resting state functional magnetic resonance imaging study[J].Neuroreport,2006,17(1):19-22.
[20]Stern ER,Fitzgerald KD,Welsh RC,et al.Resting-state functional connectivity between fronto-parietal and default mode networks in obsessive-compulsive disorder[J].PLoS One,2012,7(5):e36356.
[21]de Vries FE,de Wit SJ,van den Heuvel OA,et al.Cognitive control networks in OCD:A resting-state connectivity study in unmedicated patients with obsessive-compulsive disorder and their unaffected relatives[J].World J Biol Psychiatry,2017,18(9):1-13.
[22]Posner J,Song I,Lee S,et al.Increased functional connectivity between the default mode and salience networks in unmedicated adults with obsessive-compulsive disorder[J].Hum Brain Mapp,2017,38(2):678-687.
[2]吴海苏,肖泽萍.谷氨酸系统在强迫症发病机制中的作用[J].中华精神科杂志,2013,46(5):314-317.
[3]Ruscio AM,Stein DJ,Chiu WT,et al.The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication[J].Mol Psychiatry,2010,15(1):53-63.
[4]Barkhof F,Haller S,Rombouts SA.Resting-state functional MR imaging:a new window to the brain[J].Radiology,2014,272(1):29-49.
[5]Groves AR,Beckmann CF,Smith SM,et al.Linked independent component analysis for multimodal data fusion[J].Neuroimage,2011,54(3):2198-2217.
[6]Chao-Gan Y,Yu-Feng Z.DPARSF:a MATLAB toolbox for"pipeline"data analysis of resting-state fMRI[J].Front Syst Neurosci,2010,14(4):13.
[7]Beaulieu C.The basis of anisotropic water diffusion in the nervous system-a technical review[J].NMR Biomed,2002,15(7-8):435-455.
[8]Posner J,Marsh R,Maia TV,et al.Reduced functional connectivity within the limbic cortico-striato-thalamo-cortical loop in unmedicated adults with obsessive-compulsive disorder[J].Hum Brain Mapp,2014,35(6):2852-2860.
[9]杨涛,程宇琪,罗春蓉,等.强迫症首次发病未服药患者脑静息态低频振幅研究[J].中华精神科杂志,2011,44(3):140-144.
[10]马丽沙,徐曙,黄茹燕,等.未经治疗的强迫障碍患者静息态磁共振脑功能局部一致性研究[J].南京医科大学学报(自然科学版),2015,35(4):580-584.
[11]Anand A,Li Y,Wang Y,et al.Antidepressant effect on connectivity of the mood-regulating circuit:an fMRI study[J].Neuropsychopharmacology,2005,30(7):1334-1344.
[12]卢光明,张志强.静息态脑功能连接磁共振成像技术及临床应用[J].中华医学杂志,2010,90(21):1441-1442.
[13]Raichle ME,MacLeod AM,Snyder AZ,et al.A default mode of brainfunction[J].Proc Natl Acad Sci USA,2001,98(2):676-682.
[14]Gruner P,Vo A,Argyelan M,et al.Independent component analysis of resting state activity in pediatric obsessive-compulsive disorder[J].Hum Brain Mapp,2014,35(10):5306-5315.
[15]Weber AM,Soreni N,Noseworthy MD,et al.A preliminary study of functional connectivity of medication nave children with obsessive-compulsive disorder[J].Prog Neuropsychopharmacol Biol Psychiatry,2014,53(4):129-136.
[16]Cheng B,Cai W,Wang X,et al.Brain gray matter abnormalities in first-episode,treatment-naive children with obsessive-compulsive disorder[J].Front Behav Neurosci,2016,30(10):141.
[17]陈惠娟,孔祥,文吉秋,等.肾移植术后脑默认网络和认知功能变化的研究[J].放射学实践,2015,30(5):513-518.
[18]庄丽频,史尧胜,陈毓颤,等.强迫症和精神分裂症患者的听及视信患加工过程中感觉性脑诱发电位特征比较[J].中国临床康复,2004,8(30):6782-6784.
[19]Liu H,Liu Z,Liang M,et al.Decreased regional homogeneity in schizophrenia:a resting state functional magnetic resonance imaging study[J].Neuroreport,2006,17(1):19-22.
[20]Stern ER,Fitzgerald KD,Welsh RC,et al.Resting-state functional connectivity between fronto-parietal and default mode networks in obsessive-compulsive disorder[J].PLoS One,2012,7(5):e36356.
[21]de Vries FE,de Wit SJ,van den Heuvel OA,et al.Cognitive control networks in OCD:A resting-state connectivity study in unmedicated patients with obsessive-compulsive disorder and their unaffected relatives[J].World J Biol Psychiatry,2017,18(9):1-13.
[22]Posner J,Song I,Lee S,et al.Increased functional connectivity between the default mode and salience networks in unmedicated adults with obsessive-compulsive disorder[J].Hum Brain Mapp,2017,38(2):678-687.